array:24 [
  "pii" => "S2173572719301456"
  "issn" => "21735727"
  "doi" => "10.1016/j.medine.2019.01.008"
  "estado" => "S300"
  "fechaPublicacion" => "2019-11-01"
  "aid" => "1305"
  "copyright" => "Elsevier España, S.L.U. and SEMICYUC"
  "copyrightAnyo" => "2019"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "cor"
  "cita" => "Med Intensiva. 2019;43:513"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2
    "HTML" => 2
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0210569119300178"
      "issn" => "02105691"
      "doi" => "10.1016/j.medin.2019.01.001"
      "estado" => "S300"
      "fechaPublicacion" => "2019-11-01"
      "aid" => "1305"
      "copyright" => "Elsevier España, S.L.U. y SEMICYUC"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "cor"
      "cita" => "Med Intensiva. 2019;43:513"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 294
        "formatos" => array:3 [
          "EPUB" => 12
          "HTML" => 232
          "PDF" => 50
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>"
        "titulo" => "Ingenier&#237;a de materiales&#44; <span class="elsevierStyleItalic">mechanical power&#44;</span> ventilaci&#243;n protectora y una de paraca&#237;das"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:1 [
            "paginaInicial" => "513"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Materials engineering&#44; mechanical power&#44; protective ventilation and a parachute"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "P&#46; Escudero-Acha, A&#46; Gonz&#225;lez-Castro, Y&#46; Pe&#241;asco, M&#46; Feo-Gonzalez"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "P&#46;"
                "apellidos" => "Escudero-Acha"
              ]
              1 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Gonz&#225;lez-Castro"
              ]
              2 => array:2 [
                "nombre" => "Y&#46;"
                "apellidos" => "Pe&#241;asco"
              ]
              3 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Feo-Gonzalez"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173572719301456"
          "doi" => "10.1016/j.medine.2019.01.008"
          "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/S2173572719301456?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569119300178?idApp=WMIE"
      "url" => "/02105691/0000004300000008/v1_201910220814/S0210569119300178/v1_201910220814/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2173572719301468"
    "issn" => "21735727"
    "doi" => "10.1016/j.medine.2019.01.009"
    "estado" => "S300"
    "fechaPublicacion" => "2019-11-01"
    "aid" => "1312"
    "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;43:514-5"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2
      "HTML" => 2
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Reply to &#8220;Materials engineering&#44; mechanical power&#44; protective ventilation and a parachute&#8221;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "514"
          "paginaFinal" => "515"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Respuesta a &#171;Ingenier&#237;a de materiales&#44; <span class="elsevierStyleItalic">mechanical power</span>&#44; ventilaci&#243;n protectora y una de paraca&#237;das&#187;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "V&#46; Modesto i Alapont, M&#46; Aguar Carrascosa, A&#46; Medina"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "V&#46;"
              "apellidos" => "Modesto i Alapont"
            ]
            1 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Aguar Carrascosa"
            ]
            2 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Medina"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0210569119300385"
        "doi" => "10.1016/j.medin.2019.01.007"
        "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/S0210569119300385?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719301468?idApp=WMIE"
    "url" => "/21735727/0000004300000008/v1_201910261026/S2173572719301468/v1_201910261026/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2173572719301845"
    "issn" => "21735727"
    "doi" => "10.1016/j.medine.2018.09.015"
    "estado" => "S300"
    "fechaPublicacion" => "2019-11-01"
    "aid" => "1282"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Med Intensiva. 2019;43:510-2"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2
      "HTML" => 2
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
      "titulo" => "Lymphopenic hospital acquired sepsis &#40;L-HAS&#41;&#58; An immunological phenotype conferring higher risk of mortality"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "510"
          "paginaFinal" => "512"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Sepsis nosocomial linfop&#233;nica&#58; un fenotipo inmunol&#243;gico que confiere un mayor riesgo de mortalidad"
        ]
      ]
      "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" => 1386
              "Ancho" => 1583
              "Tamanyo" => 63336
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Kaplan&#8211;Meier survival curve&#46; Groups were compared by the log rank test &#40;Mantel&#8211;Henzel&#41;&#46; Circulating Lymphocyte Count &#40;CLC&#41; at HAS diagnosis were divided in two groups&#44; &#8804;775<span class="elsevierStyleHsp" style=""></span>lymphocytes&#47;mm<span class="elsevierStyleSup">3</span> and greater&#46; Time was censored at 90 days following HAS diagnosis&#46; Cum&#58; cumulative&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "C&#46; L&#243;pez-Mestanza, D&#46; Andaluz-Ojeda, J&#46;R&#46; G&#243;mez-L&#243;pez, J&#46;F&#46; Bermejo-Mart&#237;n"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "L&#243;pez-Mestanza"
            ]
            1 => array:2 [
              "nombre" => "D&#46;"
              "apellidos" => "Andaluz-Ojeda"
            ]
            2 => array:2 [
              "nombre" => "J&#46;R&#46;"
              "apellidos" => "G&#243;mez-L&#243;pez"
            ]
            3 => array:2 [
              "nombre" => "J&#46;F&#46;"
              "apellidos" => "Bermejo-Mart&#237;n"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719301845?idApp=WMIE"
    "url" => "/21735727/0000004300000008/v1_201910261026/S2173572719301845/v1_201910261026/en/main.assets"
  ]
  "en" => array:13 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "Materials engineering&#44; mechanical power&#44; protective ventilation and a parachute"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#58;"
    "paginas" => array:1 [
      0 => array:1 [
        "paginaInicial" => "513"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "P&#46; Escudero-Acha, A&#46; Gonz&#225;lez-Castro, Y&#46; Pe&#241;asco, M&#46; Feo-Gonzalez"
        "autores" => array:4 [
          0 => array:2 [
            "nombre" => "P&#46;"
            "apellidos" => "Escudero-Acha"
          ]
          1 => array:4 [
            "nombre" => "A&#46;"
            "apellidos" => "Gonz&#225;lez-Castro"
            "email" => array:1 [
              0 => "e409@humv.es"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          2 => array:2 [
            "nombre" => "Y&#46;"
            "apellidos" => "Pe&#241;asco"
          ]
          3 => array:2 [
            "nombre" => "M&#46;"
            "apellidos" => "Feo-Gonzalez"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servicio de Medicina Intensiva&#44; Hospital Universitario Marqu&#233;s de Valdecilla&#44; Santander&#44; Cantabria&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Ingenier&#237;a de materiales&#44; <span class="elsevierStyleItalic">mechanical power&#44;</span> ventilaci&#243;n protectora y una de paraca&#237;das"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We have been carefully and enthusiastically reading the manuscript written by Modesto et al&#46; published in your journal&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Citing the authors&#58; the fact of interpreting the existence of a mechanical power &#40;MP&#41; threshold that would be originating ventilator-induced lung injury &#40;VILI&#41; means undoubtfully that what we are talking about here is the future of mechanical ventilation&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> However&#44; paradigm shifts are never easy&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">This storm of new concepts&#44; at least for the undersigned&#44; opens a new path in our passion for mechanical ventilation&#46; However&#44; before jumping into opening new doors maybe we should reflect on whether we have managed to close old doors&#46; Is the protective mechanical ventilation completely integrated today in our daily practice for the management of respiratory distress&#63;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> Some will be shocked to know that the answer is &#8220;no&#8221;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">We will be a little more controversial&#46; The escalation of respiratory support measures is happening arbitrarily and triggered by the actual technological trends&#46; The so-called extracorporeal membrane oxygenation &#40;ECMO&#41; technique is the next best thing today&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The statement &#8220;ECMO saves lives&#8221;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> will need to be confirmed in the future&#46; For the time being it is established that protective ventilation saves lives&#44; muscle relaxation saves lives and prone ventilation saves lives in the management of distress&#46; Let&#39;s do a fly-by on the tools we have available today&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Nearly 15 years ago now&#44; the authors of a very clever paper concluded that the effectiveness of parachutes had not been put to rigorous test through randomized controlled clinical trials&#46; They also claimed that everybody would benefit here if the most radical detractors put together a blinded&#44; randomized&#44; placebo-controlled clinical trial on the use of parachutes&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Maybe the time is ripe now&#46; If possible and feasible&#44; let&#39;s find the funding for such a trial and let&#39;s coordinate it&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> Let us look for the volunteers of this trial among those in whom technological trends take over the rational use of our tools&#58; &#8220;Rational escalation of ventilatory support measures that have proven successful increasing survival&#8221; versus &#8220;the machine that is in fashion now comes first&#8221;&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Escudero-Acha P&#44; Gonz&#225;lez-Castro A&#44; Pe&#241;asco Y&#44; Feo-Gonzalez M&#46; Ingenier&#237;a de materiales&#44; <span class="elsevierStyleItalic">mechanical power&#44;</span> ventilaci&#243;n protectora y una de paraca&#237;das&#46; Med Intensiva&#46; 2019&#59;43&#58;513&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:5 [
            0 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical implications of the rheological theory in the prevention of ventilator-induced lung injury&#58; is mechanical power the solution&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "I&#46; Modesto"
                            1 => "V&#46; Alapont"
                            2 => "M&#46; Aguar Carrascosa"
                            3 => "A&#46; Medina Villanueva"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.medin.2018.06.005"
                      "Revista" => array:2 [
                        "tituloSerie" => "Med Intensiva"
                        "fecha" => "2018"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology patterns of care&#44; and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "ESICM Trials Group"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Bellani"
                            1 => "J&#46;G&#46; Laffey"
                            2 => "T&#46; Pham"
                            3 => "E&#46; Fan"
                            4 => "L&#46; Brochard"
                            5 => "A&#46; Esteban"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2016.0291"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2016"
                        "volumen" => "315"
                        "paginaInicial" => "788"
                        "paginaFinal" => "800"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26903337"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Combes"
                            1 => "D&#46; Hajage"
                            2 => "G&#46; Capellier"
                            3 => "A&#46; Demoule"
                            4 => "S&#46; Lavou&#233;"
                            5 => "C&#46; Guervilly"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1800385"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2018"
                        "volumen" => "378"
                        "paginaInicial" => "1965"
                        "paginaFinal" => "1975"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29791822"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Parachute use to prevent death and major trauma related to gravitational challenge&#58; systematic review of randomised controlled trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;C&#46; Smith"
                            1 => "J&#46;P&#46; Pell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmj.327.7429.1459"
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2003"
                        "volumen" => "327"
                        "paginaInicial" => "1459"
                        "paginaFinal" => "1461"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14684649"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Use of ECMO in ARDS&#58; does the EOLIA trial really help&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Gattinoni"
                            1 => "F&#46; Vasques"
                            2 => "M&#46; Quintel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s13054-018-2098-6"
                      "Revista" => array:5 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2018"
                        "volumen" => "22"
                        "paginaInicial" => "171"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29976250"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735727/0000004300000008/v1_201910261026/S2173572719301456/v1_201910261026/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/21735727/0000004300000008/v1_201910261026/S2173572719301456/v1_201910261026/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719301456?idApp=WMIE"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Letter to the Editor
Materials engineering, mechanical power, protective ventilation and a parachute
Ingeniería de materiales, mechanical power, ventilación protectora y una de paracaídas
P. Escudero-Acha, A. González-Castro
Corresponding author
e409@humv.es

Corresponding author.
, Y. Peñasco, M. Feo-Gonzalez
Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
Read
3263
Times
was read the article
1553
Total PDF
1710
Total HTML
Share statistics
 array:24 [
  "pii" => "S2173572719301456"
  "issn" => "21735727"
  "doi" => "10.1016/j.medine.2019.01.008"
  "estado" => "S300"
  "fechaPublicacion" => "2019-11-01"
  "aid" => "1305"
  "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
  "copyrightAnyo" => "2019"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "cor"
  "cita" => "Med Intensiva. 2019;43:513"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2
    "HTML" => 2
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0210569119300178"
      "issn" => "02105691"
      "doi" => "10.1016/j.medin.2019.01.001"
      "estado" => "S300"
      "fechaPublicacion" => "2019-11-01"
      "aid" => "1305"
      "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "cor"
      "cita" => "Med Intensiva. 2019;43:513"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 294
        "formatos" => array:3 [
          "EPUB" => 12
          "HTML" => 232
          "PDF" => 50
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>"
        "titulo" => "Ingenier&#237;a de materiales&#44; <span class="elsevierStyleItalic">mechanical power&#44;</span> ventilaci&#243;n protectora y una de paraca&#237;das"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:1 [
            "paginaInicial" => "513"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Materials engineering&#44; mechanical power&#44; protective ventilation and a parachute"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "P&#46; Escudero-Acha, A&#46; Gonz&#225;lez-Castro, Y&#46; Pe&#241;asco, M&#46; Feo-Gonzalez"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "P&#46;"
                "apellidos" => "Escudero-Acha"
              ]
              1 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Gonz&#225;lez-Castro"
              ]
              2 => array:2 [
                "nombre" => "Y&#46;"
                "apellidos" => "Pe&#241;asco"
              ]
              3 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Feo-Gonzalez"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173572719301456"
          "doi" => "10.1016/j.medine.2019.01.008"
          "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/S2173572719301456?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569119300178?idApp=WMIE"
      "url" => "/02105691/0000004300000008/v1_201910220814/S0210569119300178/v1_201910220814/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2173572719301468"
    "issn" => "21735727"
    "doi" => "10.1016/j.medine.2019.01.009"
    "estado" => "S300"
    "fechaPublicacion" => "2019-11-01"
    "aid" => "1312"
    "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;43:514-5"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2
      "HTML" => 2
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Reply to &#8220;Materials engineering&#44; mechanical power&#44; protective ventilation and a parachute&#8221;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "514"
          "paginaFinal" => "515"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Respuesta a &#171;Ingenier&#237;a de materiales&#44; <span class="elsevierStyleItalic">mechanical power</span>&#44; ventilaci&#243;n protectora y una de paraca&#237;das&#187;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "V&#46; Modesto i Alapont, M&#46; Aguar Carrascosa, A&#46; Medina"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "V&#46;"
              "apellidos" => "Modesto i Alapont"
            ]
            1 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Aguar Carrascosa"
            ]
            2 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Medina"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0210569119300385"
        "doi" => "10.1016/j.medin.2019.01.007"
        "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/S0210569119300385?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719301468?idApp=WMIE"
    "url" => "/21735727/0000004300000008/v1_201910261026/S2173572719301468/v1_201910261026/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2173572719301845"
    "issn" => "21735727"
    "doi" => "10.1016/j.medine.2018.09.015"
    "estado" => "S300"
    "fechaPublicacion" => "2019-11-01"
    "aid" => "1282"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Med Intensiva. 2019;43:510-2"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2
      "HTML" => 2
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
      "titulo" => "Lymphopenic hospital acquired sepsis &#40;L-HAS&#41;&#58; An immunological phenotype conferring higher risk of mortality"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "510"
          "paginaFinal" => "512"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Sepsis nosocomial linfop&#233;nica&#58; un fenotipo inmunol&#243;gico que confiere un mayor riesgo de mortalidad"
        ]
      ]
      "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" => 1386
              "Ancho" => 1583
              "Tamanyo" => 63336
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Kaplan&#8211;Meier survival curve&#46; Groups were compared by the log rank test &#40;Mantel&#8211;Henzel&#41;&#46; Circulating Lymphocyte Count &#40;CLC&#41; at HAS diagnosis were divided in two groups&#44; &#8804;775<span class="elsevierStyleHsp" style=""></span>lymphocytes&#47;mm<span class="elsevierStyleSup">3</span> and greater&#46; Time was censored at 90 days following HAS diagnosis&#46; Cum&#58; cumulative&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "C&#46; L&#243;pez-Mestanza, D&#46; Andaluz-Ojeda, J&#46;R&#46; G&#243;mez-L&#243;pez, J&#46;F&#46; Bermejo-Mart&#237;n"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "L&#243;pez-Mestanza"
            ]
            1 => array:2 [
              "nombre" => "D&#46;"
              "apellidos" => "Andaluz-Ojeda"
            ]
            2 => array:2 [
              "nombre" => "J&#46;R&#46;"
              "apellidos" => "G&#243;mez-L&#243;pez"
            ]
            3 => array:2 [
              "nombre" => "J&#46;F&#46;"
              "apellidos" => "Bermejo-Mart&#237;n"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719301845?idApp=WMIE"
    "url" => "/21735727/0000004300000008/v1_201910261026/S2173572719301845/v1_201910261026/en/main.assets"
  ]
  "en" => array:13 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "Materials engineering&#44; mechanical power&#44; protective ventilation and a parachute"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#58;"
    "paginas" => array:1 [
      0 => array:1 [
        "paginaInicial" => "513"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "P&#46; Escudero-Acha, A&#46; Gonz&#225;lez-Castro, Y&#46; Pe&#241;asco, M&#46; Feo-Gonzalez"
        "autores" => array:4 [
          0 => array:2 [
            "nombre" => "P&#46;"
            "apellidos" => "Escudero-Acha"
          ]
          1 => array:4 [
            "nombre" => "A&#46;"
            "apellidos" => "Gonz&#225;lez-Castro"
            "email" => array:1 [
              0 => "e409@humv.es"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          2 => array:2 [
            "nombre" => "Y&#46;"
            "apellidos" => "Pe&#241;asco"
          ]
          3 => array:2 [
            "nombre" => "M&#46;"
            "apellidos" => "Feo-Gonzalez"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servicio de Medicina Intensiva&#44; Hospital Universitario Marqu&#233;s de Valdecilla&#44; Santander&#44; Cantabria&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Ingenier&#237;a de materiales&#44; <span class="elsevierStyleItalic">mechanical power&#44;</span> ventilaci&#243;n protectora y una de paraca&#237;das"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We have been carefully and enthusiastically reading the manuscript written by Modesto et al&#46; published in your journal&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Citing the authors&#58; the fact of interpreting the existence of a mechanical power &#40;MP&#41; threshold that would be originating ventilator-induced lung injury &#40;VILI&#41; means undoubtfully that what we are talking about here is the future of mechanical ventilation&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> However&#44; paradigm shifts are never easy&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">This storm of new concepts&#44; at least for the undersigned&#44; opens a new path in our passion for mechanical ventilation&#46; However&#44; before jumping into opening new doors maybe we should reflect on whether we have managed to close old doors&#46; Is the protective mechanical ventilation completely integrated today in our daily practice for the management of respiratory distress&#63;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> Some will be shocked to know that the answer is &#8220;no&#8221;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">We will be a little more controversial&#46; The escalation of respiratory support measures is happening arbitrarily and triggered by the actual technological trends&#46; The so-called extracorporeal membrane oxygenation &#40;ECMO&#41; technique is the next best thing today&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The statement &#8220;ECMO saves lives&#8221;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> will need to be confirmed in the future&#46; For the time being it is established that protective ventilation saves lives&#44; muscle relaxation saves lives and prone ventilation saves lives in the management of distress&#46; Let&#39;s do a fly-by on the tools we have available today&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Nearly 15 years ago now&#44; the authors of a very clever paper concluded that the effectiveness of parachutes had not been put to rigorous test through randomized controlled clinical trials&#46; They also claimed that everybody would benefit here if the most radical detractors put together a blinded&#44; randomized&#44; placebo-controlled clinical trial on the use of parachutes&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Maybe the time is ripe now&#46; If possible and feasible&#44; let&#39;s find the funding for such a trial and let&#39;s coordinate it&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> Let us look for the volunteers of this trial among those in whom technological trends take over the rational use of our tools&#58; &#8220;Rational escalation of ventilatory support measures that have proven successful increasing survival&#8221; versus &#8220;the machine that is in fashion now comes first&#8221;&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Escudero-Acha P&#44; Gonz&#225;lez-Castro A&#44; Pe&#241;asco Y&#44; Feo-Gonzalez M&#46; Ingenier&#237;a de materiales&#44; <span class="elsevierStyleItalic">mechanical power&#44;</span> ventilaci&#243;n protectora y una de paraca&#237;das&#46; Med Intensiva&#46; 2019&#59;43&#58;513&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:5 [
            0 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical implications of the rheological theory in the prevention of ventilator-induced lung injury&#58; is mechanical power the solution&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "I&#46; Modesto"
                            1 => "V&#46; Alapont"
                            2 => "M&#46; Aguar Carrascosa"
                            3 => "A&#46; Medina Villanueva"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.medin.2018.06.005"
                      "Revista" => array:2 [
                        "tituloSerie" => "Med Intensiva"
                        "fecha" => "2018"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology patterns of care&#44; and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "ESICM Trials Group"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Bellani"
                            1 => "J&#46;G&#46; Laffey"
                            2 => "T&#46; Pham"
                            3 => "E&#46; Fan"
                            4 => "L&#46; Brochard"
                            5 => "A&#46; Esteban"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2016.0291"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2016"
                        "volumen" => "315"
                        "paginaInicial" => "788"
                        "paginaFinal" => "800"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26903337"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Combes"
                            1 => "D&#46; Hajage"
                            2 => "G&#46; Capellier"
                            3 => "A&#46; Demoule"
                            4 => "S&#46; Lavou&#233;"
                            5 => "C&#46; Guervilly"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1800385"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2018"
                        "volumen" => "378"
                        "paginaInicial" => "1965"
                        "paginaFinal" => "1975"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29791822"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Parachute use to prevent death and major trauma related to gravitational challenge&#58; systematic review of randomised controlled trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;C&#46; Smith"
                            1 => "J&#46;P&#46; Pell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmj.327.7429.1459"
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2003"
                        "volumen" => "327"
                        "paginaInicial" => "1459"
                        "paginaFinal" => "1461"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14684649"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Use of ECMO in ARDS&#58; does the EOLIA trial really help&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Gattinoni"
                            1 => "F&#46; Vasques"
                            2 => "M&#46; Quintel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s13054-018-2098-6"
                      "Revista" => array:5 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2018"
                        "volumen" => "22"
                        "paginaInicial" => "171"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29976250"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735727/0000004300000008/v1_201910261026/S2173572719301456/v1_201910261026/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/21735727/0000004300000008/v1_201910261026/S2173572719301456/v1_201910261026/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719301456?idApp=WMIE"
]
Article information
ISSN: 21735727
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 3 6 9
2024 October 29 39 68
2024 September 33 24 57
2024 August 31 34 65
2024 July 20 26 46
2024 June 36 32 68
2024 May 30 33 63
2024 April 48 36 84
2024 March 33 18 51
2024 February 29 32 61
2024 January 22 35 57
2023 December 21 42 63
2023 November 25 32 57
2023 October 23 21 44
2023 September 31 37 68
2023 August 17 16 33
2023 July 28 28 56
2023 June 21 19 40
2023 May 27 31 58
2023 April 22 20 42
2023 March 46 26 72
2023 February 45 26 71
2023 January 25 15 40
2022 December 44 23 67
2022 November 52 22 74
2022 October 53 24 77
2022 September 31 24 55
2022 August 64 45 109
2022 July 62 27 89
2022 June 70 18 88
2022 May 33 35 68
2022 April 19 31 50
2022 March 31 55 86
2022 February 23 35 58
2022 January 23 39 62
2021 December 28 45 73
2021 November 29 29 58
2021 October 34 59 93
2021 September 16 24 40
2021 August 17 35 52
2021 July 20 27 47
2021 June 23 23 46
2021 May 29 51 80
2021 April 70 79 149
2021 March 54 42 96
2021 February 40 27 67
2021 January 27 24 51
2020 December 30 17 47
2020 November 23 13 36
2020 October 19 10 29
2020 July 16 5 21
2020 June 23 10 33
2020 May 25 7 32
2020 April 26 15 41
2020 March 8 3 11
2020 February 2 2 4
2020 January 1 0 1
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?