Impact des différentes modalités de support respiratoire nasal sur les réflexes protecteurs des voies aériennes inférieures chez les agneaux prématurés
Bibliographic record
Abstract
Abstract: Introduction: Preterm infants have immature vital lower airway protective reflexes. Therefore, oral feeding or gastroesophageal refluxes (GER) can be associated, in certain infants, with serious complications such as laryngeal penetrations, pulmonary aspirations and acute cardiorespiratory events (bradycardias, apneas, oxygen desaturations). Nasal respiratory support (NRS), such as nasal continuous positive airway pressure (nCPAP) and high-flow nasal cannula (HFNC), is routinely used in preterm infants. However, the impact of NRS on these protective mechanisms of the lower airways remains largely unknown in this population. Project 1: Some teams fear that NRS might disrupt sucking–swallowing–breathing coordination and could induce severe cardiorespiratory events. Standardized bottle-feeding was assessed under video-fluoroscopy with and without induced tachypnea using our unique preterm lamb model. The article published in Front. Physiol. (DOI: 10.3389/fphys.2021.785086) shows that NRS do not impact the safety or efficiency of bottle-feeding or sucking–swallowing–breathing coordination in preterm lambs, even in the presence of tachypnea. Project 2: Significant cardiorespiratory events can be triggered in preterm infants during laryngeal chemoreflexes (LCRs) and esophageal reflexes. We previously showed that nCPAP blunted the cardiorespiratory inhibition induced by LCRs. The article published in Pediatr. Res. (DOI: 10.1038/s41390-023-02883-w) shows that nCPAP 6 cmH2O decreases the cardiorespiratory inhibition induced with LCRs, but not with esophageal reflexes in preterm lambs. This blunting effect is less marked with HFNC 7 L/min. Project 3: Nasal CPAP was previously shown to strongly inhibit GER in full-term lambs as well as in adult humans. The manuscript submitted in Am. J. Physiol. Gastrointest. Liver Physiol. also shows that nCPAP 6 cmH2O strongly inhibits GER in preterm lambs, although it increases air-containing swallows. In contrast, HFNC does not have an overall effect on GER in preterm lambs. Conclusion: Results reported in this thesis largely contribute to an improved understanding of the effects of nCPAP and HFNC on lower airway protective reflexes in a preclinical model of the preterm newborn. Neither of the tested NRS alters bottle-feeding. In addition, nCPAP is beneficial in the context of laryngeal chemoreflexes and GER. Our preclinical results must be confirmed through clinical studies in preterm infants.
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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 | 0.001 | 0.000 |
| Open science | 0.000 | 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".