Abstract 04: Chest Compressions Superimposed With Sustained Inflations Compared to Continuous Chest Compressions with Asynchronized Ventilation During Cardiopulmonary Resuscitation in Asphyxiated Pediatric Piglets - A Randomized Controlled Animal Study
Bibliographic record
Abstract
Introduction: Respiratory arrest is the leading cause of pediatric cardiac arrest. Pediatric CRP guidelines therefore focus on respiratory support during CPR, but the optimal approach to oxygen delivery and coronary perfusion during pediatric CPR is not known. Animal studies reported that chest compressions superimposed with constant high distending pressure, or sustained inflation (CC+SI), significantly reduces time to return of spontaneous circulation (ROSC) compared to 3:1 chest compression:ventilation in neonatal piglets or chest compressions with asynchronous ventilation (CCaV) in pediatric piglets. During CC+SI, both cardiovascular and respiratory parameters were improved, which resulted in the faster time to ROSC. Hypothesis: In the current study, we hypothesized that CC+SI, compared to CCaV, would reduce time to ROSC in pediatric piglets with asphyxia-induced cardiac arrest. Methods: Twenty-eight pediatric piglets (21-24 days old, 7.5-9.2 kg) were anesthetized, intubated, instrumented, and exposed to 30 min normocapnic hypoxia followed by asphyxia. Piglets were then randomized to, and received, either CC+SI or CCaV for resuscitation (n=14 per group). Resuscitative efforts were continued until ROSC was achieved, or up to a maximum of 10 min. Hemodynamic parameters were monitored throughout the experiment and up to 30 min post-ROSC. Results and Conclusions: Overall, the mean (SD) time to ROSC was 208 (190) sec with CC+SI and 388 (258) sec with CCaV (p=0.045) (Table 1). There was a 100% increase in the number of piglets achieving ROSC with CC+SI compared to CCaV (CC+SI n=12 versus CCaV n=6, p=0.046). Median minute ventilation in the CC+SI group was 2,315 mL/min compared with 354 mL/min in the CCaV group (p=0.0001). Both systolic and diastolic blood pressure were higher in the CC+SI group, compared to the CCaV group throughout resuscitation. In summary, CC+SI improved time to ROSC and increased the number of piglets achieving ROSC. There was significantly higher minute ventilation with CC+SI, compared to CCaV, and both systolic and diastolic blood pressure were higher throughout resuscitation with CC+SI compared to CCaV. Studies in pediatric patients using CC+SI are warranted.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 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".