Venovenous extracorporeal membrane oxygenation in obese patients
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Feature Editor's Note-The use of venovenous (VV) extracorporeal membrane oxygenation (ECMO) has experienced broader adoption over the preceding decade for the management of respiratory failure. As experience with VV-ECMO has grown, VV-ECMO has been applied to more patients afflicted with a greater burden of comorbidities, which has been particularly evident during the global COVID-19 pandemic. One of the more common comorbidities is that of obesity. The use of VV ECMO in obese patients poses significant challenges and requires adoption of different techniques to achieve adequate respiratory support and successful outcomes. In this Invited Expert Technique article, Javidfar and colleagues review respiratory management and VV-ECMO techniques for application in obese patients. The authors discuss optimal respiratory management practices including use of esophageal pressure monitoring to assess lung pressures and special considerations in use of prone positioning. Optimal cannulation techniques are reviewed as well as techniques to obtain optimal ECMO flow, gas exchange and oxygenation, and facilitate airway management and physical therapy. Importantly, the authors review thresholds and situations in which conversion to veno-arterial ECMO might be necessary. Javidar and colleagues should be congratulated on a timely, insightful, and comprehensive review on the topic VV-ECMO for respiratory failure in obese patients and for providing an excellent guide to achieving optimal outcomes.
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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) | 0.000 | 0.001 |
| 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 | 0.001 | 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 it