Efficacy and safety of an open lung ventilation strategy with staircase recruitment followed by comparison on two different modes of ventilation, in moderate ARDS in cirrhosis: A pilot randomized trial
Bibliographic record
Abstract
Background: Mechanical ventilation in cirrhosis with acute respiratory distress syndrome (ARDS) is not widely studied.We aimed to study the effect of the staircase recruitment manoeuvre followed by two different modes of ventilation.Methods: Thirty patients with cirrhosis with moderate ARDS underwent the staircase recruitment manoeuvre followed by randomisation to volume control or pressure control group.Results: The PaO 2 /FiO 2 ratio showed a significant improvement in both the groups after recruitment.The improvement was significantly higher in the pressure control ventilation (PCV) group at the end of the first hour as compared to the volume control ventilation (VCV) group.However, this difference was not significant at the end of 6 and 12 h.In the PCV group it improved from 118.47 ± 10.21 at baseline to 189.87 ± 55.18 12 h post-recruitment.In the VCV group it improved from 113.79 ± 13.22 at baseline to 180.93 ± 81.971.Static lung compliance also improved in both the groups significantly (P < 0.001).The PCV group showed an improvement from 25.42 ± 11.94 mL/cm H 2 O at baseline to 29.51 ± 14.58 mL/cm H 2 O.In the VCV group the lung compliance improved from 24.78 ± 4.87 mL/cm H 2 O to 31.31 ± 10.88 mL/cm H 2 O. Conclusion: This study shows that stepwise recruitment manoeuvre is an effective rescue therapy to improve oxygenation in cirrhosis with moderate ARDS.PCV may have an advantage over VCV in terms of better oxygenation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
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.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
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".