array:24 [
  "pii" => "S2173572719300700"
  "issn" => "21735727"
  "doi" => "10.1016/j.medine.2018.08.005"
  "estado" => "S300"
  "fechaPublicacion" => "2019-05-01"
  "aid" => "1258"
  "copyrightAnyo" => "2019"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "cor"
  "cita" => "Med Intensiva. 2019;43:256"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 319
    "formatos" => array:3 [
      "EPUB" => 49
      "HTML" => 183
      "PDF" => 87
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:18 [
      "pii" => "S0210569118302535"
      "issn" => "02105691"
      "doi" => "10.1016/j.medin.2018.08.006"
      "estado" => "S300"
      "fechaPublicacion" => "2019-05-01"
      "aid" => "1258"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "cor"
      "cita" => "Med Intensiva. 2019;43:256"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 911
        "formatos" => array:3 [
          "EPUB" => 125
          "HTML" => 554
          "PDF" => 232
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>"
        "titulo" => "En respuesta a &#171;Factores de confusi&#243;n en el an&#225;lisis del registro de ecograf&#237;a d&#250;plex transcraneal codificado color&#187;"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:1 [
            "paginaInicial" => "256"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "In reply to &#8220;Bias in the interpretation of the transcranial color-coded duplex sonography register&#8221;"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "M&#46; Arroyo Diez, A&#46; Zabalegui P&#233;rez, G&#46; Kaminsky, E&#46;M&#46; P&#233;rez Cabo"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Arroyo Diez"
              ]
              1 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Zabalegui P&#233;rez"
              ]
              2 => array:2 [
                "nombre" => "G&#46;"
                "apellidos" => "Kaminsky"
              ]
              3 => array:2 [
                "nombre" => "E&#46;M&#46;"
                "apellidos" => "P&#233;rez Cabo"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173572719300700"
          "doi" => "10.1016/j.medine.2018.08.005"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719300700?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569118302535?idApp=WMIE"
      "url" => "/02105691/0000004300000004/v4_201907180823/S0210569118302535/v4_201907180823/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2173572719300608"
    "issn" => "21735727"
    "doi" => "10.1016/j.medine.2019.03.005"
    "estado" => "S300"
    "fechaPublicacion" => "2019-05-01"
    "aid" => "1219"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Med Intensiva. 2019;43:257"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 434
      "formatos" => array:3 [
        "EPUB" => 75
        "HTML" => 238
        "PDF" => 121
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Images in Intensive Medicine</span>"
      "titulo" => "Recurrent subdural hematoma"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "257"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Hematoma subdural de repetici&#243;n"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:6 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 722
              "Ancho" => 950
              "Tamanyo" => 86100
            ]
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46; S&#225;nchez Arguiano, M&#46; Arlab&#225;n Carpintero, Y&#46; Pe&#241;asco Mart&#237;n"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "S&#225;nchez Arguiano"
            ]
            1 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Arlab&#225;n Carpintero"
            ]
            2 => array:2 [
              "nombre" => "Y&#46;"
              "apellidos" => "Pe&#241;asco Mart&#237;n"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S021056911830158X"
        "doi" => "10.1016/j.medin.2018.04.011"
        "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/S021056911830158X?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719300608?idApp=WMIE"
    "url" => "/21735727/0000004300000004/v2_201905020913/S2173572719300608/v2_201905020913/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2173572719300694"
    "issn" => "21735727"
    "doi" => "10.1016/j.medine.2018.07.013"
    "estado" => "S300"
    "fechaPublicacion" => "2019-05-01"
    "aid" => "1233"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Med Intensiva. 2019;43:255"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 353
      "formatos" => array:3 [
        "EPUB" => 52
        "HTML" => 198
        "PDF" => 103
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Bias in the interpretation of the transcranial color-coded duplex sonography register"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "255"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Factores de confusi&#243;n en el an&#225;lisis del registro de ecograf&#237;a d&#250;plex transcraneal codificado color"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "N&#46;S&#46; Rocchetti, J&#46;J&#46; Egea-Guerrero"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "N&#46;S&#46;"
              "apellidos" => "Rocchetti"
            ]
            1 => array:2 [
              "nombre" => "J&#46;J&#46;"
              "apellidos" => "Egea-Guerrero"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0210569118301888"
        "doi" => "10.1016/j.medin.2018.07.002"
        "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/S0210569118301888?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719300694?idApp=WMIE"
    "url" => "/21735727/0000004300000004/v2_201905020913/S2173572719300694/v2_201905020913/en/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:19 [
      "pii" => "S2173572719300694"
      "issn" => "21735727"
      "doi" => "10.1016/j.medine.2018.07.013"
      "estado" => "S300"
      "fechaPublicacion" => "2019-05-01"
      "aid" => "1233"
      "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "cor"
      "cita" => "Med Intensiva. 2019;43:255"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 353
        "formatos" => array:3 [
          "EPUB" => 52
          "HTML" => 198
          "PDF" => 103
        ]
      ]
      "en" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
        "titulo" => "Bias in the interpretation of the transcranial color-coded duplex sonography register"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:1 [
            "paginaInicial" => "255"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Factores de confusi&#243;n en el an&#225;lisis del registro de ecograf&#237;a d&#250;plex transcraneal codificado color"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "N&#46;S&#46; Rocchetti, J&#46;J&#46; Egea-Guerrero"
            "autores" => array:2 [
              0 => array:2 [
                "nombre" => "N&#46;S&#46;"
                "apellidos" => "Rocchetti"
              ]
              1 => array:2 [
                "nombre" => "J&#46;J&#46;"
                "apellidos" => "Egea-Guerrero"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "es" => array:9 [
          "pii" => "S0210569118301888"
          "doi" => "10.1016/j.medin.2018.07.002"
          "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/S0210569118301888?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719300694?idApp=WMIE"
      "url" => "/21735727/0000004300000004/v2_201905020913/S2173572719300694/v2_201905020913/en/main.assets"
    ]
  ]
  "en" => array:13 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "In reply to &#8220;Bias in the interpretation of the transcranial color-coded duplex sonography register&#8221;"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#44;"
    "paginas" => array:1 [
      0 => array:1 [
        "paginaInicial" => "256"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "M&#46; Arroyo Diez, A&#46; Zabalegui P&#233;rez, G&#46; Kaminsky, E&#46;M&#46; P&#233;rez Cabo"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "M&#46;"
            "apellidos" => "Arroyo Diez"
            "email" => array:1 [
              0 => "martaarroyo84&#64;hotmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Zabalegui P&#233;rez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "G&#46;"
            "apellidos" => "Kaminsky"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "E&#46;M&#46;"
            "apellidos" => "P&#233;rez Cabo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servicio de Medicina Intensiva&#44; Hospital Universitario de Burgos&#44; Burgos&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Medicina Intensiva&#44; Hospital Universitario de Fuenlabrada&#44; Fuenlabrada&#44; Madrid&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "En respuesta a &#171;Factores de confusi&#243;n en el an&#225;lisis del registro de ecograf&#237;a d&#250;plex transcraneal codificado color&#187;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We wish to thank the interest shown by Rochetti and Egea-Guerrero<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> toward our paper &#8220;<span class="elsevierStyleItalic">Desaparici&#243;n del flujo diast&#243;lico cerebral tras una complicaci&#243;n inesperada</span>&#8221;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> &#40;Disappearance of diastolic flow after unexpected complication&#41; and their interesting comments made since this allows us to have much more information on the clinical case that&#44; due to the limited space of the section &#8220;Images in Medicina Intensiva&#8221; we could not provide&#46; We wish to expose the case in detail and analyze the comments made by these authors&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Female patient admitted to the ICU diagnosed with left parietal-occipital transtentorial tumor &#40;postoperative biopsy&#58; atypical meningioma&#41; with peripheral edema and signs of intratumor subacute hemorrhage&#46; Four days later the patient presents impaired cognitive level &#40;GCS 3&#41; and right mydriasis that requires intubation&#44; invasive mechanical ventilation &#40;IMV&#41;&#44; and venous catheter &#40;VC&#41; canalization through the subclavian&#46; The cranial CT scan rules out re-bleeding and confirms the presence of extensive perilesional edema and mass effect on neighboring structures&#46; We keep osmotherapy and timely moderate hyperventilation&#46; Then we proceed to implant an ICP sensor that reveals pressure values of 65<span class="elsevierStyleHsp" style=""></span>mmHg&#44; which is not consistent with the findings from the CT scan&#44; but still verified through calibration on two occasions&#46; The anomalous flow pattern &#40;lack of diastolic flow&#41; seen at the color-coded duplex sonography &#40;CCDS&#41; and the progressive decline of the BIS value down to 0 confirm the clinical urgency&#46; A chest X-ray is performed &#40;which was pending after the insertion of the catheter and delayed for priority reasons&#41; showing tension pneumothorax that is immediately drained to eventually reverse the parameters of poor prognosis described&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">As Rochetti and Egea-Guerrero<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> say&#44; for the correct interpretation of the brain blood flow parameters seen at the CCDS&#44; the patient&#39;s hemodynamic and respiratory situation &#40;concept of self-regulation and brain vasoreactivity&#41; plays a key role here&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">3&#8211;5</span></a> Although it is true that the patient showed neurological instability &#40;both pre- and post-implantation of the VC&#41; with limited episodes of reduced GCS&#44; and hemodynamic instability &#40;with fluctuating HR and BP&#41;&#44; she was scrutinized&#44; at all time&#44; through state-of-the-art monitoring modalities with optimization of fluid therapy and vasoactive drugs&#46; While both CCDSs were being conducted&#44; the patient remained normotensive and normoventilated&#46; It is obvious that had we seen hemodynamic or respiratory changes&#44; hyperthermia&#44; anemia&#44; or any other significant alterations affecting the brain blood flow&#44; these changes would have been described and detailed in our paper&#46; Due to the aforementioned space constraints&#44; such information was taken for granted and&#44; therefore&#44; overlooked&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The respiratory auscultation that followed the insertion of the VC was conducted according to the protocol from our unit but&#44; in this case&#44; it did not reveal unilateral hypoventilation&#44; altered HR&#44; or significant hypoxia&#46; We should not forget&#44; however&#44; that the patient had just been intubated and connected to IMV&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">With this letter we wish to show how a non-invasive imaging modality like the CCDS can help us detect and&#47;or confirm urgent situations &#40;if rearranged to look for origin&#44; severity&#44; and therapeutic possibilities&#41; and assess the responses to the therapy administered&#46; Similarly&#44; it is important to raise all intensivists&#8217; awareness on the CCDS imaging modality since it is always available and help us interpret the situation of neurocritical patients&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar10005">Please cite this article as&#58; Arroyo Diez M&#44; Zabalegui P&#233;rez A&#44; Kaminsky G&#44; P&#233;rez Cabo EM&#46; En respuesta a &#171;Factores de confusi&#243;n en el an&#225;lisis del registro de ecograf&#237;a d&#250;plex transcraneal codificado color&#187;&#46; Med Intensiva&#46; 2019&#59;43&#58;256&#46;</p>"
      ]
      1 => array:1 [
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">SEE RELATED ARTICLE&#58; <a class="elsevierStyleInterRef" target="_blank" id="intr0010" href="https://doi.org/10.1016/j.medine.2018.07.013">https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1016&#47;j&#46;medine&#46;2018&#46;07&#46;013</a></p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:6 [
            0 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factores de confusi&#243;n en el an&#225;lisis del registro de ecograf&#237;a d&#250;plex transcraneal codificado color"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "N&#46;S&#46; Rocchetti"
                            1 => "J&#46;J&#46; Egea-Guerrero"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Med Intensiva"
                        "fecha" => "2019"
                        "volumen" => "43"
                        "paginaInicial" => "255"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Desaparici&#243;n del flujo diast&#243;lico cerebral tras una complicaci&#243;n inesperada"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Arroyo Diez"
                            1 => "A&#46; Zabalegui Perez"
                            2 => "G&#46; Kaminsky"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Med Intensiva"
                        "fecha" => "2019"
                        "volumen" => "43"
                        "paginaInicial" => "259"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Aplicaciones del D&#250;plex Transcraneal Codificado en color en la monitorizaci&#243;n del enfermo neurocr&#237;tico"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;M&#46; Abadal"
                            1 => "J&#46;A&#46; Llompart-Pou"
                            2 => "J&#46; Homar"
                            3 => "J&#46; P&#233;rez-B&#225;rcena"
                            4 => "J&#46; Ib&#225;&#241;ez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Intensiva"
                        "fecha" => "2007"
                        "volumen" => "31"
                        "paginaInicial" => "510"
                        "paginaFinal" => "517"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18039451"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Noninvasive transcraneal Doppler Ultrasound recording of flow velocity in basal cerebral arteries"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Aaslid"
                            1 => "T&#46;M&#46; Markwalder"
                            2 => "H&#46; Nornes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1982.57.6.0769"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1982"
                        "volumen" => "57"
                        "paginaInicial" => "769"
                        "paginaFinal" => "774"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7143059"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "discussion 375&#8211;6"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Transcranial Doppler identification of changing autoregulatory thresholds after autoregulatory impairment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46;B&#46; Lewis"
                            1 => "M&#46;L&#46; Wong"
                            2 => "P&#46;E&#46; Bannan"
                            3 => "I&#46;R&#46; Piper"
                            4 => "P&#46;L&#46; Reilly"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2001"
                        "volumen" => "48"
                        "paginaInicial" => "369"
                        "paginaFinal" => "375"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11220381"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Transcranial Doppler after traumatic brain injury&#58; is there a role&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Bouzat"
                            1 => "M&#46; Oddo"
                            2 => "J&#46;F&#46; Payen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Curr Opin Crit Care"
                        "fecha" => "2014"
                        "volumen" => "20"
                        "paginaInicial" => "153"
                        "paginaFinal" => "160"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735727/0000004300000004/v2_201905020913/S2173572719300700/v2_201905020913/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "64604"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Letters to the Editor"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735727/0000004300000004/v2_201905020913/S2173572719300700/v2_201905020913/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719300700?idApp=WMIE"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Letter to the Editor
In reply to “Bias in the interpretation of the transcranial color-coded duplex sonography register”
En respuesta a «Factores de confusión en el análisis del registro de ecografía dúplex transcraneal codificado color»
M. Arroyo Dieza,
Corresponding author
martaarroyo84@hotmail.com

Corresponding author.
, A. Zabalegui Péreza, G. Kaminskyb, E.M. Pérez Caboa
a Servicio de Medicina Intensiva, Hospital Universitario de Burgos, Burgos, Spain
b Servicio de Medicina Intensiva, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
Read
3911
Times
was read the article
1741
Total PDF
2170
Total HTML
Share statistics
 array:24 [
  "pii" => "S2173572719300700"
  "issn" => "21735727"
  "doi" => "10.1016/j.medine.2018.08.005"
  "estado" => "S300"
  "fechaPublicacion" => "2019-05-01"
  "aid" => "1258"
  "copyrightAnyo" => "2019"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "cor"
  "cita" => "Med Intensiva. 2019;43:256"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 319
    "formatos" => array:3 [
      "EPUB" => 49
      "HTML" => 183
      "PDF" => 87
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:18 [
      "pii" => "S0210569118302535"
      "issn" => "02105691"
      "doi" => "10.1016/j.medin.2018.08.006"
      "estado" => "S300"
      "fechaPublicacion" => "2019-05-01"
      "aid" => "1258"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "cor"
      "cita" => "Med Intensiva. 2019;43:256"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 911
        "formatos" => array:3 [
          "EPUB" => 125
          "HTML" => 554
          "PDF" => 232
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>"
        "titulo" => "En respuesta a &#171;Factores de confusi&#243;n en el an&#225;lisis del registro de ecograf&#237;a d&#250;plex transcraneal codificado color&#187;"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:1 [
            "paginaInicial" => "256"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "In reply to &#8220;Bias in the interpretation of the transcranial color-coded duplex sonography register&#8221;"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "M&#46; Arroyo Diez, A&#46; Zabalegui P&#233;rez, G&#46; Kaminsky, E&#46;M&#46; P&#233;rez Cabo"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Arroyo Diez"
              ]
              1 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Zabalegui P&#233;rez"
              ]
              2 => array:2 [
                "nombre" => "G&#46;"
                "apellidos" => "Kaminsky"
              ]
              3 => array:2 [
                "nombre" => "E&#46;M&#46;"
                "apellidos" => "P&#233;rez Cabo"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173572719300700"
          "doi" => "10.1016/j.medine.2018.08.005"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719300700?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569118302535?idApp=WMIE"
      "url" => "/02105691/0000004300000004/v4_201907180823/S0210569118302535/v4_201907180823/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2173572719300608"
    "issn" => "21735727"
    "doi" => "10.1016/j.medine.2019.03.005"
    "estado" => "S300"
    "fechaPublicacion" => "2019-05-01"
    "aid" => "1219"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Med Intensiva. 2019;43:257"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 434
      "formatos" => array:3 [
        "EPUB" => 75
        "HTML" => 238
        "PDF" => 121
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Images in Intensive Medicine</span>"
      "titulo" => "Recurrent subdural hematoma"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "257"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Hematoma subdural de repetici&#243;n"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:6 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 722
              "Ancho" => 950
              "Tamanyo" => 86100
            ]
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46; S&#225;nchez Arguiano, M&#46; Arlab&#225;n Carpintero, Y&#46; Pe&#241;asco Mart&#237;n"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "S&#225;nchez Arguiano"
            ]
            1 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Arlab&#225;n Carpintero"
            ]
            2 => array:2 [
              "nombre" => "Y&#46;"
              "apellidos" => "Pe&#241;asco Mart&#237;n"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S021056911830158X"
        "doi" => "10.1016/j.medin.2018.04.011"
        "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/S021056911830158X?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719300608?idApp=WMIE"
    "url" => "/21735727/0000004300000004/v2_201905020913/S2173572719300608/v2_201905020913/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2173572719300694"
    "issn" => "21735727"
    "doi" => "10.1016/j.medine.2018.07.013"
    "estado" => "S300"
    "fechaPublicacion" => "2019-05-01"
    "aid" => "1233"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Med Intensiva. 2019;43:255"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 353
      "formatos" => array:3 [
        "EPUB" => 52
        "HTML" => 198
        "PDF" => 103
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Bias in the interpretation of the transcranial color-coded duplex sonography register"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "255"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Factores de confusi&#243;n en el an&#225;lisis del registro de ecograf&#237;a d&#250;plex transcraneal codificado color"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "N&#46;S&#46; Rocchetti, J&#46;J&#46; Egea-Guerrero"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "N&#46;S&#46;"
              "apellidos" => "Rocchetti"
            ]
            1 => array:2 [
              "nombre" => "J&#46;J&#46;"
              "apellidos" => "Egea-Guerrero"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0210569118301888"
        "doi" => "10.1016/j.medin.2018.07.002"
        "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/S0210569118301888?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719300694?idApp=WMIE"
    "url" => "/21735727/0000004300000004/v2_201905020913/S2173572719300694/v2_201905020913/en/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:19 [
      "pii" => "S2173572719300694"
      "issn" => "21735727"
      "doi" => "10.1016/j.medine.2018.07.013"
      "estado" => "S300"
      "fechaPublicacion" => "2019-05-01"
      "aid" => "1233"
      "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "cor"
      "cita" => "Med Intensiva. 2019;43:255"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 353
        "formatos" => array:3 [
          "EPUB" => 52
          "HTML" => 198
          "PDF" => 103
        ]
      ]
      "en" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
        "titulo" => "Bias in the interpretation of the transcranial color-coded duplex sonography register"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:1 [
            "paginaInicial" => "255"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Factores de confusi&#243;n en el an&#225;lisis del registro de ecograf&#237;a d&#250;plex transcraneal codificado color"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "N&#46;S&#46; Rocchetti, J&#46;J&#46; Egea-Guerrero"
            "autores" => array:2 [
              0 => array:2 [
                "nombre" => "N&#46;S&#46;"
                "apellidos" => "Rocchetti"
              ]
              1 => array:2 [
                "nombre" => "J&#46;J&#46;"
                "apellidos" => "Egea-Guerrero"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "es" => array:9 [
          "pii" => "S0210569118301888"
          "doi" => "10.1016/j.medin.2018.07.002"
          "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/S0210569118301888?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719300694?idApp=WMIE"
      "url" => "/21735727/0000004300000004/v2_201905020913/S2173572719300694/v2_201905020913/en/main.assets"
    ]
  ]
  "en" => array:13 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "In reply to &#8220;Bias in the interpretation of the transcranial color-coded duplex sonography register&#8221;"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#44;"
    "paginas" => array:1 [
      0 => array:1 [
        "paginaInicial" => "256"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "M&#46; Arroyo Diez, A&#46; Zabalegui P&#233;rez, G&#46; Kaminsky, E&#46;M&#46; P&#233;rez Cabo"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "M&#46;"
            "apellidos" => "Arroyo Diez"
            "email" => array:1 [
              0 => "martaarroyo84&#64;hotmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Zabalegui P&#233;rez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "G&#46;"
            "apellidos" => "Kaminsky"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "E&#46;M&#46;"
            "apellidos" => "P&#233;rez Cabo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Servicio de Medicina Intensiva&#44; Hospital Universitario de Burgos&#44; Burgos&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Medicina Intensiva&#44; Hospital Universitario de Fuenlabrada&#44; Fuenlabrada&#44; Madrid&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "En respuesta a &#171;Factores de confusi&#243;n en el an&#225;lisis del registro de ecograf&#237;a d&#250;plex transcraneal codificado color&#187;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We wish to thank the interest shown by Rochetti and Egea-Guerrero<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> toward our paper &#8220;<span class="elsevierStyleItalic">Desaparici&#243;n del flujo diast&#243;lico cerebral tras una complicaci&#243;n inesperada</span>&#8221;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> &#40;Disappearance of diastolic flow after unexpected complication&#41; and their interesting comments made since this allows us to have much more information on the clinical case that&#44; due to the limited space of the section &#8220;Images in Medicina Intensiva&#8221; we could not provide&#46; We wish to expose the case in detail and analyze the comments made by these authors&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Female patient admitted to the ICU diagnosed with left parietal-occipital transtentorial tumor &#40;postoperative biopsy&#58; atypical meningioma&#41; with peripheral edema and signs of intratumor subacute hemorrhage&#46; Four days later the patient presents impaired cognitive level &#40;GCS 3&#41; and right mydriasis that requires intubation&#44; invasive mechanical ventilation &#40;IMV&#41;&#44; and venous catheter &#40;VC&#41; canalization through the subclavian&#46; The cranial CT scan rules out re-bleeding and confirms the presence of extensive perilesional edema and mass effect on neighboring structures&#46; We keep osmotherapy and timely moderate hyperventilation&#46; Then we proceed to implant an ICP sensor that reveals pressure values of 65<span class="elsevierStyleHsp" style=""></span>mmHg&#44; which is not consistent with the findings from the CT scan&#44; but still verified through calibration on two occasions&#46; The anomalous flow pattern &#40;lack of diastolic flow&#41; seen at the color-coded duplex sonography &#40;CCDS&#41; and the progressive decline of the BIS value down to 0 confirm the clinical urgency&#46; A chest X-ray is performed &#40;which was pending after the insertion of the catheter and delayed for priority reasons&#41; showing tension pneumothorax that is immediately drained to eventually reverse the parameters of poor prognosis described&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">As Rochetti and Egea-Guerrero<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> say&#44; for the correct interpretation of the brain blood flow parameters seen at the CCDS&#44; the patient&#39;s hemodynamic and respiratory situation &#40;concept of self-regulation and brain vasoreactivity&#41; plays a key role here&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">3&#8211;5</span></a> Although it is true that the patient showed neurological instability &#40;both pre- and post-implantation of the VC&#41; with limited episodes of reduced GCS&#44; and hemodynamic instability &#40;with fluctuating HR and BP&#41;&#44; she was scrutinized&#44; at all time&#44; through state-of-the-art monitoring modalities with optimization of fluid therapy and vasoactive drugs&#46; While both CCDSs were being conducted&#44; the patient remained normotensive and normoventilated&#46; It is obvious that had we seen hemodynamic or respiratory changes&#44; hyperthermia&#44; anemia&#44; or any other significant alterations affecting the brain blood flow&#44; these changes would have been described and detailed in our paper&#46; Due to the aforementioned space constraints&#44; such information was taken for granted and&#44; therefore&#44; overlooked&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The respiratory auscultation that followed the insertion of the VC was conducted according to the protocol from our unit but&#44; in this case&#44; it did not reveal unilateral hypoventilation&#44; altered HR&#44; or significant hypoxia&#46; We should not forget&#44; however&#44; that the patient had just been intubated and connected to IMV&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">With this letter we wish to show how a non-invasive imaging modality like the CCDS can help us detect and&#47;or confirm urgent situations &#40;if rearranged to look for origin&#44; severity&#44; and therapeutic possibilities&#41; and assess the responses to the therapy administered&#46; Similarly&#44; it is important to raise all intensivists&#8217; awareness on the CCDS imaging modality since it is always available and help us interpret the situation of neurocritical patients&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar10005">Please cite this article as&#58; Arroyo Diez M&#44; Zabalegui P&#233;rez A&#44; Kaminsky G&#44; P&#233;rez Cabo EM&#46; En respuesta a &#171;Factores de confusi&#243;n en el an&#225;lisis del registro de ecograf&#237;a d&#250;plex transcraneal codificado color&#187;&#46; Med Intensiva&#46; 2019&#59;43&#58;256&#46;</p>"
      ]
      1 => array:1 [
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">SEE RELATED ARTICLE&#58; <a class="elsevierStyleInterRef" target="_blank" id="intr0010" href="https://doi.org/10.1016/j.medine.2018.07.013">https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1016&#47;j&#46;medine&#46;2018&#46;07&#46;013</a></p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:6 [
            0 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factores de confusi&#243;n en el an&#225;lisis del registro de ecograf&#237;a d&#250;plex transcraneal codificado color"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "N&#46;S&#46; Rocchetti"
                            1 => "J&#46;J&#46; Egea-Guerrero"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Med Intensiva"
                        "fecha" => "2019"
                        "volumen" => "43"
                        "paginaInicial" => "255"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Desaparici&#243;n del flujo diast&#243;lico cerebral tras una complicaci&#243;n inesperada"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Arroyo Diez"
                            1 => "A&#46; Zabalegui Perez"
                            2 => "G&#46; Kaminsky"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Med Intensiva"
                        "fecha" => "2019"
                        "volumen" => "43"
                        "paginaInicial" => "259"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Aplicaciones del D&#250;plex Transcraneal Codificado en color en la monitorizaci&#243;n del enfermo neurocr&#237;tico"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;M&#46; Abadal"
                            1 => "J&#46;A&#46; Llompart-Pou"
                            2 => "J&#46; Homar"
                            3 => "J&#46; P&#233;rez-B&#225;rcena"
                            4 => "J&#46; Ib&#225;&#241;ez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Intensiva"
                        "fecha" => "2007"
                        "volumen" => "31"
                        "paginaInicial" => "510"
                        "paginaFinal" => "517"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18039451"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Noninvasive transcraneal Doppler Ultrasound recording of flow velocity in basal cerebral arteries"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Aaslid"
                            1 => "T&#46;M&#46; Markwalder"
                            2 => "H&#46; Nornes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1982.57.6.0769"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1982"
                        "volumen" => "57"
                        "paginaInicial" => "769"
                        "paginaFinal" => "774"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7143059"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "discussion 375&#8211;6"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Transcranial Doppler identification of changing autoregulatory thresholds after autoregulatory impairment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46;B&#46; Lewis"
                            1 => "M&#46;L&#46; Wong"
                            2 => "P&#46;E&#46; Bannan"
                            3 => "I&#46;R&#46; Piper"
                            4 => "P&#46;L&#46; Reilly"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "2001"
                        "volumen" => "48"
                        "paginaInicial" => "369"
                        "paginaFinal" => "375"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11220381"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Transcranial Doppler after traumatic brain injury&#58; is there a role&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Bouzat"
                            1 => "M&#46; Oddo"
                            2 => "J&#46;F&#46; Payen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Curr Opin Crit Care"
                        "fecha" => "2014"
                        "volumen" => "20"
                        "paginaInicial" => "153"
                        "paginaFinal" => "160"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735727/0000004300000004/v2_201905020913/S2173572719300700/v2_201905020913/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "64604"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Letters to the Editor"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735727/0000004300000004/v2_201905020913/S2173572719300700/v2_201905020913/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719300700?idApp=WMIE"
]
Article information
ISSN: 21735727
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 4 9 13
2024 October 46 32 78
2024 September 44 30 74
2024 August 43 30 73
2024 July 37 30 67
2024 June 38 37 75
2024 May 41 26 67
2024 April 28 37 65
2024 March 34 16 50
2024 February 37 31 68
2024 January 30 30 60
2023 December 21 36 57
2023 November 32 44 76
2023 October 30 31 61
2023 September 25 37 62
2023 August 19 22 41
2023 July 32 20 52
2023 June 20 14 34
2023 May 28 27 55
2023 April 16 18 34
2023 March 31 31 62
2023 February 35 32 67
2023 January 31 10 41
2022 December 40 21 61
2022 November 30 28 58
2022 October 47 26 73
2022 September 30 26 56
2022 August 33 46 79
2022 July 28 40 68
2022 June 28 21 49
2022 May 24 25 49
2022 April 24 40 64
2022 March 32 51 83
2022 February 27 27 54
2022 January 28 35 63
2021 December 39 38 77
2021 November 26 29 55
2021 October 49 70 119
2021 September 27 28 55
2021 August 23 28 51
2021 July 22 20 42
2021 June 27 26 53
2021 May 32 44 76
2021 April 64 95 159
2021 March 45 34 79
2021 February 31 26 57
2021 January 36 23 59
2020 December 34 17 51
2020 November 27 17 44
2020 October 26 26 52
2020 September 80 22 102
2020 August 86 21 107
2020 July 77 23 100
2020 June 31 15 46
2020 May 41 12 53
2020 April 38 10 48
2020 March 35 8 43
2020 February 65 24 89
2020 January 55 15 70
2019 December 29 15 44
2019 November 24 20 44
2019 October 28 14 42
2019 August 0 0 0
2019 May 0 5 5
Show all

Follow this link to access the full text of the article

Idiomas
Medicina Intensiva (English Edition)
es en

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

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