Spontaneous ventilation with remifentanil in children
Bibliographic record
Abstract
BACKGROUND: Remifentanil is a short-acting drug that allows us to study the specific respiratory effects of potent opioid analgesics. The purpose of this study is to describe the effects of a remifentanil infusion during spontaneous ventilation in children. Pharmacokinetic studies provide useful information on the time course of opioid blood concentrations; however, they cannot be easily translated into infusion administration guidelines for pediatric clinical practice. METHODS: A total of 32 children, aged 2-7 years, undergoing restorative dentistry, spontaneously breathing under sevoflurane anesthesia were enrolled in the study. After an initial bolus dose of remifentanil, an infusion was administered in ascending logarithmic increments at 10 min intervals. Increments were discontinued when endtidal carbon dioxide exceeded 9 kPa (70 mmHg), desaturation occurred (SpO2 < 94%) or with the onset of apnea (>5 s). The maximum tolerated dose was determined for each subject. Endtidal carbon dioxide, minute ventilation and respiratory rate were continuously recorded. RESULTS: The median tolerated dose of remifentanil was 0.127 microg.kg(-1).min(-1) (range: 0.053-0.3 microg.kg(-1).min(-1)). When comparing the last four incremental increases in each subject, 35% change in respiratory rate occurred in the last 10 min period while changes in endtidal carbon dioxide and minute ventilation were gradual and of less magnitude. There was no correlation between age and respiratory rate. CONCLUSIONS: There is a large variation in the dose of remifentanil tolerated by children while breathing spontaneously under anesthesia. A respiratory rate of <10 b.min(-1) appears to be the best predictor of the maximum tolerated dose.
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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) | 0.000 | 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 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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".