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Record W3174184549 · doi:10.1186/s13054-021-03647-w

Evolution of inspiratory muscle function in children during mechanical ventilation

2021· article· en· W3174184549 on OpenAlexafffund
Benjamin Crulli, Atsushi Kawaguchi, Jean‐Paul Praud, Basil J. Petrof, Karen Harrington, Guillaume Émériaud

Bibliographic record

VenueCritical Care · 2021
Typearticle
Languageen
FieldMedicine
TopicIntensive Care Unit Cognitive Disorders
Canadian institutionsChildren's Hospital of Eastern OntarioMcGill University Health CentreUniversité de SherbrookeUniversité de MontréalCentre Hospitalier Universitaire Sainte-Justine
FundersFonds de Recherche du Québec - SantéCentre de recherche du CHU Sainte-Justine
KeywordsMedicineMechanical ventilationDiaphragm (acoustics)Pediatric intensive care unitAnesthesiaAirwayVentilation (architecture)Intensive care unitPopulationPeak inspiratory pressureInternal medicineRespiratory systemPediatricsTidal volume

Abstract

fetched live from OpenAlex

Abstract Background There is no universally accepted method to assess the pressure-generating capacity of inspiratory muscles in children on mechanical ventilation (MV), and no study describing its evolution over time in this population. Methods In this prospective observational study, we have assessed the function of the inspiratory muscles in children on various modes of MV. During brief airway occlusion maneuvers, we simultaneously recorded airway pressure depression at the endotracheal tube (ΔPaw, force generation) and electrical activity of the diaphragm (EAdi, central respiratory drive) over five consecutive inspiratory efforts. The neuro-mechanical efficiency ratio (NME, ΔPaw/EAdi max ) was also computed. The evolution over time of these indices in a group of children in the pediatric intensive care unit (PICU) was primarily described. As a secondary objective, we compared these values to those measured in a group of children in the operating room (OR). Results In the PICU group, although median NME occl decreased over time during MV (regression coefficient − 0.016, p = 0.03), maximum ΔPaw max remained unchanged (regression coefficient 0.109, p = 0.50). Median NME occl at the first measurement in the PICU group (after 21 h of MV) was significantly lower than at the only measurement in the OR group (1.8 cmH 2 O/µV, Q 1 – Q 3 1.3–2.4 vs. 3.7 cmH 2 O/µV, Q 1 – Q 3 3.5–4.2; p = 0.015). Maximum ΔPaw max in the PICU group was, however, not significantly different from the OR group (35.1 cmH 2 O, Q 1 – Q 3 21–58 vs. 31.3 cmH 2 O, Q 1 – Q 3 28.5–35.5; p = 0.982). Conclusions The function of inspiratory muscles can be monitored at the bedside of children on MV using brief airway occlusions. Inspiratory muscle efficiency was significantly lower in critically ill children than in children undergoing elective surgery, and it decreased over time during MV in critically ill children. This suggests that both critical illness and MV may have an impact on inspiratory muscle efficiency.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.005
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.470
Threshold uncertainty score0.603

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.005
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.011
GPT teacher head0.272
Teacher spread0.261 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations24
Published2021
Admission routes2
Has abstractyes

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