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          "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Ultrasound measures used to assess the success of extubation&#46; Mean in M-mode&#46; 1&#46;1&#58; Thickening fraction &#40;TFdi&#44; &#37;&#41;&#44; expiratory thickness &#40;A&#41;&#44; inspiratory thickness &#40;B&#41;&#46; 1&#46;2&#58; Measurement of diaphragmatic excursion &#40;a&#41; &#40;DE&#44; cm&#41;&#44; time to peak inspiratory amplitude &#40;b&#41; &#40;TPIA<span class="elsevierStyleInf">dia</span>&#44; s&#41;&#44; diaphragmatic contraction velocity &#40;DE&#47;TPIA<span class="elsevierStyleInf">dia</span> &#91;cm&#47;s&#93;&#41;&#46; 1&#46;3&#58; Time to peak inspiratory amplitude &#40;a&#41; &#40;TPIA<span class="elsevierStyleInf">dia</span>&#44; s&#41;&#44; total time &#40;b&#41; &#40;s&#41;&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The need for mechanical ventilation &#40;MV&#41; is one of the main reasons for admission to the Intensive Care Unit &#40;ICU&#41;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">1</span></a>&#46; Despite its benefits&#44; however&#44; the complications of MV are an important source of patient morbidity&#8211;mortality<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">2&#8211;4</span></a>&#46; Establishing the optimum moment for withdrawal of ventilatory support remains one of the greatest challenges for the treating professional team&#44; since late extubation is directly associated to an increased incidence of in-hospital infections&#44; including ventilator-associated pneumonia &#40;VAP&#41;&#44; as well as to increased costs&#44; diaphragm dysfunction&#44; worsened quality of life over the middle term&#44; and a longer stay in the ICU and in hospital in general<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">5&#8211;7</span></a>&#46; In contrast&#44; early extubation resulting in a need for reintubation has been associated to a 25&#8211;50&#37; increase in patient mortality<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">8&#44;9</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The heterogeneity of the patients admitted to the ICU implies that the causes of extubation failure are also multiple<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">10</span></a>&#59; diaphragm dysfunction appears to be implicated in up to 50&#37; of all failed extubations<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">11</span></a>&#46; This situation is related to the structural and functional changes observed in the muscle fibers after the start of ventilatory support<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">12&#44;13</span></a>&#46; On the basis of the above&#44; one of the cornerstones of patient management is the facilitation of early rehabilitation<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">1&#44;14</span></a>&#46; To date&#44; no reference parameters have been able to predict extubation success&#46; The most widely used clinical parameters are the rapid shallow breathing index &#40;RSBI&#41;&#44; vital capacity &#40;VC&#41; and peak inspiratory pressure &#40;PI<span class="elsevierStyleInf">max</span>&#41;&#44; among others<a class="elsevierStyleCrossRefs" href="#bib0270"><span class="elsevierStyleSup">15&#44;16</span></a>&#46; There is great variability in the cut-off points and diagnostic precision of these parameters<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">11</span></a>&#44; and none of them reflect the integrity of diaphragm structure and function&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In this context&#44; in recent years ultrasound at the patient bedside &#40;point of care&#41; has become one of the tools of choice in the ICU due to its accessibility and low cost&#46; It allows us to assess structure and function quantitatively and qualitatively before&#44; during and after extubation<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">17</span></a>&#46; A range of ultrasound parameters have been studied to date&#58; diaphragmatic excursion &#40;DE&#41;&#44; thickening fraction &#40;TF<span class="elsevierStyleInf">di</span>&#41;&#44; contraction velocity &#40;V&#41;<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">18&#8211;20</span></a> and even variations in rapid shallow breathing index &#40;respiratory frequency&#47;DE&#41;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">21</span></a>&#46; The cut-off points of these parameters are likewise diverse&#44; with great variability in performing the test&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The present study was carried out to evaluate the diagnostic accuracy of diaphragmatic ultrasound at the patient bedside in predicting extubation success&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Patients and methods</span><p id="par0030" class="elsevierStylePara elsevierViewall">A prospective&#44; observational cohort study on diagnostic accuracy was carried out&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Study population</span><p id="par0035" class="elsevierStylePara elsevierViewall">The study was carried out in the ICU of an academic institution in the city of Bogot&#225; &#40;Colombia&#41;&#44; with the consecutive inclusion of all patients over 18 years of age subjected to invasive MV for over 48<span class="elsevierStyleHsp" style=""></span>h and who met the following inclusion criteria&#58; &#40;1&#41; resolution of the cause of respiratory failure&#59; &#40;2&#41; hemodynamic stability&#59; &#40;3&#41; metabolic equilibrium&#59; &#40;4&#41; optimum level of consciousness&#59; and &#40;5&#41; indication of spontaneous breathing test &#40;SBT&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">The exclusion criteria were&#58; &#40;1&#41; neuromuscular disease&#59; &#40;2&#41; previous diaphragmatic paralysis&#59; &#40;3&#41; use of neuromuscular blockers during admission to the Unit&#59; &#40;4&#41; pneumothorax or pneumomediastinum&#59; and &#40;5&#41; pregnancy&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The following data were compiled at baseline&#58; patient age and gender&#44; cause of respiratory failure&#44; duration of MV&#44; and arterial gas and laboratory test values before extubation&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Measurements</span><p id="par0050" class="elsevierStylePara elsevierViewall">The decision to perform the spontaneous breathing test &#40;SBT&#41; was assessed daily by the supervising medical team and the respiratory therapy group of the Unit&#46; After the 30<span class="elsevierStyleHsp" style=""></span>min of the SBT&#44; diaphragmatic function was assessed by ultrasound&#44; with calculation of the rapid shallow breathing index as part of the standard evaluation for establishing extubation&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The diaphragmatic measurements were carried out by intensivists trained in ultrasound in the critical care setting&#44; using a Sonocare ultrasound system &#40;Sonosite EDGE 03VRYF&#41;&#46; A 1&#8211;5<span class="elsevierStyleHsp" style=""></span>MHz transducer was used for the M-mode evaluation of diaphragmatic excursion &#40;DE&#44; cm&#41;&#44; time to peak inspiratory amplitude &#40;TPIA<span class="elsevierStyleInf">dia</span>&#44; s&#41;&#44; contraction velocity of the diaphragm &#40;DE&#47;TPIA<span class="elsevierStyleInf">dia</span>&#44; cm&#47;s&#41; and total time &#40;T<span class="elsevierStyleInf">tot</span>&#44; s&#41;&#46; The thickening fraction &#40;TF<span class="elsevierStyleInf">di</span>&#44; &#37;&#41; was evaluated with a 6&#8211;13<span class="elsevierStyleHsp" style=""></span>MHz transducer in M-mode &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a> and <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Diaphragm dysfunction was defined as DE<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>1<span class="elsevierStyleHsp" style=""></span>cm or paradoxical motion<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">18</span></a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">The measurements were made only in the right half of the diaphragm&#44; with the patient in the semi-sitting position &#40;headrest raised 45 degrees&#41;&#46; The transducer was positioned just below the ribcage&#44; between the clavicular midline and the anterior axillary line&#46; The ultrasound beam was directed cephalad&#44; perpendicular to the posterior third of the diaphragm&#46; Three operators performed the ultrasound explorations in the ICU&#44; distributed as follows&#58; 45 explorations made by an intensivist during the morning shift&#44; and 20 explorations each performed by two intensivists in the afternoon&#46; Before the study&#44; a 12-h training session with an expert radiologist was held to ensure standardization of the ultrasound measurements&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Before extubation&#44; all patients were reconnected to their previous ventilation mode during 1<span class="elsevierStyleHsp" style=""></span>h<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">22</span></a>&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Study objectives</span><p id="par0070" class="elsevierStylePara elsevierViewall">The primary study objective was to determine the accuracy of diaphragmatic ultrasound as a predictor of the success of weaning from MV&#46; Successful extubation was defined as the capacity to maintain spontaneous breathing for over 48<span class="elsevierStyleHsp" style=""></span>h without ventilatory assistance after extubation&#46; Failed extubation in turn was defined as the need for patient reintubation in under 48<span class="elsevierStyleHsp" style=""></span>h<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">9</span></a>&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">As secondary objective&#44; we evaluated the differences in extubation success or failure in relation to the different demographic&#44; clinical and ultrasound parameters&#44; and diaphragm dysfunction &#40;defined as DE<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>1<span class="elsevierStyleHsp" style=""></span>cm or paradoxical motion&#41;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">18</span></a>&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Ethical aspects</span><p id="par0080" class="elsevierStylePara elsevierViewall">The study protocol was approved by the local Ethics Committee &#40;Ref&#46; no&#46;&#58; 205 of 2014&#41;&#46; The study was considered to pose minimal risks for patients according to resolution 8430 of 1993 of the Colombian Ministry of Health&#46; Informed consent was obtained from all the participants&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Statistical analysis</span><p id="par0085" class="elsevierStylePara elsevierViewall">Convenience non-probability sampling was performed&#44; calculating a sample size of 84 patients based on an estimated prevalence of 20&#37; for extubation failure&#44; with a sensitivity of 90&#37; and a specificity of 86&#37;&#44; a 95&#37; confidence interval with an area under the receiver operating characteristic curve &#40;AUC-ROC&#41; of 0&#46;15&#44; an alpha error of 0&#46;05&#44; and a statistical power of 80&#37;<a class="elsevierStyleCrossRefs" href="#bib0310"><span class="elsevierStyleSup">23&#44;24</span></a>&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Central tendency and dispersion measures were used for the quantitative variables&#44; and frequencies and percentages for the qualitative variables&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">The patients were divided into two groups according to the primary outcome &#40;extubation success or failure&#41;&#46; The chi-squared test was used for the bivariate comparison of categorical variables&#46; The Student <span class="elsevierStyleItalic">t</span>-test in turn was used for the comparison of continuous variables exhibiting a normal distribution&#44; while parameters with a non-normal distribution were contrasted by means of the Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span>-test&#46; The quantitative variables with a non-parametric distribution that included follow-up time were subjected to negative binomial regression or Poisson analysis&#44; depending on whether the standard deviation &#40;SD&#41; was greater or smaller than the mean of such variables&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">We calculated the operator characteristics of each of the ultrasound measures to predict extubation success or failure&#44; and ROC curves were plotted to establish the diagnostic accuracy of each of the ultrasound parameters&#46; The point of maximum discriminating capacity was selected&#44; based on the Youden index&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The AUC-ROC was interpreted as follows<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">25</span></a>&#58; &#61;0&#46;5&#44; no discriminating capacity&#59; &#62;0&#46;7&#8211;0&#46;79&#58; acceptable discriminating capacity&#59; &#62;0&#46;8&#8211;0&#46;89&#58; excellent discriminating capacity&#59; &#62;0&#46;9&#58; outstanding discriminating capacity&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The data were analyzed using the SPSS version 20 statistical package and MedCalc version 19&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Results</span><p id="par0115" class="elsevierStylePara elsevierViewall">A total of 84 patients were included in the study&#44; and no losses were recorded&#46; The general characteristics of the study sample are described in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; The median patient age was 58 years &#40;range 35&#8211;51&#41;&#44; with a female predominance &#40;56&#37;&#41;&#46; Most of the patients &#40;88&#37;&#41; presented medical conditions as the indication of MV&#44; with an APACHE II severity score of 21 &#40;17&#8211;28&#41;&#46; The method of choice for SBT was the T-tube technique &#40;85&#46;7&#37;&#41;&#44; versus pressure support &#40;14&#46;3&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">Successful extubation was achieved in 79&#46;8&#37; of the patients &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>67&#41;&#44; and extubation failed in the remaining 20&#46;2&#37; of the cases &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>17&#41;&#46; The comparison of results between both groups is shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; There were no significant differences between the groups in terms of the demographic or clinical characteristics&#46; However&#44; the patients with failed extubation presented APACHE II scores that were slightly higher than those recorded in the patients with successful extubation&#46; The rapid shallow breathing index was also similar in both groups&#44; with slightly higher scores among the patients with successful extubation versus those with failed extubation&#58; 48 &#40;36&#8211;64&#41; and 40 &#40;32&#8211;62&#41;&#44; respectively&#46; The SBT choice likewise showed no significant differences&#46; The duration of MV and of ICU stay was slightly longer in the failed extubation group&#44; though the differences failed to reach statistical significance&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Of the different ultrasound parameters&#44; differences were only observed for contraction velocity and diaphragm dysfunction &#40;DE<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>1<span class="elsevierStyleHsp" style=""></span>cm&#41;&#59; the latter was only present in 1&#46;2&#37; of the total cases&#46; The ROC curve for diaphragm contraction velocity is shown in <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#46; This variable presented AUC 0&#46;70 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#59; 95&#37; CI&#58; 0&#46;58&#8211;0&#46;79&#41;&#46; Three cut-off points were calculated &#40;shown in <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46; The point of maximum discriminating capacity according to the Youden index was &#62;2&#46;9<span class="elsevierStyleHsp" style=""></span>cm&#47;s&#44; with a sensitivity of 4&#46;27&#37; &#40;95&#37; CI&#58; 0&#46;34&#8211;0&#46;59&#41; and a specificity of 88&#46;24&#37; &#40;95&#37; CI&#58; 0&#46;50&#8211;0&#46;93&#41;&#46; Values of over 1&#46;74<span class="elsevierStyleHsp" style=""></span>cm&#47;s were associated to greater sensitivity &#40;85&#37; &#91;95&#37; CI&#58; 0&#46;74&#8211;0&#46;93&#93;&#41; and lesser specificity &#40;41&#37; &#91;95&#37; CI&#58; 0&#46;19&#8211;0&#46;67&#93;&#41;&#46; On the other hand&#44; thresholds of over 4&#46;3<span class="elsevierStyleHsp" style=""></span>cm&#47;s showed a sensitivity of 19&#46;4&#37; &#40;95&#37; CI&#58; 0&#46;11&#8211;0&#46;30&#41; and a specificity of 88&#46;24&#37; &#40;95&#37; CI&#58; 0&#46;64&#8211;0&#46;99&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Discussion</span><p id="par0130" class="elsevierStylePara elsevierViewall">The main finding of our investigation was an acceptable discriminating capacity &#40;AUC 0&#46;70&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008 &#91;95&#37; CI&#58; 0&#46;58&#8211;0&#46;79&#93;&#41; in predicting extubation success or failure on assessing diaphragmatic contraction velocity as isolated marker in critical patients admitted to the ICU&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">A range of ultrasound parameters have been evaluated in the MV weaning process<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">26</span></a>&#46; The most widely studied are DE and TF<span class="elsevierStyleInf">di</span>&#46; Two meta-analyses have compiled the available evidence&#46; The first included 19 observational studies with a total of 1068 patients&#46; The DE values were between 10 and 27<span class="elsevierStyleHsp" style=""></span>mm and the TF<span class="elsevierStyleInf">di</span> values between 20 and 36&#37;&#46; The analysis of the ROC curve for TF<span class="elsevierStyleInf">di</span> yielded AUC 0&#46;87&#44; while in the case of DE the lack of data and their heterogeneity only allowed the estimation of a cumulative specificity of 75&#37; and a sensitivity of 80&#37;<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">27</span></a>&#46; The second meta-analysis&#44; published in 2018&#44; evaluated 13 observational studies with a total of 742 patients&#46; The findings were similar to those of the previous meta-analysis&#44; with good performance being observed for both DE and TF<span class="elsevierStyleInf">di</span>&#44; with AUC 0&#46;859 and 0&#46;838&#44; respectively<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">28</span></a>&#46; Nevertheless&#44; both meta-analyses were characterized by heterogeneity in defining extubation failure&#44; in the selection of patients&#44; the indication of intubation&#44; and the selection of cut-off points&#46; In our study&#44; neither DE nor TF<span class="elsevierStyleInf">di</span> showed differences between the extubation success and failure groups&#46; The only variable exhibiting statistically significant differences was diaphragmatic contraction velocity&#46; This variable is taken to be an indirect measure of diaphragm contraction strength&#46; In healthy individuals&#44; the normal value is estimated to be 1&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;4<span class="elsevierStyleHsp" style=""></span>cm&#47;s&#46; The role of this variable has not been widely studied to date&#44; though higher values appear to be related to an increased probability of successful extubation<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">29</span></a>&#46; We recorded values of &#62;2&#46;9<span class="elsevierStyleHsp" style=""></span>cm&#47;s &#40;2&#46;00&#8211;4&#46;01&#41; in the successful extubation group versus &#62;2&#46;02<span class="elsevierStyleHsp" style=""></span>cm&#47;s in the failed extubation group &#40;1&#46;49&#8211;2&#46;80&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;013&#41;&#46; A number of cut-off points were analyzed with a view to optimizing the discriminating capacity of the test&#46; A velocity &#62;1&#46;74<span class="elsevierStyleHsp" style=""></span>cm&#47;s showed high sensitivity&#46; However&#44; the low associated specificity could indicate a greater number of patients at risk of reintubation&#46; On the other hand&#44; thresholds above 4&#46;3<span class="elsevierStyleHsp" style=""></span>cm&#47;s &#40;sensitivity 19&#46;4&#37; and specificity 88&#46;24&#37;&#41; would limit the start of weaning in clinical practice&#46; The maximum discriminating capacity was established at &#62;2&#46;9<span class="elsevierStyleHsp" style=""></span>cm&#47;s&#44; with only acceptable overall performance &#40;AUC 0&#46;70&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41;&#46; To date&#44; three studies have defined velocity as a differential marker in the extubation process&#46; The first study described much lower thresholds than those established in our study &#40;&#62;0&#46;8<span class="elsevierStyleHsp" style=""></span>cm&#47;s&#41;&#44; with a sensitivity of 100&#37;&#44; a specificity of 86&#46;67&#37; and an outstanding discriminating capacity &#40;AUC 0&#46;93&#41;<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">29</span></a>&#46; The second study&#44; with slightly higher thresholds &#40;0&#46;92<span class="elsevierStyleHsp" style=""></span>cm&#47;s&#41;&#44; reported a sensitivity of 100&#37;&#44; with low specificity &#40;45&#37;&#41; in discriminating extubation success &#40;AUC 0&#46;66&#41;<a class="elsevierStyleCrossRef" href="#bib0345"><span class="elsevierStyleSup">30</span></a>&#46; Lastly&#44; the third study evaluated TPIA<span class="elsevierStyleInf">dia</span> as derived variable &#40;DE&#47;TPIA<span class="elsevierStyleInf">dia</span>&#41;&#44; with a discriminating capacity similar to that found in our study &#40;AUC 0&#46;71&#41;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">11</span></a>&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">The optimum time for suspending MV remains a challenge for multidisciplinary teams in the ICU&#46; The need for reintubation is one of the most feared complications&#44; because of the associated increase in patient mortality<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">8</span></a>&#46; The incidence of extubation failure reported in the literature ranges from 10 to 25&#37;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">31</span></a>&#44; which coincides with the figure recorded in our study &#40;20&#46;2&#37;&#41;&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Muscle trauma with consequent ventilator-induced diaphragm dysfunction &#40;VIDD&#41; is one of the main causes of failed ventilation withdrawal<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">32</span></a>&#46; In some cases it may go unnoticed&#59; active search on the part of the clinician is therefore essential in this regard<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">33</span></a>&#46; To date&#44; the parameter used to evaluate diaphragm function has been direct fluoroscopy&#44; though this technique is of limited applicability in the intensive care setting because of the problems posed by having to transfer critical patients outside the Unit<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">11</span></a>&#46; For this reason diaphragmatic ultrasound has been found to be very useful as a tool that can be used at the patient bedside&#46; In our study&#44; diaphragm dysfunction was only observed in 1&#46;2&#37; of the cases&#44; in contrast to other series in the literature that have reported a prevalence of 23&#8211;36&#37;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">12</span></a>&#46; Ultrasound definition also has limitations&#44; and the technique has not been prospectively contrasted versus the reference standards&#46; Furthermore&#44; the cut-off points described in the literature are heterogeneous&#46; Nevertheless&#44; we consider that the low frequency of diaphragm dysfunction recorded in our study is attributable to the presence of a strict early rehabilitation program that starts upon patient admission to the Unit&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Prolonged MV is one of the consequences of diaphragm dysfunction<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">34</span></a>&#46; Our results showed a relatively short period of MV&#44; with a median of 5 days&#44; and with no differences between the extubation success and failure groups&#46; Likewise&#44; the ventilation weaning period corresponded to 40&#37; of the ventilation time&#44; in coincidence with the data found in the literature<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">35</span></a>&#46; The total duration of stay in the Unit was slightly longer in the failure group&#44; though statistical significance was not reached&#44; probably because of statistical power limitations related to the sample size involved&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Taking into account that no clinical or imaging parameter considered isolatedly has been able to predict the outcome of the extubation process&#44; the heterogeneity of the critically ill makes it necessary to adopt a multimodal approach to ventilation withdrawal<a class="elsevierStyleCrossRef" href="#bib0375"><span class="elsevierStyleSup">36</span></a>&#46; The multiple systems involved should be evaluated qualitatively and quantitatively as part of the extubation process&#46; Ultrasound could be a tool accompanying traditional evaluation&#44; and in this sense the results of our study with regard to the rapid shallow breathing index &#40;&#60;105 in both groups&#41; confirm its scant clinical usefulness when considered isolatedly&#46; At present there are two main scenarios for ultrasound utilization at the critical patient bedside&#58; &#40;a&#41; application as an evaluation and follow-up strategy in order to avoid muscle trauma<a class="elsevierStyleCrossRefs" href="#bib0355"><span class="elsevierStyleSup">32&#44;37</span></a> and &#40;b&#41; use as part of multifunctional cardiovascular&#44; pulmonary and pleural assessment<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">38</span></a>&#46; We consider the definition of new integrating indices contemplating systematic ultrasound evaluation to be a priority with a view to improving the outcomes of the extubation process&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">The main strength of our study is the identification of contraction velocity as an independent variable for estimating the success of extubation&#46; Despite only acceptable performance in the ROC curves&#44; it deserves becoming the focus of future research&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Our study has a number of limitations&#46; Ultrasound is operator-dependent&#46; Inter- and intra-observer variability in the ventilation weaning scenario has been evaluated only in relation to the measurement of the diaphragmatic thickening fraction<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">39</span></a>&#46; Our measurements were made by different operators without conducting concordance studies between them&#59; the results of the other ultrasound variables therefore require validation&#46; On the other hand&#44; the lack of distinction between the types of ventilation withdrawal &#40;easy&#44; difficult or prolonged<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">9</span></a>&#41; could modify ultrasound performance as a prognostic tool&#46; In turn&#44; the severity of disease of the patients included in the study&#44; assessed by means of the APACHE II score&#44; was considered to be high&#59; the findings therefore might not be extrapolatable to other ICUs of lesser complexity&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Authorship</span><p id="par0170" class="elsevierStylePara elsevierViewall">Fabio Varon-Vega&#44; Angela Hernandez&#44; Luis Fernando Giraldo&#58; study design and structure&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Mauricio Lopez and Edgar Caceres&#58; data collection&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Fabio Varon-Vega&#44; Ana Maria Uribe&#44; Luis Fernando Giraldo and Stephanie Crevoisier&#58; data analysis and drafting of the manuscript&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Conflicts of interest</span><p id="par0185" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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            0 => "Critical illness"
            1 => "Airway extubation"
            2 => "Diaphragm&#47;diagnostic imaging"
            3 => "Intensive care units"
            4 => "Predictive value of tests"
            5 => "Respiration"
            6 => "Artificial"
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            2 => "Diafragma&#47;diagn&#243;stico por imagen"
            3 => "Unidades de cuidados intensivos"
            4 => "Valor predictivo de las pruebas"
            5 => "Respiraci&#243;n"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To evaluate the diagnostic accuracy of diaphragmatic ultrasound in predicting extubation success&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Design</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A diagnostic accuracy study was carried out&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Scope</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Intensive Care Unit of an Academic hospital in the city of Bogot&#225; &#40;Colombia&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Patients or participants</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A consecutive sample of patients &#62;18 years of age subjected to invasive mechanical ventilation for &#62;48<span class="elsevierStyleHsp" style=""></span>h&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Interventions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Diaphragmatic ultrasound evaluation at the end of spontaneous ventilation testing&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Main variables of interest</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Diaphragmatic excursion &#40;DE&#44; cm&#41;&#44; inspiration time &#40;TPIA<span class="elsevierStyleInf">dia</span>&#44; s&#41;&#44; diaphragm contraction speed &#40;DE&#47;TPIA<span class="elsevierStyleInf">dia</span>&#44; cm&#47;s&#41; and total time &#40;T<span class="elsevierStyleInf">tot</span>&#44; s&#41; were evaluated&#44; together with thickening fraction &#40;TF<span class="elsevierStyleInf">di</span>&#44; &#37;&#41;&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A total of 84 patients were included&#44; 79&#46;8&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>67&#41; with successful extubation and 20&#46;2&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>17&#41; with failed extubation&#46; The variable with the best discriminatory capacity in predicting extubation success was diaphragm contraction speed&#44; with AUC-ROC 0&#46;70 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;008&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Diaphragm contraction speed exhibited acceptable discriminatory capacity&#46; Ultrasound could be part of a multifactorial approach in the extubation process&#46;</p></span>"
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        "resumen" => "<span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Objetivo</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Evaluar la exactitud diagn&#243;stica de la ecograf&#237;a diafragm&#225;tica para predecir el &#233;xito en la extubaci&#243;n&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Dise&#241;o</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Estudio de exactitud diagn&#243;stica&#46;</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">&#193;mbito</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Unidad de Cuidado Intensivo M&#233;dico de un hospital acad&#233;mico de la ciudad de Bogot&#225; &#40;Colombia&#41;&#46;</p></span> <span id="abst0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Pacientes o participantes</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Muestra consecutiva de pacientes mayores de 18 a&#241;os con ventilaci&#243;n mec&#225;nica invasiva durante m&#225;s de 48<span class="elsevierStyleHsp" style=""></span>h&#46;</p></span> <span id="abst0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Intervenciones</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Evaluaci&#243;n ecogr&#225;fica diafragm&#225;tica al finalizar la prueba de ventilaci&#243;n espont&#225;nea&#46;</p></span> <span id="abst0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Variables de inter&#233;s principales</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Se evalu&#243; la excursi&#243;n diafragm&#225;tica &#40;ED&#44; cm&#41;&#44; el tiempo de inspiraci&#243;n &#40;TPIA<span class="elsevierStyleInf">dia</span>&#44; s&#41;&#44; la velocidad de contracci&#243;n del diafragma &#40;ED&#47;TPIA<span class="elsevierStyleInf">dia</span>&#44; cm&#47;s&#41;&#44; el tiempo total &#40;Ttot&#44; s&#41; y la fracci&#243;n de engrosamiento &#40;TF<span class="elsevierStyleInf">di</span>&#44; &#37;&#41;&#46;</p></span> <span id="abst0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 84 pacientes&#44; el 79&#46;8&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>67&#41; con extubaci&#243;n exitosa y el 20&#44;2&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>17&#41; con extubaci&#243;n fallida&#46; La variable con mejor capacidad discriminatoria para predecir &#233;xito en la extubaci&#243;n fue la velocidad de contracci&#243;n&#44; con un AUC-ROC de 0&#44;70 &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;008&#41;&#46;</p></span> <span id="abst0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusiones</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">La velocidad de contracci&#243;n diafragm&#225;tica mostr&#243; una capacidad discriminatoria aceptable&#46; La ultrasonograf&#237;a podr&#237;a formar parte de un abordaje multifactorial en el proceso de extubaci&#243;n&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Var&#243;n-Vega F&#44; Hern&#225;ndez &#193;&#44; L&#243;pez M&#44; C&#225;ceres E&#44; Giraldo-Cadavid LF&#44; Uribe-Hernandez AM&#44; et al&#46; Utilidad de la ecograf&#237;a diafragm&#225;tica para predecir el &#233;xito en la extubaci&#243;n&#46; Med Intensiva&#46; 2021&#59;45&#58;226&#8211;233&#46;</p>"
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                  \t\t\t\t">PaO<span class="elsevierStyleInf">2</span>&#47;PAO<span class="elsevierStyleInf">2</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">pH<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>7&#46;35<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>7&#46;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hemodynamic stability</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Norepinephrine &#60;0&#46;1<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;kg&#47;min&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dopamine &#60;5<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;kg&#47;min&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dobutamine &#60;5<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;kg&#47;min&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hemoglobin &#8805;7<span class="elsevierStyleHsp" style=""></span>g&#47;dl&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Level of consciousness</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Glasgow coma score &#8805;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CAM-ICU negative&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Spontaneous breathing test &#40;SBT&#41;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Modality&#58; T-tube&#58; patients &#8211; pressure support&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Daily evaluation by medical staff&#47;respiratory therapy to define moment of SBT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30<span class="elsevierStyleHsp" style=""></span>min duration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Metabolic equilibrium</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">pH<span class="elsevierStyleHsp" style=""></span>&#8805;<span class="elsevierStyleHsp" style=""></span>7&#46;35<span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>7&#46;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Temperature &#8804;38<span class="elsevierStyleHsp" style=""></span>&#176;C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Serum sodium&#44; potassium&#44; phosphorus in normal ranges&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Measurement&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Evaluation M-mode&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Diaphragmatic excursion &#40;DE&#44; cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Excursion amplitude from start of contraction to maximum inspiration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Time to peak inspiratory amplitude &#40;TPIA<span class="elsevierStyleInf">dia</span>&#44; s&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Time from start of diaphragmatic contraction to maximum inspiration&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diaphragmatic contraction velocity &#40;cm&#47;s&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diaphragmatic excursion &#40;DE&#41;&#47;time to peak inspiratory amplitude &#40;TPIA<span class="elsevierStyleInf">dia</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total time &#40;s&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Inspiratory time<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>expiratory time&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Thickening fraction &#40;TF<span class="elsevierStyleInf">di</span>&#44; &#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diaphragmatic thickness at end of inspiration<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>diaphragmatic thickness at end of expiration&#47;diaphragmatic thickness at end of expiration<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "leyenda" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">APACHE II&#58; Acute Physiology and Chronic Health Evaluation II&#59; SD&#58; standard deviation&#59; DE&#58; diaphragmatic excursion&#59; IQR&#58; interquartile range&#59; TF<span class="elsevierStyleInf">di</span>&#58; thickening fraction&#59; TPIA<span class="elsevierStyleInf">dia</span>&#58; time to peak inspiratory amplitude&#59; T<span class="elsevierStyleInf">tot</span>&#58; total time&#59; ICU&#58; Intensive Care Unit&#59; V&#58; contraction velocity&#59; MV&#58; mechanical ventilation&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Total&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Success&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Failure&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>67 &#40;79&#46;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>17 &#40;20&#46;2&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Age &#40;years&#41;&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">58 &#40;35&#8211;51&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">58 &#40;34&#8211;72&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59 &#40;49&#8211;64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Gender&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47 &#40;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;83&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Type of patient&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Cause of respiratory failure&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">APACHE II&#44; median &#40;IQR&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pressure support&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;14&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;83&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;16&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>DE &#40;cm&#41;&#44; median &#40;IQR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;18 &#40;1&#46;6&#8211;2&#46;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">2&#46;22 &#40;1&#46;66&#8211;2&#46;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;02 &#40;1&#46;63&#8211;2&#46;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Excursion &#60;10<span class="elsevierStyleHsp" style=""></span>mm&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;046&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>DE&#47;TPIA<span class="elsevierStyleInf">dia</span> &#40;cm&#47;s&#41;&#44; median &#40;IQR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;74 &#40;1&#46;90&#8211;3&#46;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;90 &#40;2&#46;00&#8211;4&#46;01&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;02 &#40;1&#46;49&#8211;2&#46;80&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TPIA<span class="elsevierStyleInf">dia</span> &#40;s&#41;&#44; median &#40;IQR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;79 &#40;0&#46;64&#8211;1&#46;02&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;80 &#40;0&#46;67&#8211;0&#46;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;77 &#40;0&#46;62&#8211;1&#46;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>T<span class="elsevierStyleInf">tot</span> &#40;s&#41;&#44; mean &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;96 &#40;0&#46;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;97 &#40;0&#46;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;93 &#40;0&#46;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TF<span class="elsevierStyleInf">di</span> &#40;&#37;&#41;&#44; median &#40;IQR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31 &#40;24&#8211;45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32 &#40;27&#8211;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30 &#40;21&#8211;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>TF<span class="elsevierStyleInf">di</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>30&#37;&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47 &#40;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 &#40;83&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="5" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Outcomes&#44; median &#40;IQR&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>MV time&#44; days&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;3&#8211;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;3&#8211;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;4&#8211;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;98&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Weaning time&#44; days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;1&#8211;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;1&#8211;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;1&#8211;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>ICU stay &#40;days&#41;&#44; median &#40;IQR&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;7&#8211;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;6&#8211;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;8&#8211;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;69&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Contraction velocity &#40;cm&#47;s&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sensitivity&nbsp;\t\t\t\t\t\t\n
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                        "paginaFinal" => "637"
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                        "paginaInicial" => "665"
                        "paginaFinal" => "671"
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                        "volumen" => "22"
                        "paginaInicial" => "73"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29558983"
                            "web" => "Medline"
                          ]
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                      ]
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                  ]
                ]
              ]
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                    0 => array:2 [
                      "titulo" => "How important is diaphragm function as a determinant of outcomes for MICU patients in respiratory failure&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;S&#46; Supinski"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1152/physiol.00025.2015"
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                        "tituloSerie" => "Physiology"
                        "fecha" => "2015"
                        "volumen" => "30"
                        "paginaInicial" => "336"
                        "paginaFinal" => "337"
                      ]
                    ]
                  ]
                ]
              ]
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            13 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Caring for critically ill patients with the ABCDEF bundle&#58; results of the ICU liberation collaborative in over 15&#44;000 adults"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46;T&#46; Pun"
                            1 => "M&#46;C&#46; Balas"
                            2 => "M&#46;A&#46; Barnes-Daly"
                            3 => "J&#46;L&#46; Thompson"
                            4 => "J&#46;M&#46; Aldrich"
                            5 => "J&#46; Barr"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/CCM.0000000000003482"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2019"
                        "volumen" => "47"
                        "paginaInicial" => "3"
                        "paginaFinal" => "14"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30339549"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A new integrative weaning index of discontinuation from mechanical ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;N&#46; Nemer"
                            1 => "C&#46;S&#46; Barbas"
                            2 => "J&#46;B&#46; Caldeira"
                            3 => "T&#46;C&#46; C&#225;rias"
                            4 => "R&#46;G&#46; Santos"
                            5 => "L&#46;C&#46; Almeida"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/cc8051"
                      "Revista" => array:5 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2009"
                        "volumen" => "13"
                        "paginaInicial" => "R152"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19772625"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Valor de la fracci&#243;n de espacio muerto &#40;Vd&#47;Vt&#41; como predictor de &#233;xito en la extubaci&#243;n"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Gonz&#225;lez-Castro"
                            1 => "V&#46; Su&#225;rez-Lopez"
                            2 => "V&#46; G&#243;mez-Marcos"
                            3 => "C&#46; Gonz&#225;lez-Fernandez"
                            4 => "D&#46; Iglesias-Posadilla"
                            5 => "J&#46; Bur&#243;n-Mediavilla"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.medin.2011.05.016"
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Intensiva"
                        "fecha" => "2011"
                        "volumen" => "35"
                        "paginaInicial" => "529"
                        "paginaFinal" => "538"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21782289"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Serial diaphragm ultrasonography to predict successful discontinuation of mechanical ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Palkar"
                            1 => "P&#46; Mayo"
                            2 => "K&#46; Singh"
                            3 => "S&#46; Koenig"
                            4 => "M&#46; Narasimhan"
                            5 => "A&#46; Singh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00408-018-0106-x"
                      "Revista" => array:5 [
                        "tituloSerie" => "Lung"
                        "fecha" => "2018"
                        "volumen" => "196"
                        "paginaInicial" => "363"
                        "paginaFinal" => "368"
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0285"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diaphragm dysfunction assessed by ultrasonography&#58; influence on weaning from mechanical ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "W&#46;Y&#46; Kim"
                            1 => "H&#46;J&#46; Suh"
                            2 => "S&#46;B&#46; Hong"
                            3 => "Y&#46; Koh"
                            4 => "C&#46;M&#46; Lim"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/CCM.0b013e3182266408"
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                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2011"
                        "volumen" => "39"
                        "paginaInicial" => "2627"
                        "paginaFinal" => "2630"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21705883"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0290"
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              "referencia" => array:1 [
                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "The evolution of diaphragm activity and function determined by ultrasound during spontaneous breathing trials"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "N&#46; Rittayamai"
                            1 => "S&#46; Hemvimon"
                            2 => "N&#46; Chierakul"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jcrc.2019.02.016"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Crit Care"
                        "fecha" => "2019"
                        "volumen" => "51"
                        "paginaInicial" => "133"
                        "paginaFinal" => "138"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30802759"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Sonographic evaluation of the diaphragm in critically ill patients&#46; Technique and clinical applications"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Matamis"
                            1 => "E&#46; Soilemezi"
                            2 => "M&#46; Tsagourias"
                            3 => "E&#46; Akoumianaki"
                            4 => "S&#46; Dimassi"
                            5 => "F&#46; Boroli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-013-2823-1"
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                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2013"
                        "volumen" => "39"
                        "paginaInicial" => "801"
                        "paginaFinal" => "810"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23344830"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Role of diaphragmatic rapid shallow breathing index in predicting weaning outcome in patients with acute exacerbation of COPD"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
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                            2 => "M&#46; Walaa"
                            3 => "S&#46;M&#46; Lutfy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2147/COPD.S161691"
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J COPD"
                        "fecha" => "2018"
                        "volumen" => "13"
                        "paginaInicial" => "1655"
                        "paginaFinal" => "1661"
                      ]
                    ]
                  ]
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              ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Reconnection to mechanical ventilation for 1<span class="elsevierStyleHsp" style=""></span>h after a successful spontaneous breathing trial reduces reintubation in critically ill patients&#58; a multicenter randomized controlled trial"
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                        0 => array:2 [
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                            1 => "A&#46; Gonz&#225;lez-Castro"
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                            3 => "M&#46;T&#46; Bouza"
                            4 => "M&#46; Iba&#241;ez"
                            5 => "C&#46; Garc&#237;a"
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                  "host" => array:1 [
                    0 => array:2 [
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                        "tituloSerie" => "Intensive Care Med"
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                        "volumen" => "43"
                        "paginaInicial" => "1660"
                        "paginaFinal" => "1667"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28936675"
                            "web" => "Medline"
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                ]
              ]
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              "identificador" => "bib0310"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Diaphragm ultrasound as a predictor of successful extubation from mechanical ventilation"
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                          "etal" => false
                          "autores" => array:4 [
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                            1 => "E&#46;J&#46; Gartman"
                            2 => "J&#46;M&#46; Sethi"
                            3 => "F&#46;D&#46; McCool"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/thoraxjnl-2013-204111"
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                        "tituloSerie" => "Thorax"
                        "fecha" => "2014"
                        "volumen" => "69"
                        "paginaInicial" => "423"
                        "paginaFinal" => "427"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24365607"
                            "web" => "Medline"
                          ]
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                    ]
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                ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sample size tables for clinical studies"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Assessing the fit of the model"
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                        0 => array:2 [
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                    ]
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                ]
              ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Ultrasound imaging for diaphragm dysfunction&#58; a narrative literature review"
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                          "autores" => array:6 [
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                            4 => "A&#46; Zangrillo"
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                    0 => array:2 [
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                        "tituloSerie" => "J Cardiothorac Vasc Anesth"
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                        "volumen" => "33"
                        "paginaInicial" => "2525"
                        "paginaFinal" => "2536"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30686657"
                            "web" => "Medline"
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                ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Diaphragm and lung ultrasound to predict weaning outcome&#58; systematic review and meta-analysis"
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                        "tituloSerie" => "Chest"
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                        "volumen" => "152"
                        "paginaInicial" => "1140"
                        "paginaFinal" => "1150"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28864053"
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                      ]
                    ]
                  ]
                ]
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                      "titulo" => "Diaphragmatic ultrasonography for predicting ventilator weaning&#58; a meta-analysis"
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                          "etal" => false
                          "autores" => array:6 [
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                            3 => "H&#46; Cui"
                            4 => "G&#46; Wang"
                            5 => "Z&#46; Wang"
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                        ]
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                        "tituloSerie" => "Medicine &#40;Baltimore&#41;"
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                        "paginaInicial" => "e10968"
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                  ]
                ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Comparison of lung ultrasound-based weaning indices with rapid shallow breathing index&#58; are they helpful&#63;"
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                          "etal" => false
                          "autores" => array:2 [
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                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4103/ijccm.IJCCM_331_17"
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                        "tituloSerie" => "Indian J Crit Care Med"
                        "fecha" => "2018"
                        "volumen" => "22"
                        "paginaInicial" => "435"
                        "paginaFinal" => "440"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29962745"
                            "web" => "Medline"
                          ]
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                ]
              ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Diaphragm excursion-time index&#58; a new parameter using ultrasonography to predict extubation outcome"
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                          "etal" => true
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                            3 => "K&#46; Singh"
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                            5 => "P&#46; Mayo"
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                        ]
                      ]
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                        "paginaInicial" => "1213"
                        "paginaFinal" => "1220"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29353023"
                            "web" => "Medline"
                          ]
                        ]
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Effect of pressure support vs T-piece ventilation strategies during spontaneous breathing trials on successful extubation among patients receiving mechanical ventilation"
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                        "tituloSerie" => "Curr Opin Crit Care"
                        "fecha" => "2019"
                        "volumen" => "25"
                        "paginaInicial" => "77"
                        "paginaFinal" => "85"
                        "link" => array:1 [
                          0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Coexistence and impact of limb muscle and diaphragm weakness at time of liberation from mechanical ventilation in medical intensive care unit patients"
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                          "etal" => true
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                            3 => "J&#46; Delemazure"
                            4 => "D&#46; Reuter"
                            5 => "L&#46; Brochard"
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                        "tituloSerie" => "Am J Respir Crit Care Med"
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                        "paginaInicial" => "57"
                        "paginaFinal" => "66"
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                  ]
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                          "autores" => array:1 [
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                    0 => array:2 [
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                      "Revista" => array:5 [
                        "tituloSerie" => "Curr Opin Crit Care"
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                        "volumen" => "12"
                        "paginaInicial" => "405"
                        "paginaFinal" => "411"
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                    ]
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                      "titulo" => "Diaphragmatic dysfunction is characterized by increased duration of mechanical ventilation in subjects with prolonged weaning"
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                          "etal" => false
                          "autores" => array:6 [
                            0 => "Z&#46; Lu"
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                            3 => "G&#46; Zhang"
                            4 => "F&#46; Guo"
                            5 => "H&#46; Ge"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4187/respcare.04746"
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                        "tituloSerie" => "Respir Care"
                        "fecha" => "2016"
                        "volumen" => "61"
                        "paginaInicial" => "1316"
                        "paginaFinal" => "1322"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27682813"
                            "web" => "Medline"
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                      "titulo" => "Monitoring and preventing diaphragm injury"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46;M&#46; Heunks"
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MCC.0000000000000168"
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                        "tituloSerie" => "Curr Opin Crit Care"
                        "fecha" => "2015"
                        "volumen" => "21"
                        "paginaInicial" => "34"
                        "paginaFinal" => "41"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25546533"
                            "web" => "Medline"
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                      ]
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                  ]
                ]
              ]
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                          "etal" => true
                          "autores" => array:6 [
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                            3 => "M&#46; Conseil"
                            4 => "M&#46; Mahul"
                            5 => "G&#46; Rao"
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                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
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                        "tituloSerie" => "Rev Mal Respir"
                        "fecha" => "2015"
                        "volumen" => "32"
                        "paginaInicial" => "370"
                        "paginaFinal" => "380"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25496650"
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                ]
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                      "titulo" => "Ultrasonography evaluation during the weaning process&#58; the heart&#44; the diaphragm&#44; the pleura and the lung"
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                          "etal" => false
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                        "paginaFinal" => "1117"
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                    ]
                  ]
                ]
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                            4 => "A&#46; Murray"
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                        "paginaFinal" => "649"
                        "link" => array:1 [
                          0 => array:2 [
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