Monitoring of carbon dioxide in ventilated neonates: a prospective observational study
Bibliographic record
Abstract
Objective To assess the reliability, accuracy and precision of distal end-tidal capnography (detCO2) in neonates compared with transcutaneous (tcCO2) carbon dioxide measurements. Design Observational, prospective clinical study. Setting Neonatal intensive care unit at Medical University of Vienna. Participants Conventionally ventilated neonates with a body weight between 1000 g and 3000 g. Intervention End-tidal partial pressure of CO2 was measured in distal position using the separate lumen of a double-lumen endotracheal tube connected to an external side-stream capnometer. Three consecutive detCO2 and tcCO2 values were recorded simultaneously and compared with simultaneous arterialised partial pressure of CO2 (paCO2) measurements in each patient. Main outcome measures Reliability, accuracy and precision of detCO2 and tcCO2 measurements compared with paCO2 in neonates. Results Twenty-five neonates were included with a median (range) weight at enrolment of 1410 (1010–2980) g, from which 81 simultaneous measurements of detCO2, tcCO2 and paCO2 were obtained. The mean (SD) of paCO2, detCO2 and tcCO2 was 45.0 (8.6) mmHg, 42.4 (8.4) mmHg and 50.4 (20.4) mmHg, respectively. The intraclass correlation between paCO2 and detCO2 and between paCO2 and tcCO2 reached 0.80 (95% CI 0.71 to 0.87, p<0.001) and 0.59 (95% CI 0.43 to 0.72, p<0.001), respectively. In the Bland-Altman analysis, bias and precision of detCO2 with respect to paCO2 amounted to −2.68 mmHg and 10.62 mmHg (95% CI 8.49 to 14.51), respectively. Bias and precision of tcCO2 with respect to paCO2 amounted to 5.39 mmHg and 17.22 mmHg (95% CI 13.21 to 23.34), respectively. Conclusion DetCO2 had better reliability, accuracy and precision with paCO2 than tcCO2 in ventilated neonates without severe lung diseas. Trial registration number NCT03758313 .
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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 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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.
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".