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Avellanas Chavala, M. Ayala Gallardo, I. Soteras Martínez, E. Subirats Bayego" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M.L. Avellanas" "apellidos" => "Chavala" ] 1 => array:2 [ "nombre" => "M. Ayala" "apellidos" => "Gallardo" ] 2 => array:2 [ "nombre" => "I. Soteras" "apellidos" => "Martínez" ] 3 => array:2 [ "nombre" => "E. Subirats" "apellidos" => "Bayego" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572720301296?idApp=WMIE" "url" => "/21735727/0000004400000006/v1_202007311710/S2173572720301296/v1_202007311710/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173572720300941" "issn" => "21735727" "doi" => "10.1016/j.medine.2019.05.014" "estado" => "S300" "fechaPublicacion" => "2020-08-01" "aid" => "1343" "copyright" => "Elsevier España, S.L.U. and SEMICYUC" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Med Intensiva. 2020;44:389-91" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>" "titulo" => "Clinical simulation in the polytraumatized patient. Application in medical students" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "389" "paginaFinal" => "391" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Simulación clínica en el paciente politraumatizado. Aplicación en estudiantes de Medicina" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1030 "Ancho" => 1742 "Tamanyo" => 115590 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Evaluation of skills in clinical care to polytraumatized patients. The bar represents the median and the error bar the interquartile range (P25 and P75).</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The Wilcoxon signed-rank test was used to analyze change in the skills evaluated. Significance level (<span class="elsevierStyleItalic">p</span>) was <.001 in all of them.</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Hm., hemodynamic.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.A. Ballesteros, M. Feo González, B. Suberviola, E. Miñambres" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M.A." "apellidos" => "Ballesteros" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Feo González" ] 2 => array:2 [ "nombre" => "B." "apellidos" => "Suberviola" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Miñambres" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0210569119301275" "doi" => "10.1016/j.medin.2019.05.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569119301275?idApp=WMIE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572720300941?idApp=WMIE" "url" => "/21735727/0000004400000006/v1_202007311710/S2173572720300941/v1_202007311710/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Management of accidental hypothermia: A narrative review" "tieneTextoCompleto" => true "saludo" => "Dear Editor:" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "392" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "T.M. Ferrer Marrero" "autores" => array:1 [ 0 => array:3 [ "nombre" => "T.M." "apellidos" => "Ferrer Marrero" "email" => array:1 [ 0 => "tferrermarre@mcw.edu" ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Medical College of Wisconsin, United States" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Gestión de la hipotermia accidental: revisión narrativa" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In the review article “Management of accidental hypothermia: A narrative review”, Avellanas et al. summarize the current medical literature about accidental hypothermia.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> This review article came out at a perfect timing of the year, with so much needed updated information. With the increase in the number of winter recreational sports, the United States is receiving an estimated 35 million mountain tourists annually.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> With several winter activities combining water sports, there is a need for an annual refresher on the recommendations on the management of accidental hypothermia, including the management of those patients who developed hypothermia after cold water drowning.</p><p id="par0010" class="elsevierStylePara elsevierViewall">In their article, it is emphasized that advanced life support must be started in hypothermic patients in cardiac arrest and underscores the need for a proper selection of the medical institution to transport these patients.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> Hospitals with the expertise on venoarterial extracorporeal membrane oxygenator (VA-ECMO) are the preferred ones as VA-ECMO is the technique of choice to treat hypothermic patients with cardiac arrest or hemodynamical instability.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> VA-ECMO improves the patient's survival without neurological impairment to up to 100%.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Different from Avellanas’ prior published work on accidental hypothermia, the focus in this review is not to discuss the pathophysiological changes during hypothermia or the different rewarming techniques. This review is in response to the two mentioned studies that revealed deficiencies in the out-of-hospital rescue team operations. The deficiencies included the lack of transfers of the victims in cardiac arrest or hemodynamically unstable, to equipped hospitals with VA-ECMO.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> Therefore, this article highlights the out-of-hospital management and underscores the central role the rescue team plays in improving the outcomes.</p><p id="par0020" class="elsevierStylePara elsevierViewall">There is a discussion of extraordinary cases who survived even after prolonged immersion in cold water.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> Those discussed cases challenge the data that suggest that immersion longer than 25<span class="elsevierStyleHsp" style=""></span>min is associated with poor prognosis and could potentially be used to reconsider further resuscitative efforts.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> This review article suggest that resuscitative efforts could be applied to a broader population, including those who were priorly believed to have a poor prognosis. The data presented in this review article may influence future modifications to the different societies’ recommendations and may continue to opening discussions about the extent of the protective properties of hypothermia.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gestión de la hipotermia accidental: revisión narrativa" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.L. Avellanas Chavala" 1 => "M. Ayala Gallardo" 2 => "I. Soteras Martínez" 3 => "E. Subirats Bayego" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medin.2018.11.008" "Revista" => array:6 [ "tituloSerie" => "Med Intensiva" "fecha" => "2019" "volumen" => "43" "paginaInicial" => "556" "paginaFinal" => "568" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30683520" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The risk of cardiovascular events during leisure time activities at altitude" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Burtscher" 1 => "A. 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Sanak" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1089/ham.2017.0090" "Revista" => array:6 [ "tituloSerie" => "High Alt Med Biol" "fecha" => "2017" "volumen" => "18" "paginaInicial" => "411" "paginaFinal" => "416" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28968162" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predicting outcome of drowning at the scene: a systematic review and meta-analyses" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "L. Quan" 1 => "J.J. Bierens" 2 => "R. Lis" 3 => "A. Rowhani-Rahbar" 4 => "P. Morley" 5 => "G.D. 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