Primary Non-invasive Respiratory Support in Severe Bronchiolitis: A Multicenter Cohort Study
Bibliographic record
Abstract
Abstract RATIONALE Non-Invasive Respiratory Support (NRS) has become the standard of care in severe bronchiolitis. There is a lack of evidence to guide the choice of NRS mode, including HFNC, CPAP, BiPAP and Neurally Adjusted Ventilatory Assist (NIV-NAVA). The objective of this study is to describe the use of NRS in different institutions, and associated outcomes. METHODS This retrospective cohort study included children ≤ 2 years old, admitted to three Canadian PICUs between November 2017 and April 2022 for a first episode of severe bronchiolitis. The primary outcome was the need for endotracheal intubation. Secondary outcome was the total duration of ventilatory support. RESULTS Among 839 included patients, 101 patients (12%) were primarily intubated. In the 738 patients receiving primary NRS, the use of HFNC, CPAP, BiPAP varied across centers (Table), and only one site regularly used NIV-NAVA (in 29% patients). Intubation rate was 3% (13/433) in the site with frequent NAVA use, and 7% (21/305) in the other sites (p=0.01; Fisher exact test). The duration of ventilatory support was similar. CONCLUSIONS The use of NRS is variable across different Canadian PICUs. A strategy which includes the possibility of NIV-NAVA was associated with a lower intubation rate.
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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 | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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 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".