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Record W4401170663 · doi:10.1001/jamasurg.2024.2044

Enhanced Recovery After Surgery (ERAS) Society Recommendations for Neonatal Perioperative Care

2024· article· en· W4401170663 on OpenAlexaff
Mercedes Pilkington, Gregg Nelson, Brandon Pentz, Tyara Marchand, Erin Lloyd, Priscilla Chiu, David de Beer, Nicole de Silva, Scott Else, Annie Fecteau, Stefano Giuliani, Simon Hannam, Alexandra Howlett, Kyong‐Soon Lee, David Levin, Lorna O’Rourke, Lori Stephen, Lauren Wilson, Mary Brindle

Bibliographic record

VenueJAMA Surgery · 2024
Typearticle
Languageen
FieldMedicine
TopicEnhanced Recovery After Surgery
Canadian institutionsAlberta Children's HospitalUniversity of AlbertaUniversity of CalgaryUniversity of TorontoSickKids FoundationHospital for Sick Children
Fundersnot available
KeywordsMedicinePerioperativeGuidelineIntensive care medicineIntensive careNeonatal intensive care unitNeonatologyMEDLINEPopulationEmergency medicinePediatricsSurgery

Abstract

fetched live from OpenAlex

Importance: Neonates requiring surgery are often cared for in neonatal intensive care units (NICUs). Despite a breadth of surgical pathology, neonates share many perioperative priorities that allow for the development of unit-wide evidence-based Enhanced Recovery After Surgery (ERAS) recommendations. Observations: The guideline development committee included pediatric surgeons, anesthesiologists, neonatal nurses, and neonatologists in addition to ERAS content and methodology experts. The patient population was defined as neonates (first 28 days of life) undergoing a major noncardiac surgical intervention while admitted to a NICU. After the first round of a modified Delphi technique, 42 topics for potential inclusion were developed. There was consensus to develop a search strategy and working group for 21 topic areas. A total of 5763 abstracts were screened, of which 98 full-text articles, ranging from low to high quality, were included. A total of 16 recommendations in 11 topic areas were developed with a separate working group commissioned for analgesia-related recommendations. Topics included team communication, preoperative fasting, temperature regulation, antibiotic prophylaxis, surgical site skin preparation, perioperative ventilation, fluid management, perioperative glucose control, transfusion thresholds, enteral feeds, and parental care encouragement. Although clinically relevant, there were insufficient data to develop recommendations concerning the use of nasogastric tubes, Foley catheters, and central lines. Conclusions and Relevance: Despite varied pathology, neonatal perioperative care within NICUs allows for unit-based ERAS recommendations independent of the planned surgical procedure. The 16 recommendations within this ERAS guideline are intended to be implemented within NICUs to benefit all surgical neonates.

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)0.043
metaresearch head score (Gemma)0.119
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Other · Consensus signal: none
Teacher disagreement score0.043
Threshold uncertainty score0.226

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0430.119
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0020.005
Bibliometrics0.0080.005
Science and technology studies0.0010.001
Scholarly communication0.0030.003
Open science0.0040.005
Research integrity0.0050.005
Insufficient payload (model declined to judge)0.0080.003

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 head0.020
GPT teacher head0.285
Teacher spread0.264 · 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 designNot applicable
Domainnot available
GenreOther

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

Citations25
Published2024
Admission routes1
Has abstractyes

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