Images in Intensive Medicine
Lung overdistension monitorization by ultrasound in a patient with severe bronchopulmonary dysplasia
Utilidad de la ecografía pulmonar para monitorizar la sobredistensión grave en paciente con displasia broncopulmonar grave
A. Alonso-Ojembarrena
Unidad de Neonatología, Hospital Puerta del Mar, Cádiz, Spain
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Alonso-Ojembarrena" "autores" => array:1 [ 0 => array:3 [ "nombre" => "A." "apellidos" => "Alonso-Ojembarrena" "email" => array:1 [ 0 => "aaojemba@telefonica.net" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Unidad de Neonatología, Hospital Puerta del Mar, Cádiz, Spain" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Utilidad de la ecografía pulmonar para monitorizar la sobredistensión grave en paciente con displasia broncopulmonar grave" ] ] "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" => 735 "Ancho" => 950 "Tamanyo" => 80552 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 4-month-old, ex-premature (24 weeks of pregnancy) patient with severe bronchopulmonary dysplasia on mechanical ventilation (pressure control mode with PIP 25<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O, PEEP 5.5<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O, respiratory frequency 35<span class="elsevierStyleHsp" style=""></span>rpm and FiO<span class="elsevierStyleInf">2</span> 30%). On the reported day, the patient required FiO<span class="elsevierStyleInf">2</span> of up to 50%, and the chest X-rays (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) showed intense hyperinsufflation of the right hemithorax and the absence of the lung sliding sign at pulmonary ultrasound (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). In view of the evolution of patients with bronchopulmonary dysplasia towards dynamic compression of the distal airway, we decided to progressively increase PEEP, without ultrasound improvement until PEEP 10<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O was reached; at this point pleural sliding was seen to reappear (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>) and the chest X-rays showed partial resolution of the overdistension (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0010" class="elsevierStylePara elsevierViewall">The author received no funding for the presentation of this clinical case.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Alonso-Ojembarrena A. Utilidad de la ecografía pulmonar para monitorizar la sobredistensión grave en paciente con displasia broncopulmonar grave. Med Intensiva. 2020;44:131–132.</p>" ] ] "multimedia" => array:4 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 735 "Ancho" => 950 "Tamanyo" => 80552 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1135 "Ancho" => 1583 "Tamanyo" => 196592 ] ] ] 2 => array:6 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1245 "Ancho" => 1583 "Tamanyo" => 247111 ] ] ] 3 => array:6 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 762 "Ancho" => 950 "Tamanyo" => 81191 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735727/0000004400000002/v1_202002280724/S2173572719302401/v1_202002280724/en/main.assets" "Apartado" => array:4 [ "identificador" => "66582" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Image in Intensive Medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735727/0000004400000002/v1_202002280724/S2173572719302401/v1_202002280724/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719302401?idApp=WMIE" ]
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