Effect of different ventilation modes on postoperative cognitive dysfunction in elderly patients undergoing laparoscopic abdominal wall herniorrhaphy
Bibliographic record
Abstract
Objective: To compare the effects of three ventilation modes -pressure-controlled ventilation (PC), volumecontrolled ventilation (VC), and pressure-regulated volume control ventilation (PRVC) -on postoperative cognitive dysfunction (POCD) in elderly patients undergoing laparoscopic abdominal wall hernia repair.Methods: In this prospective study, 485 elderly patients undergoing laparoscopic abdominal wall hernia repair were randomly assigned to one of three ventilation groups: PC, VC, or PRVC.Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) at baseline (D0), and on postoperative days 1 (D1) and 3 (D3).Intraoperative physiological indicators, including mean arterial pressure (MAP), heart rate (HR), PaCO 2 , central venous pressure (CVP), dynamic lung compliance (Cdyn), and optic nerve sheath diameter (ONSD), were recorded at five perioperative time points (T1-T5).Plasma concentrations of brain injury biomarkers (Aβ1-40, S-100β) and inflammatory cytokines (IL-1β, IL-6, TNF-α) were measured at baseline and serial postoperative time points (TI-TV).Results: The incidence of POCD differed significantly among the three ventilation groups on both postoperative day 1 (P = 0.040) and day 3 (P = 0.034).On day 3, post-hoc analysis revealed that the POCD rate in the PRVC group was significantly lower than in the PC group (P < 0.0167).Regarding potential mechanisms, PRVC was associated with improved dynamic lung compliance and a lower optic nerve sheath diameter compared to both PC and VC groups.Furthermore, PRVC significantly reduced plasma concentrations of the inflammatory cytokines IL-1β and IL-6 (all P < 0.05).Conclusion: In elderly patients undergoing abdominal wall hernia repair, PRVC ventilation reduced the incidence of early POCD, particularly compared to PC ventilation.This neuroprotective effect appears to be linked to improved respiratory mechanics and an attenuated systemic inflammatory response.Therefore, PRVC represents a preferable ventilation strategy for this vulnerable patient population.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| 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) | 0.001 | 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".