Ketamine Therapy in an Adolescent Patient at 35 Weeks of Gestation With Status Asthmaticus
Bibliographic record
Abstract
The patient was a 15-year-old female gravida 1 para 0 (G1P0) presenting to the emergency department (ED) with a chief complaint of shortness of breath. Her fetus had an estimated gestational age (EGA) of 35 weeks, dated by first trimester sonography. Her past medical history was significant for asthma and suicide attempts via drug overdose. On inspection, the patient was tripoding and was given standard management protocol of nebulizer and albuterol treatments to address her asthma exacerbation. A few hours after treatment, the patient progressed to status asthmaticus and was rushed to the intensive care unit (ICU). She was intubated at that time to address her extreme respiratory acidosis. Sedation was provided with ketamine, which is also occasionally used to address status asthmaticus in refractory patients, regardless of pregnancy status. The use of ketamine in status asthmaticus is still questionable in efficacy. Given that she was under the age of 18, she was transferred to a facility more capable of handling a pediatric ICU and probable future neonatal ICU patient. The patient was transferred to Texas Children's Hospital (TCH) via helicopter, where she was given repeat dosage of ketamine during her air travel. The patient later developed late decelerations, which required emergent primary cesarean section, at which time infant was born with Apgar scores of 1, 2, and 2. The patient was gradually weaned off the ventilator over about 1 week. She was discharged about 1 - 2 weeks later from TCH with several medications to address her asthma and prevent future attacks of this magnitude. J Clin Gynecol Obstet. 2023;12(1):24-27 doi: https://doi.org/10.14740/jcgo855
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 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) | 0.001 | 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".