Spontaneous respiration during intravenous anesthesia in children
Bibliographic record
Abstract
PURPOSE OF REVIEW: Maintaining spontaneous respiration during intravenous anesthesia for investigative and surgical procedures may avoid the need for airway instrumentation and reduce the risk of desaturation. In addition, when performing airway endoscopic procedures in children, maintaining spontaneous respiration while using intravenous anesthesia can reduce the need for endotracheal intubation. This facilitates improved access to the smaller airway, allows assessment of the dynamic function of the airway, and reduces exposure of personnel to inhaled anesthetic agents. RECENT FINDINGS: Anesthetic hypnotic and analgesic agents are potent dose-dependent depressants of respiration. Infants have historically been considered to be at a higher risk of respiratory depression, especially from opioid analgesics. However, recent evidence suggests that infants and younger children outside the neonatal period are more resistant to the effects of remifentanil, even when combined with propofol. Spontaneous respiration can be maintained at doses adequate to suppress somatic responses to painful procedures. The large inter-individual variation in respiratory depressant effects necessitates individualized dose titration. The drug dose is more linearly related to variation in the respiratory rhythm and respiratory rate than to minute volume or end-tidal carbon dioxide. Apneic episodes are less likely when respiratory depressant drugs are administered slowly, as this allows time for the end-tidal carbon dioxide level to rise to a new apneic threshold. Hypnotic anesthetics and opioid analgesics act synergistically to cause respiratory depression and suppression of the somatic response. SUMMARY: Spontaneous respiration can be maintained when anesthetizing children using intravenous anesthesia.
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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) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| 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".