Impact of resuscitation with 100% oxygen during physiological-based cord clamping or immediate cord clamping on lung inflammation and injury
Bibliographic record
Abstract
Abstract Background We examined whether physiological based cord clamping (PBCC) reduces oxygen-induced lung inflammation compared to immediate cord clamping (ICC) in preterm lambs ventilated with 100% oxygen for 10 min after birth. Methods Instrumented, steroid exposed preterm lambs (125 ± 1 days’ gestation) were randomized to receive 10 min of resuscitation with 100% oxygen before umbilical cord clamping or 30 s after ICC. After 10 min, oxygen was titrated to target SpO 2 of 90–95%. At 1 h, the lungs were collected for analysis of oxidative stress and inflammation, including RNASeq, and compared to an unventilated control group (UVC). Results PBCC prevented the transient fall in SpO 2 caused by ICC and reduced PaO 2 , pulmonary blood flow, mean and diastolic blood pressure during 100% oxygen ventilation. Lung markers of oxidative stress and inflammation were increased in PBCC and ICC lambs compared to UVC (all p < 0.01). IL1ß and IL6 gene expression was higher in PBCC than ICC lambs. Transcriptome analysis revealed novel pathways related to inflammation, immune response, and cytokine signalling. Conclusion PBCC prevents initial hypoxia and subsequent hyperoxia from 100% oxygen ventilation, but it does not reduce lung oxidative stress, inflammation, or injury, nor the risk or severity of lung damage during high-oxygen resuscitation. Impact The appropriate oxygen level to use during the initial resuscitation of preterm infants during delayed cord clamping/physiological based cord clamping is not known. We found that providing prolonged high oxygen during physiological based cord clamping to preterm lambs does not protect the preterm lung from inflammation, injury or oxidative stress compared to immediate cord clamping. The use of prolonged high oxygen during the initial resuscitation of preterm newborns should be avoided irrespective of what cord clamping strategy is being used.
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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 | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".