Hemodynamic Changes with Different Non-Invasive Respiratory Modes for Primary Respiratory Support in Preterm Neonates: A Randomized Controlled Trial
Bibliographic record
Abstract
Background: Non-invasive ventilation has improved the survival rate and treatment outcomes for preterm neonates with respiratory distress syndrome (RDS). The hemodynamic changes that occur, particularly during the weaning period, and alternate non-invasive breathing strategies are not well understood. Aim: To assess the hemodynamic changes that occur during and after non-invasive respiratory support and the comparative efficacy of nasal continuous positive airway pressure (NCPAP) and nasal high-frequency oscillatory ventilation (NHFOV) as the primary non-invasive respiratory support for preterm neonates. Methods: A randomized controlled study on 90 preterm neonates with RDS in need of non-invasive ventilation during their first 3 days of life, randomized into 3 groups: NHFOV, vapotherm, and NCPAP groups; 30 neonates for each group. Hemodynamic changes were assessed by echocardiography, pelviabdominal, and transcranial ultrasounds during and after discontinuation of the device. Results: The NHFOV group had the lowest failure rate compared to the other two groups (p < 0.05). The Vapotherm group had a considerably shorter hospital stay and duration on non-invasive ventilation, faster reach to full enteral feeding, and lower nose trauma score (p < 0.05 for all). In terms of hemodynamic changes, the NCPAP group experienced a considerably higher percentage increase in left ventricular output (LVO) compared to the other two modalities (p < 0.001). Conclusions: NHFOV had the lowest failure rate as a primary non-invasive respiratory support in preterm infants with RDS. However, the Vapotherm group showed a shorter hospital stay and duration on non-invasive respiratory support, quicker time to reach full oral feeding, and lower nasal trauma. The NCPAP group had a higher percentage of increment in LVO.
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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 | 0.004 | 0.006 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.004 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.006 | 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".