Peak inspiratory pressure lacks accuracy to estimate plateau pressure in infants with severe obstructive lower airway disease
Bibliographic record
Abstract
Abstract Purpose In children with acute respiratory distress syndrome receiving mechanical ventilation, the peak inspiratory pressure (PIP) is close to plateau pressure (P PLAT ) when inspiratory flow approaches zero. We aimed to evaluate the reliability of PIP to estimate P PLAT in infants with severe respiratory viral infection (SRVI), characterized by increased airway resistance, and the accuracy of an equational model to estimates P PLAT (eP PLAT ) based on PIP. Methods This was a retrospective observational study including mechanically ventilated children (1 to 24 month old) with SRVI, whose respiratory mechanics measurements were performed to evaluate PIP and P PLAT. The measured P PLAT was compared with the result of the equation: eP PLAT = PIP – [5.067 – (0.858 × static compliance) – (0.018 × inspiratory resistance) – (0.390 × pressure above positive‐end expiratory pressure) + (4.989 × inspiratory time)]. Results Thirty‐seven patients were included, with a median age of 3 (2–5) months. They presented a high inspiratory and expiratory resistance (136 ± 43 and 168 ± 66 cmH 2 O/L/s, respectively) and a moderate reduction in static compliance: 0.75 ± 0.3 mL/kg/cmH 2 O. PIP overestimated P PLAT (33 ± 3 and 26 ± 5 cmH 2 O, p = 0.01), with a mean difference of 7.3 ± 4 cmH 2 O. Moreover, the Bland‐Altman analysis demonstrated a mean difference between P PLAT and eP PLAT of 1.0 ± 4.0 cmH 2 O, with 95% limits of agreement of –6.9 and 8.8. Conclusions A significant difference between PIP and P PLAT was observed in infants with SRVI. The equation model was inaccurate for estimating P PLAT based on PIP. Any estimation of P PLAT from PIP needs to consider the resistance component of the respiratory system.
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 imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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.
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 teacher head, 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".