Asystolic cardiac arrest secondary to sugammadex administration in a young patient
Bibliographic record
Abstract
LetterS to the eDitorDear editor, Sugammadex is a modified γ-cyclo dextrin, used to rapidly and predictably reverse the neuromuscular blocking effects of rocuronium and vecuronium.its safety profile is generally superior to that of neostigmine [1], however, serious adverse events have been reported.these include profound bradycardia and cardiac arrest [2][3][4][5][6][7][8].Whilst the underlying mechanisms remain unclear the majority of these cases involve older and/or co-morbid patients.We present a case of asystolic cardiac arrest secondary to sugammadex administration in a young, physically healthy patient.Written consent for publication was obtained from the patient.A 26-year-old female was listed for an elective diagnostic laparoscopy to investigate possible endometriosis.She was an American Society of Anesthesiologists (ASA) physical status ii, with a medical history of polycystic ovarian syndrome and depression.She weighed 93 kg with a body mass index of 33 kg m -2 .As she had no significant co-morbidities, she did not undergo any formal pre-operative investigations, though a historical electrocardiogram (eCG) from two months prior showed normal sinus rhythm.her medication history included sertraline 50 mg daily and she had a documented allergy to N-acetyl cysteine, which had previously caused a rash.She had undergone a previous uncomplicated general anaesthesia for a laparoscopic appendicectomy, however, as this had taken place at a distant hospital, the associated notes were unavailable on the day of her surgery.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
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".