Respiratory Oscillometry in Patients With Acute Hypoxemic Respiratory Failure
Bibliographic record
Abstract
Background: Assessing respiratory mechanics in patients with acute hypoxemic respiratory failure who are not intubated could provide useful information about illness trajectory. Oscillometry is a respiratory function test used to measure total respiratory impedance during tidal breathing, which reveals resistive and elastic properties of the lung. This study assessed the feasibility of oscillometry in patients with acute hypoxemic respiratory failure and described their respiratory mechanics. Methods: Adult participants with acute hypoxemic respiratory failure who were receiving noninvasive respiratory support with <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" display="inline" overflow="scroll"> <mml:mrow> <mml:msub> <mml:mtext>F</mml:mtext> <mml:mrow> <mml:msub> <mml:mrow> <mml:mtext>IO</mml:mtext> </mml:mrow> <mml:mtext>2</mml:mtext> </mml:msub> </mml:mrow> </mml:msub> </mml:mrow> </mml:math> ≥0.4 and flow ≥6 L/min underwent oscillometry at baseline and after resolution of acute hypoxemic respiratory failure. The primary end point was the number of participants who completed the baseline measurement. The feasibility criterion was in obtaining baseline oscillometry measurements in ≥80% of enrolled participants. Results: Of 183 patients screened between July 2022 and August 2023, 29% were unable to cooperate due to altered mental state, 20% with extreme hypoxemia were excluded because of clinical instability, and 12% declined participation. Of the 10 participants (5.4%) recruited, all tolerated oscillometry measurements. At baseline, the median (minimum, maximum) <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" display="inline" overflow="scroll"> <mml:mrow> <mml:msub> <mml:mtext>F</mml:mtext> <mml:mrow> <mml:msub> <mml:mrow> <mml:mtext>IO</mml:mtext> </mml:mrow> <mml:mtext>2</mml:mtext> </mml:msub> </mml:mrow> </mml:msub> </mml:mrow> </mml:math> was 0.8 (0.4, 0.8), median oxygen saturation of 94% dropped to a nadir of 82% at the end of oscillometry and recovered within 2 min. Lung reactance was increased, with a reactance area of 25 (15–32) cm H 2 O/L. Hypoxemia resolved in 9 participants. After resolution of acute hypoxemic respiratory failure in 8 (6–16) d, the median reactance area dropped to 15 (14–19) cm H 2 O/L. Conclusions: Respiratory mechanics in the participants with acute hypoxemic respiratory failure who were not intubated could be assessed by oscillometry in carefully selected cases.
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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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 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".