Chest compression during sustained inflation versus 3:1 compression-to-ventilation ratio during neonatal cardiopulmonary resuscitation of asphyxiated piglets
Bibliographic record
Abstract
Background Current neonatal resuscitation guidelines recommend using the 3:1 chest compression-to-ventilation (C:V) ratio technique. However, an alternative technique using continuous compressions superimposed with a high distending pressure or sustained inflation (CC+SI) may improve return of spontaneous circulation (ROSC), survival, and post-resuscitation outcomes. Objective In a piglet model of asphyxia-induced cardiac arrest, compare time to ROSC with CC+SI or 3:1 C:V technique for providing neonatal cardiopulmonary resuscitation (CPR). Methods Secondary analysis of 132 term newborn mixed breed piglets (1-3 days of age, weighing 1.7-2.4 kg) from six different studies, which were exposed to 30-50 min of normocapnic hypoxia followed by asphyxia until cardiac arrest. This was followed by CPR with either the CC+SI or 3:1 C:V technique. Results Although the proportion of piglets achieving ROSC was similar between CC+SI and 3:1 C:V [59/83 (71%) vs. 40/49 (82%)], the time to ROSC was significantly shorter with CC+SI [median (IQR), 87.5 (66.8–147.5) vs. 120 (76.5–267) s; p = 0.0097], corresponding to a mean difference of –73.9 s (95% CI –122.5 to –25.3). Survival up to 4 h did not differ between groups (risk ratios 1.04, 95% Confidence intervals 0.82–1.32), with mean (SD) survival time among ROSC survivors of 237 (18) min for CC+SI vs 220 (55) min for 3:1 C:V (p=0.0623). In adjusted analyses, CC+SI yielded faster time to ROSC (Geometric Mean Ratio 0.67, 95% CI 0.50–0.88), with no effect modification by FiO 2 , but a rate-dependent effect on time to ROSC; 4-h survival did not differ between methods. Conclusions Use of the CC+SI technique during neonatal piglet resuscitation leads to a faster ROSC, with no difference in survival.
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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 | 0.001 |
| 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) | 0.001 | 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".