Continuous Chest Compressions with Asynchronous Ventilation in Asphyxiated Preterm Lambs with Asystole
Bibliographic record
Abstract
Introduction: Gas exchange and perfusion are impaired during neonatal cardiopulmonary resuscitation. Continuous chest compressions with asynchronous ventilation (CCCaV) improve oxygenation and hemodynamics in term animal models compared to synchronized 3:1 compressions-to-ventilation (C:V). We hypothesized that CCCaV improves gas exchange and hemodynamics in preterm lambs. Methods: Sixteen extremely preterm (124–126 days gestation) lambs were asphyxiated to cardiac arrest by umbilical cord occlusion. Lambs were randomized to 3:1 C:V following the International Liaison Committee on Resuscitation algorithm or CCCaV (120 compressions and 40 asynchronized ventilations per minute). Epinephrine was given 3 min into resuscitation and repeated every 3 min until return of spontaneous circulation (ROSC). Results: All lambs achieved ROSC with no difference in time to ROSC. There was no difference in cerebral oxygen delivery (C-DO<sub>2</sub>) in lambs resuscitated with CCCaV versus 3:1 C:V (0.05 [0.041] vs. 0.03 [0.031] mL O<sub>2</sub>/kg/min, respectively) during chest compressions. CCCaV yielded higher arterial oxygen content (CaO<sub>2</sub> 2.07 [1.00] vs. 1.07 [0.69] mL O<sub>2</sub>/dL), mean arterial pressure (14.2 [2.6] vs. 13.2 [2.3] mm Hg), and diastolic pressure (8.1 [1.8] vs. 7.1 [1.4] mm Hg) during chest compressions compared to 3:1 C:V. There was no difference in plasma reduced to oxidized glutathione [GSH/GSSG ratio] between groups at 10 min post-ROSC. Discussion: CCCaV in asystolic preterm lambs did not alter C-DO<sub>2</sub>, frequency, or time to ROSC compared to standard 3:1 C:V resuscitation but increased CaO<sub>2</sub>, mean, and diastolic arterial pressure compared to 3:1 C:V without increasing plasma oxidative stress markers.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".