array:22 [
  "pii" => "S2173572715000272"
  "issn" => "21735727"
  "doi" => "10.1016/j.medine.2014.11.003"
  "estado" => "S300"
  "fechaPublicacion" => "2015-05-01"
  "aid" => "744"
  "copyright" => "Elsevier España, S.L.U. and SEMICYUC"
  "copyrightAnyo" => "2014"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "sco"
  "cita" => "Med Intensiva. 2015;39:261"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 1714
    "formatos" => array:3 [
      "EPUB" => 156
      "HTML" => 1005
      "PDF" => 553
    ]
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2173572715000260"
    "issn" => "21735727"
    "doi" => "10.1016/j.medine.2015.04.001"
    "estado" => "S300"
    "fechaPublicacion" => "2015-05-01"
    "aid" => "712"
    "copyright" => "Elsevier España, S.L.U. and SEMICYUC"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Med Intensiva. 2015;39:256-7"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1555
      "formatos" => array:3 [
        "EPUB" => 148
        "HTML" => 902
        "PDF" => 505
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
      "titulo" => "Shock following subcutaneous injections of polymethylmethacrylate"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "256"
          "paginaFinal" => "257"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Shock despu&#233;s de inyecciones subcut&#225;neas de polimetilmetacrilato"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 2597
              "Ancho" => 1677
              "Tamanyo" => 358555
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">1A&#46; Chest X-ray showing bilateral lung infiltrates&#46; 1B-E&#46; Chest CT angiographyshowing bilateral consolidations with air-bronchograms and ground-glass-appearing opacities suggestive of alveolar damage&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "M&#46; Boattini, A&#46;R&#46; Francisco, R&#46; Cavaco, J&#46; Rodrigues, L&#46; Bento"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Boattini"
            ]
            1 => array:2 [
              "nombre" => "A&#46;R&#46;"
              "apellidos" => "Francisco"
            ]
            2 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Cavaco"
            ]
            3 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Rodrigues"
            ]
            4 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Bento"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572715000260?idApp=WMIE"
    "url" => "/21735727/0000003900000004/v3_201509260116/S2173572715000260/v3_201509260116/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Images in Intensive Medicine</span>"
    "titulo" => "Contrast-enhanced signs of cardiac arrest during CT"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:1 [
        "paginaInicial" => "261"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "S&#46; Mill&#225;n, X&#46; Gallardo, I&#46; Martin-Loeches"
        "autores" => array:3 [
          0 => array:3 [
            "nombre" => "S&#46;"
            "apellidos" => "Mill&#225;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "X&#46;"
            "apellidos" => "Gallardo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:4 [
            "nombre" => "I&#46;"
            "apellidos" => "Martin-Loeches"
            "email" => array:1 [
              0 => "drmartinloeches&#64;gmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Critical Care Centre&#44; Corporaci&#243; Sanit&#224;ria i Universitaria Parc Taul&#237; - Hospital de Sabadell&#44; Sabadell&#44; Barcelona&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Department of Radiology&#44; UDIAT-Centre Diagnostic&#44; Institut Universitari Parc Tauli-UAB&#44; Sabadell&#44; Barcelona&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Multidisciplinary Intensive Care Research Organization &#40;MICRO&#41;&#44; St James&#39;s University Hospital&#44; Trinity Centre for Health Sciences&#44; Dublin&#44; Ireland"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Signos de parada cardiaca durante la realizaci&#243;n de un TAC con contraste"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1150
            "Ancho" => 1658
            "Tamanyo" => 260240
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Retrograde flow of contrast through the inferior vena cava to the right hepatic vein and the most gravity-dependent areas of the right hepatic lobe&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 78-year-old woman with a history of smoking&#44; hypertension&#44; chronic obstructive pulmonary disease&#44; and type 2 diabetes mellitus presented sudden death&#46; After advanced life support&#44; she recovered a pulse&#46; On the EKG&#44; a newly acquired right bundle branch block &#40;RBBB&#41; was detected and she was urgently transferred to the CT scanner to rule out a massive pulmonary embolism&#46; During image acquisition&#44; the patient became hypotensive and suffered another cardiac arrest&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Contrast-enhanced multidetector CT showed &#8220;passive&#8221; filling of the right cardiac chambers with contrast material occupying the lower part of the chambers&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Retrograde flow of the contrast agent was also observed through the right atrium into the coronary sinus and the great cardiac vein&#44; filling the cardiac veins of the left ventricle &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#44; and from the inferior vena cava into the right hepatic vein and right hepatic lobe &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">These findings are pathognomonic of the absence of blood flow during the procedure&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">After 30<span class="elsevierStyleHsp" style=""></span>min advanced life support&#44; the patient died&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "multimedia" => array:2 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1195
            "Ancho" => 1658
            "Tamanyo" => 222368
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Contrast in the lower part of the right atrium and ventricle &#40;arrowheads&#41;&#46; Retrograde filling of the coronary sinus &#40;&#42;&#41; and cardiac veins of the left ventricle &#40;arrows&#41;&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1150
            "Ancho" => 1658
            "Tamanyo" => 260240
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Retrograde flow of contrast through the inferior vena cava to the right hepatic vein and the most gravity-dependent areas of the right hepatic lobe&#46;</p>"
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735727/0000003900000004/v3_201509260116/S2173572715000272/v3_201509260116/en/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/21735727/0000003900000004/v3_201509260116/S2173572715000272/v3_201509260116/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572715000272?idApp=WMIE"
]
Share
Journal Information
Vol. 39. Issue 4.
Pages 261 (May 2015)
Share
Share
Download PDF
More article options
Vol. 39. Issue 4.
Pages 261 (May 2015)
Images in Intensive Medicine
Full text access
Contrast-enhanced signs of cardiac arrest during CT
Signos de parada cardiaca durante la realización de un TAC con contraste
Visits
6624
S. Millána, X. Gallardob, I. Martin-Loechesc,
Corresponding author
drmartinloeches@gmail.com

Corresponding author.
a Critical Care Centre, Corporació Sanitària i Universitaria Parc Taulí - Hospital de Sabadell, Sabadell, Barcelona, Spain
b Department of Radiology, UDIAT-Centre Diagnostic, Institut Universitari Parc Tauli-UAB, Sabadell, Barcelona, Spain
c Multidisciplinary Intensive Care Research Organization (MICRO), St James's University Hospital, Trinity Centre for Health Sciences, Dublin, Ireland
This item has received
Article information
Full Text
Download PDF
Statistics
Figures (2)
Full Text

A 78-year-old woman with a history of smoking, hypertension, chronic obstructive pulmonary disease, and type 2 diabetes mellitus presented sudden death. After advanced life support, she recovered a pulse. On the EKG, a newly acquired right bundle branch block (RBBB) was detected and she was urgently transferred to the CT scanner to rule out a massive pulmonary embolism. During image acquisition, the patient became hypotensive and suffered another cardiac arrest.

Contrast-enhanced multidetector CT showed “passive” filling of the right cardiac chambers with contrast material occupying the lower part of the chambers.

Retrograde flow of the contrast agent was also observed through the right atrium into the coronary sinus and the great cardiac vein, filling the cardiac veins of the left ventricle (Fig. 1), and from the inferior vena cava into the right hepatic vein and right hepatic lobe (Fig. 2).

Fig. 1.

Contrast in the lower part of the right atrium and ventricle (arrowheads). Retrograde filling of the coronary sinus (*) and cardiac veins of the left ventricle (arrows).

(0.21MB).
Fig. 2.

Retrograde flow of contrast through the inferior vena cava to the right hepatic vein and the most gravity-dependent areas of the right hepatic lobe.

(0.25MB).

These findings are pathognomonic of the absence of blood flow during the procedure.

After 30min advanced life support, the patient died.

Copyright © 2014. Elsevier España, S.L.U. and SEMICYUC
Download PDF
Idiomas
Medicina Intensiva (English Edition)
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?