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Record W55343604 · doi:10.1136/bmj.329.7459.220

Intensive care management and control of infection

2004· review· en· W55343604 on OpenAlexaff
Carolyn Hemsley

Bibliographic record

VenueBMJ · 2004
Typereview
Languageen
FieldMedicine
TopicBurn Injury Management and Outcomes
Canadian institutionsBC Children's Hospital
Fundersnot available
KeywordsMedicineIntensive careAirwayIntensive care unitIntensive care medicineBurn injuryAirway managementSurgery

Abstract

fetched live from OpenAlex

Intensive care managementThe goal in management of an acute burn is to limit the extent of the systemic insult.Intensive care management should not be seen as rescue for failed initial treatment but as a preventive measure in patients at high risk of organ failure.Intensive care units have the resources for improved monitoring and expertise in managing acute physiological changes.Intensive care management should not, however, become an obstacle to early aggressive surgical excision of the burn wound, which is associated with improved outcome. Airway burnsThe term "inhalational injury" has been used to describe the aspiration of toxic products of combustion, but also more generally any pulmonary insult associated with a burn injury.Patients with cutaneous burns are two to three times more likely to die if they also have lower airway burns.Death may be a direct result of lung injury but is usually due to the systemic consequences of such injury.It may be impossible to distinguish lung injury caused at the time of the burn directly to the lungs by a burn from injury due to the systemic consequences of the burn.Diagnosis of lower airway burns is largely based on the patient's history and clinical examination.Clinicians should have a high index of suspicion of airway burns in patients with one or more of the warning signs.Special investigations will support clinical suspicion.However, severity of injury or prediction of outcome is not aided by additional tests.The pathophysiology of airway burns is highly variable, depending on the environment of the burn and the incomplete products of combustion.The clinical manifestations are often delayed for the first few hours but are usually apparent by 24 hours.Airway debris-including secretions, mucosal slough, and smoke residue-can seriously compromise pulmonary function.There is no specific treatment for airway burns other than ensuring adequate oxygenation and minimising iatrogenic lung insult.Prophylactic corticosteroids or antibiotics have no role in treatment.Control of the airway, by endotracheal intubation, is essential before transporting any patient with suspected airway burn.Rapid fluid administration, with inevitable formation of oedema, may lead to life threatening airway compromise if control of the airway is delayed.Endotracheal intubation before oedema formation is far safer and simpler.Oxygen (100%) should be given until the risk of carbon monoxide toxicity has been excluded, since high concentrations of oxygen will clear carbon monoxide from the body more rapidly than atmospheric concentrations.Importantly, carbon monoxide toxicity may result in a falsely elevated pulse oximetry saturation.Airway burns are associated with a substantially increased requirement for fluid resuscitation.Reducing the fluid volume administered, to avoid fluid accumulation in the lung, results in a worse outcome.Invasive monitoring may be required to guide fluid administration, especially with failure to respond to increasing volumes of fluid.Adequate oxygen delivery to all the tissues of the body is essential to prevent multi-organ failure.

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 imitation

Not 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.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.004
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.007
Threshold uncertainty score0.024

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.004
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0020.001
Bibliometrics0.0020.002
Science and technology studies0.0000.001
Scholarly communication0.0010.001
Open science0.0010.001
Research integrity0.0020.001
Insufficient payload (model declined to judge)0.0070.002

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.

Opus teacher head0.035
GPT teacher head0.364
Teacher spread0.329 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreReview

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".

Quick stats

Citations76
Published2004
Admission routes1
Has abstractyes

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