Use of high-frequency oscillatory ventilation in burn patients
Bibliographic record
Abstract
BACKGROUND: Patients with major burn injuries frequently develop acute respiratory distress syndrome (ARDS). High-frequency oscillatory ventilation (HFOV) has been used successfully in our regional burn center since 1999 for the management of oxygenation failure secondary to ARDS and as a method of intraoperative ventilation to allow surgical burn wound excision to proceed, despite the presence of severe ARDS. OBJECTIVE: The objective of this article is to review the use of HFOV in burn patients, with an emphasis on the indications and selection criteria for the initiation of HFOV, special considerations for patients with smoke inhalation injury, and our approach to intra-operative HFOV. SETTING: Adult regional burn center in a university-affiliated tertiary care hospital. RESULTS: We have now used HFOV in 36 severely burned patients, 33% of whom had an associated smoke inhalation injury. HFOV produced significant improvements in oxygenation among burn patients with oxygenation failure secondary to ARDS. HFOV produced a slower and less robust reversal of oxygenation failure in those with smoke inhalation compared with patients with burns alone. HFOV has been used intraoperatively for 33 procedures in 18 patients without complications. CONCLUSION: HFOV has been an indispensable ventilation modality in our burn center, and has played an important role in reversing oxygenation failure in patients with ARDS and in facilitating early excision and closure of the burn wound in these patients.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 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) | 0.001 | 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".