An overview of patient-ventilator asynchrony in children
Bibliographic record
Abstract
INTRODUCTION: Mechanically ventilated children often have patient-ventilator asynchrony (PVA). When a ventilated patient has spontaneous effort, the ventilator attempts to synchronize with the patient, but PVA represents a mismatch between patient respiratory effort and ventilator delivered breaths. AREAS COVERED: This review will focus on subtypes of patient ventilator asynchrony, methods to detect or measure PVA, risk factors for and characteristics of patients with PVA subtypes, potential clinical implications, treatment or prevention strategies, and future areas for research. Throughout this review, we will provide pediatric specific considerations. EXPERT OPINION: PVA in pediatric patients supported by mechanical ventilation occurs frequently and is understudied. Pediatric patients have unique physiologic and pathophysiologic characteristics which affect PVA. While recognition of PVA and its subtypes is important for bedside clinicians, the clinical implications and risks versus benefits of treatment targeted at reducing PVA remain unknown. Future research should focus on harmonizing PVA terminology, refinement of automated detection technologies, determining which forms of PVA are harmful, and development of PVA-specific ventilator interventions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot 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.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 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 source (direct Gemma or distilled Codex), 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".