Abstract 279: Sustained Inflation and Chest Compression versus 3:1 Chest Compression to Ventilation Ratio During Cardiopulmonary Resuscitation of Asphyxiated Newborns A Cluster Randomized Controlled Trial
Bibliographic record
Abstract
Background: Neonatal resuscitation guidelines recommend 3:1 compression to ventilation ratio (C:V) ratio during chest compression (CC). In piglets, continuous CC superimposed by sustained inflation (CC+SI) resulted in faster time to return of spontaneous circulation (ROSC), lower mortality, improved hemodynamics and ventilation compared to 3:1 C:V. Similar a pilot trial in preterm infants reported significant faster ROSC with CC+SI compared to 3:1 C:V. Objective: To test the hypothesis that in newborn infants receiving chest compression with CC+SI compared with 3:1 C:V time to ROSC will be reduced or increased. Design/Methods: Multicenter cluster randomized trial of CC+SI vs. 3:1 C:V in newborn infants receiving CC. Hospitals were randomized to CC+SI or 3:1 C:V for 12 months then switched to 2 nd intervention for another 12 months. Infants were eligible if bradycardic with heart rate <60/min or asystolic. Primary outcome was time to ROSC (heart rate >60 for one minute). Analysis was performed according to intention-to-treat. The trial was stopped to slow enrolment, Covid-19 pandemic, and funding constrains. Results: Four sites (Edmonton, Graz, Halifax, and Vienna) included infants, which were randomized to either CC+SI (n=11) and 3:1 C:V (n=14). The groups were balanced in relation to demographics and delivery room interventions.The median (IQR) time to ROSC with CC+SI was 90 (60-270)sec and with 3:1 C:V was 615 (174-780)sec (p=0.0502 - log rank, and 0.16 cox proportional hazards regression) (Figure).Survival was 9/11 (82%) with CC+SI and 7/14 (50%) with 3:1 C:V [relative risk (RR) 0.36, 95% Confidence interval (CI) 0.094 to 1.42]. There were no differences in secondary outcomes between groups. Conclusion: CC+SI resulted in a reduction in time to ROSC. There was a trend towards higher survival rates with CC+SI.
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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 | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.005 | 0.003 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
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".