Images in Medicina Intensiva
Chest ultrasound for guiding lung recruitment maneuvers
Ecografía torácica para guiar maniobras de reclutamiento pulmonar
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A) Área de consolidación que muestra pulmón hepatizado con broncograma aéreo observándose líneas hiperecogénicas paralelas a la pleura en el área consolidada (flecha) y broncograma líquido con zonas hipoecoicas en el área consolidada (asterisco), ausencia de líneas A y refuerzo pleural con derrame pleural que corresponde con patrón de atelectasia. Parámetros respiratorios VAFO: MAP 12, amplitud 40 y frecuencia 9. B) Abundantes líneas B coalescentes (asterisco), que indican abertura de atelectasia con presencia de edema pulmonar. Refuerzo de la ecogenicidad pleural y derrame pleural. Aumento de parámetros respiratorios a MAP: 15, amplitud 50 y frecuencia 8. C) Pulmón reclutado, con parénquima normal; presencia de líneas A (flecha) y escasas líneas B (asterisco). Aumento de parámetros respiratorios a MAP: 18, amplitud 55 y frecuencia 8.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "B. del Rey Hurtado de Mendoza, J. Sanchez-de-Toledo, J. 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Invasion of right maxillary sinus including cystic lesion suggestive of periapical cyst (arrow). Ipsilateral frontal pneumocephalus.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "N. Palomo López, M.D. Freire Aragón, V. Rivera Fernández" "autores" => array:3 [ 0 => array:2 [ "nombre" => "N." "apellidos" => "Palomo López" ] 1 => array:2 [ "nombre" => "M.D." "apellidos" => "Freire Aragón" ] 2 => array:2 [ "nombre" => "V." "apellidos" => "Rivera Fernández" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210569117302152" "doi" => "10.1016/j.medin.2017.07.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569117302152?idApp=WMIE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572718301395?idApp=WMIE" "url" => "/21735727/0000004200000008/v1_201810270616/S2173572718301395/v1_201810270616/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173572718301450" "issn" => "21735727" "doi" => "10.1016/j.medine.2018.07.004" "estado" => "S300" "fechaPublicacion" => "2018-11-01" "aid" => "1085" "copyright" => "Elsevier España, S.L.U. and SEMICYUC" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Med Intensiva. 2018;42:e19" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2069 "formatos" => array:3 [ "EPUB" => 168 "HTML" => 1567 "PDF" => 334 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Intensive Medicine</span>" "titulo" => "Basic sign in lung echography. Liquid and air bronchogram: Differentiation" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "e19" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Signos básicos en ecografía pulmonar. Broncograma líquido y broncograma aéreo: diferenciación" ] ] "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" => 870 "Ancho" => 1200 "Tamanyo" => 85581 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Lung ultrasound showing hypoechogenic pleural effusion (PE), liver (L), and pulmonary parenchyma (PP) with the fluid bronchogram sign (arrows) where the bronchi show lack of air inside.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Montero Baladía, M. Arroyo Diez, O. Badallo Areválo" "autores" => array:3 [ 0 => array:2 [ "nombre" => "M." 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Sanchez-de-Toledo, J. Rodríguez-Fanjul" "autores" => array:3 [ 0 => array:3 [ "nombre" => "B." "apellidos" => "del Rey Hurtado de Mendoza" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "J." "apellidos" => "Sanchez-de-Toledo" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 2 => array:4 [ "nombre" => "J." "apellidos" => "Rodríguez-Fanjul" "email" => array:1 [ 0 => "jrodriguezf@hsjdbcn.org" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Neonatología, BCNatal, Sant Joan de Déu-Hospital Clínic, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Cardiología Pediátrica, Sant Joan de Déu-Hospital Clínic, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Critical Care Medicine Department, University of Pittsburgh, Pittsburgh, PA, United States" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Ecografía torácica para guiar maniobras de reclutamiento pulmonar" ] ] "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" => 797 "Ancho" => 2533 "Tamanyo" => 196196 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Thoracic ultrasound scans of the patient's left lung. (A) Area of consolidation showing hepatized lungs with aerial bronchogram showing hyperechogenic lines parallel to the pleura in the consolidated area (arrow) and fluid bronchogram with hyperechoic zones in the consolidated area (asterisk), lack of A lines and pleural reinforcement with pleural effusion consistent with a pattern of atelectasis. HFOV respiratory parameters: MAP 12, amplitude 40 and frequency 9. (B) Abundant coalescent B lines (asterisk) indicative of opening of atelectasis in the presence of pulmonary edema. Reinforcement of pleural echogenicity and pleural effusion. Increased respiratory parameters to MAP: 15, amplitude 50 and frequency 8. (C) Lung recruitment with normal parenchyma; presence of A lines (arrow) and scarce B lines (asterisk). Increased respiratory parameters to MAP: 18, amplitude 55 and frequency 8.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">New-born infants with left congenital diaphragmatic hernia require therapy with veno-venous extracorporeal membrane oxygenation (ECMO) due to pulmonary hypertensive crisis. Forty-eight hours after receiving ECMO therapy, the patient's respiratory parameters get worse and a diagnosis of left lung atelectasis is confirmed (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> A) that resolves successfully through thoracic ultrasound-guided alveolar recruitment maneuvers at the patient's bedside (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B and C).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: del Rey Hurtado de Mendoza B, Sanchez-de-Toledo J, Rodríguez-Fanjul J. Ecografía torácica para guiar maniobras de reclutamiento pulmonar. Med Intens. 2018;42:e20.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 797 "Ancho" => 2533 "Tamanyo" => 196196 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Thoracic ultrasound scans of the patient's left lung. (A) Area of consolidation showing hepatized lungs with aerial bronchogram showing hyperechogenic lines parallel to the pleura in the consolidated area (arrow) and fluid bronchogram with hyperechoic zones in the consolidated area (asterisk), lack of A lines and pleural reinforcement with pleural effusion consistent with a pattern of atelectasis. HFOV respiratory parameters: MAP 12, amplitude 40 and frequency 9. (B) Abundant coalescent B lines (asterisk) indicative of opening of atelectasis in the presence of pulmonary edema. Reinforcement of pleural echogenicity and pleural effusion. Increased respiratory parameters to MAP: 15, amplitude 50 and frequency 8. (C) Lung recruitment with normal parenchyma; presence of A lines (arrow) and scarce B lines (asterisk). Increased respiratory parameters to MAP: 18, amplitude 55 and frequency 8.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735727/0000004200000008/v1_201810270616/S2173572718301462/v1_201810270616/en/main.assets" "Apartado" => array:4 [ "identificador" => "64602" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Intensive Medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735727/0000004200000008/v1_201810270616/S2173572718301462/v1_201810270616/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572718301462?idApp=WMIE" ]
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