MétaCan
Menu
Back to cohort

Extubation guidelines: use of airway exchange catheters

2012· letter· en· W1517727448 on OpenAlexaff
J. Adam Law, Laura V. Duggan

Bibliographic record

VenueAnaesthesia · 2012
Typeletter
Languageen
FieldMedicine
TopicAirway Management and Intubation Techniques
Canadian institutionsDalhousie University
Fundersnot available
KeywordsMedicineIntubationTracheal tubeTube (container)Tracheal intubationAirwayCatheterSurgeryAirway managementMechanical engineering

Abstract

fetched live from OpenAlex

The authors are to be congratulated for comprehensive and practical guidelines on an important topic [1]. We agree that re-intubation over an airway exchange catheter (AEC) can be a complex procedure. A small calibre (11-FG) AEC provides patient comfort and tolerability, but renders the relatively flimsy AEC prone to posterior displacement as the larger and stiffer adult tracheal tube is advanced during re-intubation, such that the tube may snag on the corniculate/arytenoid cartilages. However, the Difficult Airway Society (DAS) guidelines fail to mention intermediate use of an Aintree intubation catheter (William Cook Europe, Bjaeverskov, Denmark) during re-intubation. Whilst not appropriate for primary use as an AEC at extubation due to its larger (19-FG) diameter and stiffness, these same attributes temporarily stiffen and enlarge an 11-FG AEC (Fig. 1) during re-intubation, allowing for easier railroading of a the tube, with less likelihood of snagging. Intermediate use of an Aintree intubating catheter over an 11-FG airway exchange catheter minimises tracheal tube hold-up on glottic soft tissues. In addition, mismatch between the external diameter of the small AEC and the internal diameter of the larger tracheal tube leaves a ‘lip’ of tracheal tube that can snag on glottic structures. Previous authors have recommended the use of a tracheal tube with a ‘beaked’ leading edge to avoid this problem [2]. The DAS guidelines advise railroading a tube with the bevel facing anteriorly, achieved by clockwise rotation of the tube by 90 degrees from the beaked position, but this risks snagging. We suggest that counterclockwise rotation of the tube by 90 degrees over an AEC, with the bevel facing posteriorly, is more likely to avoid this problem [3].

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow), Insufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Commentary · Consensus signal: Commentary
Teacher disagreement score0.176
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0010.000
Insufficient payload (model declined to judge)0.0020.000

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.

Opus teacher head0.096
GPT teacher head0.312
Teacher spread0.217 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designNot applicable
Domainnot available
GenreCommentary

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".

Quick stats

Citations8
Published2012
Admission routes1
Has abstractyes

Explore more

Same venueAnaesthesiaSame topicAirway Management and Intubation TechniquesFrench-language works237,207