Successful Use of Prone Positioning in Severe Acute Respiratory Distress Syndrome After 44 Days of Veno-Venous Extracorporeal Membrane Oxygenation: A Case Report
Bibliographic record
Abstract
Introduction: Prone positioning is conventionally done early in patients with acute respiratory distress syndrome (ARDS), regardless of concurrent treatment with veno-venous extracorporeal membrane oxygenation (V-V ECMO).Its benefits in later phase of disease are less studied.We report a patient with severe ARDS who underwent prone positioning after 44 days of treatment with V-V ECMO.Case Presentation: A 49-year-old man with severe ARDS following SARS-CoV2 infection was placed under V-V ECMO support as rescue for refractory hypoxemia despite mechanically ventilation with muscle relaxants and prone positioning.His illness was complicated with multiple episodes of hospital-acquired pneumonia and gastrointestinal bleeding requiring transfusions, resulting in failure in weaning ECMO therapy.He underwent five consecutive prone positioning sessions starting from day 44 of ECMO support, which results in improvement in gas exchange and lung mechanics.After 77 days, he could be liberated from the ECMO and continued to improve after his hospital discharge.Conclusion: Prone positioning may serve as a potential treatment in patients receiving V-V ECMO, even in those who have been supported for longer period.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.006 | 0.004 |
| Insufficient payload (model declined to judge) | 0.001 | 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".