Bibliographic record
Abstract
Thoracic surgical operations require the anaesthetist to be able to cease ventilation and allow deflation of the operative lung, to protect the lower lung from contamination with blood, tumour or infective material and to continue ventilation of the non-operative, dependent lung. Without the ability to separate and independently ventilate the lungs, thoracic surgery is hazardous. The first planned pulmonary resection by Block on a young female relative in 1883 was a disaster. She died on the operating table and Block committed suicide. A major component of safe thoracic anaesthesia is the appropriate use of endobronchial tubes, double-lumen tubes (DLTs) and bronchial blockers. Indications for their use are not restricted to pulmonary surgery and there are other clinical indications for lung separation (Table 14.1). Endobronchial tubes The First attempts at selective lung ventilation were with endobronchial tubes. These long, single-lumen tubes were placed in the bronchus of the dependent, non-operative lung. The classical technique, devised by Magill, was to load the tube onto a rigid intubating bronchoscope and place the tube under direct bronchoscopic view. It was possible to ventilate both lungs at the end of surgery by withdrawing the endobronchial tube into the trachea. The technique of one-lung ventilation by endobronchial placement of a single-lumen tube is still in practice in specialized circumstances, usually with blind or fibreoptic positioning into the appropriate bronchus. The next development was of a combined tracheal tube and bronchial blocker (Macintosh–Leatherdale). This tube consisted of a standard tracheal tube and a cuffed blocker limb which entered the bronchus of the operative lung. Both lungs could be ventilated when the blocker cuff was deflated, and subsequent inflation of the cuff would isolate the operative lung.
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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 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.035 | 0.026 |
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".