Walk a Tightrope or Burn a Bridge?: Sedation versus General Anesthesia for Intubation of a Pediatric Difficult Airway
Bibliographic record
Abstract
Editorial| October 2022 Walk a Tightrope or Burn a Bridge?: Sedation versus General Anesthesia for Intubation of a Pediatric Difficult Airway This article has an Audio Podcast Allan F. Simpao, M.D., M.B.I.; Allan F. Simpao, M.D., M.B.I. 3 Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania; and Department of Anesthesiology and Critical Care Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania https://orcid.org/0000-0001-8871-2579 Search for other works by this author on: This Site PubMed Google Scholar Clyde T. Matava, M.B.Ch.B., D.A., M.Med.; Clyde T. Matava, M.B.Ch.B., D.A., M.Med. 2 Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, Ontario, Canada; and Department of Anesthesiology and Pain Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada Search for other works by this author on: This Site PubMed Google Scholar Andrew Davidson, M.B.B.S., M.D., F.A.N.Z.C.A. Andrew Davidson, M.B.B.S., M.D., F.A.N.Z.C.A. 1 Department of Anesthesia, Royal Children’s Hospital, Parkville, Victoria, Australia; Melbourne Children’s Trials Center, Murdoch Children’s Research Institute, Parkville, Victoria, Australia; and Departments of Pediatrics and Critical Care, University of Melbourne, Parkville, Victoria, Australia Search for other works by this author on: This Site PubMed Google Scholar Author and Article Information This editorial accompanies the article on p. 418. Accepted for publication August 2, 2022. Address correspondence to Dr. Simpao: Anesthesiology October 2022, Vol. 137, 384–386. https://doi.org/10.1097/ALN.0000000000004343 Connected Content Article: Sedation versus General Anesthesia for Tracheal Intubation in Children with Difficult Airways: A Cohort Study from the Pediatric Difficult Intubation Registry Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Cite Icon Cite Get Permissions Search Site Citation Allan F. Simpao, Clyde T. Matava, Andrew Davidson; Walk a Tightrope or Burn a Bridge?: Sedation versus General Anesthesia for Intubation of a Pediatric Difficult Airway. Anesthesiology 2022; 137:384–386 doi: https://doi.org/10.1097/ALN.0000000000004343 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsAnesthesiology Search Advanced Search Topics: anesthesia, general, burns, intubation, pediatric difficult airway, sedation procedure Children—and their airways—come in all shapes and sizes, and the most seasoned pediatric anesthesiologists can share harrowing stories of patients who were difficult to ventilate or intubate. In 2012, a special interest group in the Society for Pediatric Anesthesia created the Pediatric Difficult Intubation Registry, an international, multicenter, web-based registry of observational data on pediatric difficult airway management, with the goal of improving the care of these challenging patients. The Pediatric Difficult Intubation Collaborative has produced a panoply of clinically relevant findings, and their most recent research sought to answer how these patients fare when managed with sedation versus general anesthesia.1–4 When confronted with a potentially or known difficult airway, most pediatric anesthesiologists induce general anesthesia, albeit with the goal of maintaining both adequate depth and spontaneous respiration.1 In contrast, there are some who decry general anesthesia may “burn the bridge” of spontaneous ventilation and instead choose to... You do not currently have access to this content.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 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) | 0.003 | 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".