Relationship between PEEP levels, central venous pressure, systemic inflammation and AKI in critically ill ventilated COVID-19 patients. A monocenter retrospective study
Bibliographic record
Abstract
Abstract Introduction: The role of positive pressure ventilation, central venous pressure (CVP) and inflammation on the occurrence of acute renal failure (AKI) have been poorly described in mechanically ventilated patient secondary to Sars-Cov-2 infection (Covid-19). Methods This was a monocenter retrospective cohort study of consecutive ventilated COVID-19 patients admitted in a French surgical ICU between Mars 2020 et July 2020. Worsening renal function (WRF) was defined as development of a new AKI or a persistent AKI during the five days after mechanical ventilation initiation. We studied the association between WRF and ventilatory parameters including positive end pressure (PEEP), CVP, and leukocytes count. Results 57 patients were included, 12 (21%) presented WRF. Daily PEEP, 5 days mean PEEP and daily CVP values were not associated with occurrence of WRF. 5 days mean CVP was higher in the WRF group compared to patients without WRF (median 12 [IQR, 11–13] mmHg vs 10 [9–12] mmHg, p = 0.03). Multivariate models with adjustment on leukocytes and SAPS II confirmed the association between CVP value and risk of WRF, odd ratio: 1.97 (IC95: 1.12–4.33). Leukocytes count was also associated with occurrence of WRF (14.3 [11.3–17.5]) G/L in the WRF group vs 9.2 [8.1–11.1] G/L in the no-WRF group) (p = 0,002). Conclusion In Mechanically ventilated COVID-19 patients, PEEP levels did not appear to influence occurrence of WRF. High CVP levels and leukocytes count are associated with risk of WRF.
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 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".