Bibliographic record
Abstract
and recommendationsFrom October 2006 the Association of Surgeons of Great Britain and Ireland, SARS, BAPEN Medical, the Intensive Care Society, the Association for Clinical Biochemistry and the Renal Association nominated core members of a steering committee who came together to establish consensus for good perioperative fluid prescribing.Concern arose from a high incidence of postoperative sodium and water overload, and evidence to suggest that preventing or treating this, by more accurate fluid therapy, would improve outcome.The following recommendations are extracted from the complete document below.Members of the steering committee used the definitions of the Oxford Centre for Evidence-based Medicine Levels of Evidence (May 2001) accessed from http://www.cebm.net/index.aspx?o=1025 to assign levels of evidence each of which, after debate, was accepted unanimously.Distinction is made (a) between fluid and electrolytes required for normal existence (daily maintenance) and (b) for resuscitation or replacement of abnormal losses.No intravenous infusion should be continued simply because it is a "routine" component of clinical care.Food and fluids should be provided orally or enterally and intravenous infusions discontinued as soon as possible.Prescribers need to understand the effects of surgical and metabolic stress on the renin-angiotensin-aldosterone system and on vasopressin elaboration.They must take care to assess the patient's sodium, chloride, potassium, and water requirements from a knowledge of the stress response and any current deficit or excess; they must take into consideration normal maintenance requirements and the expected composition of intestinal or other losses.Requirements thus calculated are to be met based on a quantitative knowledge of the sodium, chloride and potassium contents of the fluids prescribed.Prescription should not be made without such knowledge and no intravenous fluid should be regarded as intrinsically safe.Nutrition should be assessed and cautiously maintained.The oedematous patient should be managed with particular care, in order to achieve successful negative sodium and water balance.Recommendation 1 Because of the risk of inducing hyperchloraemic acidosis in routine practice, when crystalloid resuscitation or replacement is indicated, balanced salt solutions e.g.Ringer's lactate/acetate or Hartmann's solution should replace 0.9% saline, except in cases of hypochloraemia e.g. from vomiting or gastric drainage.Evidence level 1b [1][2][3][4][5][6]
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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.016 | 0.006 |
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".