Notice bibliographique
Résumé
Intensive care managementThe goal in management of an acute burn is to limit the extent of the systemic insult.Intensive care management should not be seen as rescue for failed initial treatment but as a preventive measure in patients at high risk of organ failure.Intensive care units have the resources for improved monitoring and expertise in managing acute physiological changes.Intensive care management should not, however, become an obstacle to early aggressive surgical excision of the burn wound, which is associated with improved outcome. Airway burnsThe term "inhalational injury" has been used to describe the aspiration of toxic products of combustion, but also more generally any pulmonary insult associated with a burn injury.Patients with cutaneous burns are two to three times more likely to die if they also have lower airway burns.Death may be a direct result of lung injury but is usually due to the systemic consequences of such injury.It may be impossible to distinguish lung injury caused at the time of the burn directly to the lungs by a burn from injury due to the systemic consequences of the burn.Diagnosis of lower airway burns is largely based on the patient's history and clinical examination.Clinicians should have a high index of suspicion of airway burns in patients with one or more of the warning signs.Special investigations will support clinical suspicion.However, severity of injury or prediction of outcome is not aided by additional tests.The pathophysiology of airway burns is highly variable, depending on the environment of the burn and the incomplete products of combustion.The clinical manifestations are often delayed for the first few hours but are usually apparent by 24 hours.Airway debris-including secretions, mucosal slough, and smoke residue-can seriously compromise pulmonary function.There is no specific treatment for airway burns other than ensuring adequate oxygenation and minimising iatrogenic lung insult.Prophylactic corticosteroids or antibiotics have no role in treatment.Control of the airway, by endotracheal intubation, is essential before transporting any patient with suspected airway burn.Rapid fluid administration, with inevitable formation of oedema, may lead to life threatening airway compromise if control of the airway is delayed.Endotracheal intubation before oedema formation is far safer and simpler.Oxygen (100%) should be given until the risk of carbon monoxide toxicity has been excluded, since high concentrations of oxygen will clear carbon monoxide from the body more rapidly than atmospheric concentrations.Importantly, carbon monoxide toxicity may result in a falsely elevated pulse oximetry saturation.Airway burns are associated with a substantially increased requirement for fluid resuscitation.Reducing the fluid volume administered, to avoid fluid accumulation in the lung, results in a worse outcome.Invasive monitoring may be required to guide fluid administration, especially with failure to respond to increasing volumes of fluid.Adequate oxygen delivery to all the tissues of the body is essential to prevent multi-organ failure.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,002 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».