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Record W4391310318 · doi:10.1164/rccm.202310-1826oc

Oxygen-Saturation Targets and Cognitive and Functional Outcomes in Mechanically Ventilated Adults

2024· article· en· W4391310318 on OpenAlexaboutno aff
Matthew F. Mart, Matthew W. Semler, Cathy A. Jenkins, Guanchao Wang, Jonathan D. Casey, E. Wesley Ely, James C. Jackson, Amy L. Kiehl, Patsy T. Bryant, S. Pugh, L. Wang, Stephanie C. DeMasi, Todd W. Rice, Gordon R. Bernard, Robert E. Freundlich, Wesley H. Self, Jin H. Han

Bibliographic record

VenueAmerican Journal of Respiratory and Critical Care Medicine · 2024
Typearticle
Languageen
FieldMedicine
TopicIntensive Care Unit Cognitive Disorders
Canadian institutionsnot available
FundersNational Center for Advancing Translational SciencesNational Institute of General Medical SciencesNational Heart, Lung, and Blood InstituteNational Institute on AgingVanderbilt University Medical CenterVanderbilt UniversityU.S. Department of Veterans Affairs
KeywordsInterquartile rangeMedicineConfidence intervalCognitionOdds ratioMontreal Cognitive AssessmentNeuropsychologyVerbal fluency testQuality of life (healthcare)Oxygen saturationPhysical therapyInternal medicineOxygenCognitive impairmentPsychiatry

Abstract

fetched live from OpenAlex

Abstract Rationale Among mechanically ventilated critically ill adults, the PILOT (Pragmatic Investigation of Optimal Oxygen Targets) trial demonstrated no difference in ventilator-free days among lower, intermediate, and higher oxygen-saturation targets. The effects on long-term cognition and related outcomes are unknown. Objectives To compare the effects of lower (90% [range, 88–92%]), intermediate (94% [range, 92–96%]), and higher (98% [range, 96–100%]) oxygen-saturation targets on long-term outcomes. Methods Twelve months after enrollment in the PILOT trial, blinded neuropsychological raters conducted assessments of cognition, disability, employment status, and quality of life. The primary outcome was global cognition as measured using the Telephone Montreal Cognitive Assessment. In a subset of patients, an expanded neuropsychological battery measured executive function, attention, immediate and delayed memory, verbal fluency, and abstraction. Measurements and Main Results A total of 501 patients completed follow-up, including 142 in the lower, 186 in the intermediate, and 173 in the higher oxygen target groups. Median (interquartile range) peripheral oxygen saturation values in the lower, intermediate, and higher target groups were 94% (91–96%), 95% (93–97%), and 97% (95–99%), respectively. Telephone Montreal Cognitive Assessment score did not differ between lower and intermediate (adjusted odds ratio [OR], 1.36 [95% confidence interval (CI), 0.92–2.00]), intermediate and higher (adjusted OR, 0.90 [95% CI, 0.62–1.29]), or higher and lower (adjusted OR, 1.22 [95% CI, 0.83–1.79]) target groups. There was also no difference in individual cognitive domains, disability, employment, or quality of life. Conclusions Among mechanically ventilated critically ill adults who completed follow-up at 12 months, oxygen-saturation targets were not associated with cognition or related outcomes.

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.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.004
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Randomized trial · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.001
Threshold uncertainty score0.007

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.004
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.000

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 head0.014
GPT teacher head0.305
Teacher spread0.291 · 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

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designRandomized trial
Domainnot available
GenreEmpirical

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".

Quick stats

Citations11
Published2024
Admission routes1
Has abstractyes

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