Sedation with sevoflurane improves reperfusion in acute myocardial infarction
Bibliographic record
Abstract
Background: Experimental evidence suggests that the inhalation anesthetic sevoflurane has a cardioprotective effect. Methods: We randomized 47 patients with a first acute ST elevation myocardial infarction, treated by primary PCI within 6 h from symptom onset, to inhalation of sevoflurane or control (oxygen+midazolam). Sevoflurane and oxygen were administered using a tight fitting mask by the anesthesia team. Coronary flow at the end of PCI was assessed by corrected TIMI frame count (CTFC). Myocardial reperfusion was assessed by ST segment resolution. Infarct size was assessed by release of CK and troponin T. Results: 25 patients (age 62±12, 6 females) were randomized to sevoflurane and 22 (age 62±11, 5 females) to control. Time from first contact to balloon was similar in both groups (mean 78 min). In the sevoflurane group, the proportion of patients with anterior MI was higher (64% vs 36%), as was the total ST elevation (11.6±10.7 vs 8.4±6.2mm). The use of thrombectomy (56%) and administration of IIbIIIa inhibitors (90%) were similar. CTFC was 12.3±1.5 with sevoflurane and 15.6±9.1 in control, p=0.16. There was more ST resolution in patients treated by sevoflurane 80.7±25.8% vs 56.6±35.7%, p=0.01. There was no difference in troponin T or CK release between groups (AUC or peak). However, there was a trend to lower peak CK (1725±1589 vs 3206±1795 IU/L, p=0.05), and peak troponin T (4.4±3.9 vs 7.3±3.7 μg/L, p=0.1) in the sevoflurane group patients with anterior MI (Figure). Infarct size Conclusions: In this pilot randomized study, sevoflurane administration during primary PCI was associated with improvement in ST segment elevation resolution. There was a decrease in cardiac markers in patients with anterior STEMI who received sevoflurane. These results should be confirmed in a larger clinical trial.
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 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) | 0.001 | 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 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".