Tracheal gas insufflation using a bronchial blocking catheter
Bibliographic record
Abstract
We would like to report a novel apparatus for delivering tracheal gas insufflation using an adapted bronchial blocker. Whilst treating a severely hypercapnoeic patient on our ICU we considered various strategies to decrease the arterial carbon dioxide tension. Tracheal gas insufflation (TGI) has been used as a respiratory adjunct in these circumstances as a means of decreasing carbon dioxide within dead space by delivering fresh gas near the end of the tracheal tube [1]. TGI has been used during permissive hypercapnoea, and in combination with high-frequency oscillatory ventilation, as a strategy for managing patients with acute respiratory distress syndrome [2, 3]. In a study of Canadian intensivists, only 6.4% considered using TGI for selected patients, and part of the reason for this may be that dedicated equipment for delivering TGI is not readily available in most ICUs [4, 5]. Cutting a bronchial blocker has resulted in a device which allows TGI to be delivered. After shortening the bronchial blocker it is essential that the interior stiffening wire is removed so that no sharp ends remain. In our experience, using a cut bronchial blocker rather than a suction catheter results in a stiffer tube which does not kink, and which seals well at the angle-piece, resulting in less leakage. The dedicated angle-piece within the bronchial blocker kit has the additional advantage of having three lumens (Fig. 3), allowing tracheal suction to be performed alongside ventilation and TGI. Tracheal gas insufflation apparatus with shortened bronchial blocker in situ. Clearly, it is less than ideal to adapt equipment for uses other than that for which it is intended, and in this case it was only justified by the severity of the patient's illness and the lack of alternatives for delivering TGI.
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 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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.002 |
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".