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Record W4399671024 · doi:10.1056/nejmoa2404245

Stress Ulcer Prophylaxis during Invasive Mechanical Ventilation

2024· article· en· W4399671024 on OpenAlexafffundabout
Adam M. Deane, François Lauzier, Nicole Zytaruk, Gordon Guyatt, Lois Saunders, M.J. Hardie, Diane Heels‐Ansdell, Waleed Alhazzani, John C. Marshall, John Muscedere, John Myburgh, Shane English, Yaseen M. Arabi, Marlies Ostermann, Serena Knowles, Naomi Hammond, Kathleen Byrne, Marianne J. Chapman, Balasubramanian Venkatesh, Paul J. Young, Dorrilyn Rajbhandari, Alexis Poole, Abdulrahman Al‐Fares, Gilmar Reis, Mobeen Iqbal, Richard Hall, Maureen O. Meade, Lori Hand, Erick Duan, France Clarke, Joanna C. Dionne, Jennifer Tsang, Bram Rochwerg, Timothy Karachi, François Lamontagne, Frédérick D’Aragon, Charles St. Arnaud, Brenda Reeve, Anna Geagea, Daniel J. Niven, Gloria Vázquez‐Grande, Ryan Zarychanski, Daniel Ovakim, Gordon Wood, Karen E. A. Burns, Alberto Goffi, M. Elizabeth Wilcox, William R. Henderson, David M. Forrest, Rob Fowler, Neill K. J. Adhikari, Ian Ball, Tina Mele, Alexandra Binnie, Sébastien Trop, Sangeeta Mehta, Ingrid Morgan, Osama Loubani, Meredith Vanstone, Kirsten M. Fiest, Emmanuel Charbonney, Yiorgos Alexandros Cavayas, Patrick Archambault, Oleksa Rewa, Vincent Lau, Arnold S. Kristof, Kosar Khwaja, David Williamson, Salmaan Kanji, Eric Sy, Brittany B. Dennis, Steve Reynolds, François Marquis, François Lellouche, Adam Rahman, Paul Hosek, Jeffrey F. Barletta, Robert Cirrone, Mark Tutschka, Feng Xie, Laurent Billot, Lehana Thabane, Simon Finfer

Bibliographic record

VenueNew England Journal of Medicine · 2024
Typearticle
Languageen
FieldMedicine
TopicNosocomial Infections in ICU
Canadian institutionsWindsor Regional HospitalHôpital Maisonneuve-RosemontRoyal Columbian HospitalSaskatchewan HealthUniversity of ReginaOttawa HospitalUniversité de MontréalMcGill UniversityMcGill University Health CentreUniversity of AlbertaUniversité LavalCentre Hospitalier de l’Université de MontréalSt. Joseph's HospitalHôpital du Sacré-Cœur de MontréalSaint John Regional HospitalWilliam Osler Health SystemUniversity of CalgaryHealth Sciences CentreSunnybrook Health Science CentreCambridge Memorial HospitalNorth York General HospitalSt. Michael's HospitalMount Sinai HospitalVancouver General HospitalGrand River HospitalRoyal Jubilee HospitalWestern UniversityImpactUniversité de SherbrookeUniversity of TorontoNiagara Health SystemBrantford Energy (Canada)Brampton Civic HospitalDalhousie UniversityUniversity of OttawaUniversity of ManitobaSt. Joseph’s Healthcare HamiltonCentre hospitalier universitaire de QuébecQueen's UniversityMcMaster University
FundersNational Health and Medical Research CouncilNational Institute for Health and Care ResearchPhysicians' Services Incorporated FoundationCanadian Institutes of Health ResearchHamilton Health Sciences
KeywordsStress ulcerMedicineMechanical ventilationIntensive care medicineAnesthesiaInternal medicine

Abstract

fetched live from OpenAlex

BACKGROUND: Whether proton-pump inhibitors are beneficial or harmful for stress ulcer prophylaxis in critically ill patients undergoing invasive ventilation is unclear. METHODS: infection, and patient-important bleeding. RESULTS: A total of 4821 patients underwent randomization in 68 ICUs. Clinically important upper gastrointestinal bleeding occurred in 25 of 2385 patients (1.0%) receiving pantoprazole and in 84 of 2377 patients (3.5%) receiving placebo (hazard ratio, 0.30; 95% confidence interval [CI], 0.19 to 0.47; P<0.001). At 90 days, death was reported in 696 of 2390 patients (29.1%) in the pantoprazole group and in 734 of 2379 patients (30.9%) in the placebo group (hazard ratio, 0.94; 95% CI, 0.85 to 1.04; P = 0.25). Patient-important bleeding was reduced with pantoprazole; all other secondary outcomes were similar in the two groups. CONCLUSIONS: Among patients undergoing invasive ventilation, pantoprazole resulted in a significantly lower risk of clinically important upper gastrointestinal bleeding than placebo, with no significant effect on mortality. (Funded by the Canadian Institutes of Health Research and others; REVISE ClinicalTrials.gov number, NCT03374800.).

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 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)0.001
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: Bench or experimental · Consensus signal: Bench or experimental
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.238
Threshold uncertainty score0.730

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.001
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 integrity0.0000.001
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 head0.019
GPT teacher head0.300
Teacher spread0.281 · 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 teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designBench or experimental
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

Citations87
Published2024
Admission routes3
Has abstractyes

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