Noninvasive Nocturnal Ventilatory Support in Advanced Lung Disease from Cystic Fibrosis
Bibliographic record
Abstract
INTRODUCTION: Respiratory failure is the most common cause of death among people with cystic fibrosis (CF). The role of noninvasive positive-pressure ventilation (NPPV) in severe but stable lung disease from CF has not been adequately determined. We therefore sought to determine the tolerability and efficacy of NPPV in people with advanced lung disease from CF. METHODS: We studied 13 patients with CF, severe air flow limitation (mean +/- SD forced expiratory volume in the first second 0.8 +/- 0.3 L), and chronic respiratory failure (mean +/- SD P(aO2) 67 +/- 19 mm Hg and P(aCO2) 51 +/- 8 mm Hg). All patients were awaiting lung transplantation. NPPV was prescribed for 2 months. Overnight polysomnography, arterial blood gas values, pulmonary function, exercise capacity, and health-related quality of life were evaluated at baseline, after 2 months of NPPV, and again after a 1-month wash-out period off NPPV. RESULTS: Eight patients completed the study and tolerated NPPV extremely well. These patients subjectively noted improvement in their symptoms and requested that they restart NPPV after completing the protocol. Nevertheless, NPPV did not improve objective measures of sleep quality, daytime blood gas values, pulmonary function, respiratory muscle strength, or exercise tolerance. All 8 patients were continued on NPPV and underwent successful lung transplantation. CONCLUSIONS: NPPV is well tolerated by most patients with CF and severe lung disease and may be a useful bridge to support CF patients awaiting lung transplantation. However, despite subjective improvement, standard objective measures did not improve and cannot explain the reduced symptoms reported by these patients.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 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 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".