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Record W4389220732 · doi:10.1097/cce.0000000000001014

Impact of Supine Versus Semirecumbent Body Posture on the Distribution of Ventilation in Acute Respiratory Distress Syndrome

2023· article· en· W4389220732 on OpenAlex
Alex K. Pearce, W. Cameron McGuire, Ann R. Elliott, Ewan C. Goligher, G. Kim Prisk, James P. Butler, Atul Malhotra

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.

Bibliographic record

VenueCritical Care Explorations · 2023
Typearticle
Languageen
FieldMedicine
TopicRespiratory Support and Mechanisms
Canadian institutionsUniversity of TorontoUniversity Health Network
FundersNational Heart, Lung, and Blood InstituteUniversity of California, San DiegoLivaNovaNational Institutes of HealthResMedEli Lilly and Company
KeywordsSupine positionARDSAnesthesiaMedicineVentilation (architecture)Mechanical ventilationProne positionRespiratory distressRespiratory physiologyRespiratory systemLungInternal medicine

Abstract

fetched live from OpenAlex

In some patients with acute respiratory distress syndrome (ARDS), a paradoxical improvement in respiratory system compliance (C RS ) has been observed when assuming a supine (head of bed [HOB] 0°) compared with semirecumbent (HOB 35–40°) posture. We sought to test the hypothesis that mechanically ventilated patients with ARDS would have improved C RS , due to changes in ventilation distribution, when moving from the semirecumbent to supine position. We conducted a prospective, observational ICU study including 14 mechanically ventilated patients with ARDS. For each patient, ventilation distribution (assessed by electrical impedance tomography) and pulmonary mechanics were compared in supine versus semirecumbent postures. Compared with semirecumbent, in the supine posture C RS increased (33 ± 21 vs. 26 ± 14 mL/cm H 2 O, p = 0.005), driving pressure was reduced (14 ± 6 vs. 17 ± 7 cm H 2 O, p < 0.001), and dorsal fraction of ventilation was decreased (48.5 ± 14.1% vs. 54.5 ± 12.0%, p = 0.003). Posture change from semirecumbent to supine resulted in a favorable physiologic response in terms of improved C RS and reduced driving pressure—with a corresponding increase in ventral ventilation, possibly related to reduced ventral overdistension.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.749
Threshold uncertainty score0.338

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.068
GPT teacher head0.388
Teacher spread0.320 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it