Abstract Sun105: Effects of a Flow Modulation Valve on Manual Ventilation Performance and Hemodynamics During Hemorrhagic Shock Resuscitation
Bibliographic record
Abstract
Background: Hemorrhagic shock, precipitated by rapid blood loss, is highly lethal. Successful treatment requires rapid stabilization to prevent mortality. Ventilatory support may be required when accompanied by respiratory failure, and in austere prehospital settings is most likely to occur via manual bagging, which carries risks of barotrauma and hemodynamic compromise. Airway flow limiting devices can facilitate correct manual ventilation, but their utility in the hemorrhagic shock resuscitation setting is not well established. Objective: Evaluate the use of an airway flow limiting device on manual ventilation performance and hemodynamics in a preclinical model of hemorrhagic shock resuscitation. Methods: We sedated, anesthetized and intubated 20 mixed-breed Yorkshire swine, mean(SD) weight 53.1(4) kg. Animals were mechanically ventilated at 8mL/kg while undergoing instrumentation (pressure transducer in descending aorta via femoral cutdown for assessing mean arterial pressure (MAP) and systolic blood pressure (SBP)). Airway flow, pressure (P AW ) and tidal volume (V T ) were monitored continuously. We bled animals in 60cc draws until MAP <40mmHg, and then commenced manual bagging, with animals randomized to standard ventilation (“SHAM”) or flow modulated ventilation (“FM”; Sotair, SafeBVM, Inc). Respiratory rate was guided by a metronome, dynamically adjusted to maintain eucapnia. After 30 min, all withdrawn blood was returned and bagging continued for another 30 min. Performance and hemodynamic parameters were compared between groups and across shock&resuscitation phases (t-tests; ANOVA). a = 0.05 was the threshold for statistical significance. Results: Fourteen pigs survived initial hemorrhage until randomization (1 animal arrested during resuscitation) and initiation of bagging (FM, n = 7; SHAM, n = 7). Airway performance parameters differed between FM and SHAM (p<0.001). MAP and SBP did not differ between FM and SHAM groups but differed between phases (p<0.001). Conclusions: Bagged ventilations with a flow modulation device resulted in more favorable ventilation performance, but no differences in hemodynamics during hemorrhagic shock/resuscitation.
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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 | 0.000 | 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) | 0.002 | 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".