Cardiopulmonary resuscitation with Synchronized Ventilation: A new technique of Neonatal Resuscitation that reduces time to return of spontaneous circulation in a neonatal porcine model
Bibliographic record
Abstract
Abstract Introduction Current neonatal resuscitation guidelines recommend a 3:1 Compression:Ventilation ratio (3:1 C:V) during cardiopulmonary resuscitation. One of the concerns with 3:1 C:V is lung derecruitment, which contributes to a delay in achieving return to spontaneous circulation (ROSC). An alternative approach might be chest compression synchronized ventilation (CCSV), which delivers a ventilation with each chest compression thereby achieving lung recruitment. We hypothesized that in asphyxiated newborn piglets with cardiac arrest CCSV vs 3:1 C:V would decrease the time to ROSC. Methods Newborn piglets were anesthetized, intubated, instrumented, and exposed to 45-minute normocapnic hypoxia, followed by asphyxia. Piglets were randomized to either CCSV or 3:1 C:V. Piglets assigned to CCSV received 120 compressions/min with a ventilator-synchronized inflation delivered during every compression (CCSV-Mode, Weinmann Germany). In the 3:1 C:V group, piglets received 90 compressions/min and 30 ventilations/min. Compressions and ventilations were continued until ROSC. Continuous respiratory parameters, cardiac output, mean systemic artery pressures, and blood flows were measured. Results Sixteen neonatal mixed breed pigs (1-3 days of age, weighing 1.8-2.3kg) and were randomly assigned to CCSV or 3:1 C:V. The median (IQR) asphyxia time was not significantly different between CCSV (326 (275-405)sec) and 3:1 C:V (416 (266-475)sec) (p=0.442). Time to ROSC was significantly lower using CCSV with 68 (50-125)sec vs 170 (105-312)sec with 3:1 C:V (p=0.030). Rate of ROSC was 6/8 with CCSV and 5/8 with 3:1 C:V (p=1.000). Conclusions In a neonatal piglet model of asystolic cardiac arrest, CCSV resulted in a significantly faster time to ROSC compared to 3:1 C:V. Using CCSV might be an alternative to 3:1 C:V for neonatal resuscitation, but further studies are warranted.
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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 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| 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".