array:23 [
  "pii" => "S2173572722001230"
  "issn" => "21735727"
  "doi" => "10.1016/j.medine.2022.06.009"
  "estado" => "S300"
  "fechaPublicacion" => "2022-09-01"
  "aid" => "1744"
  "copyrightAnyo" => "2022"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "cor"
  "cita" => "Med Intensiva. 2022;46:539-40"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0210569122000158"
      "issn" => "02105691"
      "doi" => "10.1016/j.medin.2022.01.003"
      "estado" => "S300"
      "fechaPublicacion" => "2022-09-01"
      "aid" => "1744"
      "copyright" => "Elsevier España, S.L.U. y SEMICYUC"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "cor"
      "cita" => "Med Intensiva. 2022;46:539-40"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:1 [
        "total" => 0
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">CARTA AL EDITOR</span>"
        "titulo" => "Posibles efectos adversos de la donaci&#243;n de sangre de pacientes en muerte encef&#225;lica"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "539"
            "paginaFinal" => "540"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Possible adverse effects of the blood donation from brain-dead patients"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "E&#46; Jim&#233;nez-Guerra, J&#46; Revuelto-Rey, N&#46;S&#46; Rocchetti, J&#46;J&#46; Egea-Guerrero"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "E&#46;"
                "apellidos" => "Jim&#233;nez-Guerra"
              ]
              1 => array:2 [
                "nombre" => "J&#46;"
                "apellidos" => "Revuelto-Rey"
              ]
              2 => array:2 [
                "nombre" => "N&#46;S&#46;"
                "apellidos" => "Rocchetti"
              ]
              3 => array:2 [
                "nombre" => "J&#46;J&#46;"
                "apellidos" => "Egea-Guerrero"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173572722001230"
          "doi" => "10.1016/j.medine.2022.06.009"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572722001230?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569122000158?idApp=WMIE"
      "url" => "/02105691/0000004600000009/v1_202208290552/S0210569122000158/v1_202208290552/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S2173572722001242"
    "issn" => "21735727"
    "doi" => "10.1016/j.medine.2022.06.010"
    "estado" => "S300"
    "fechaPublicacion" => "2022-09-01"
    "aid" => "1763"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Med Intensiva. 2022;46:540-1"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Reflections and aspects to consider about blood donation in brain-dead patients"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "540"
          "paginaFinal" => "541"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Reflexiones y aspectos a considerar de la donaci&#243;n de sangre de pacientes en muerte encef&#225;lica"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "K&#46;L&#46; Nanwani Nanwani, B&#46; Est&#233;banez Montiel, M&#46; Quintana-D&#237;az, J&#46;A&#46; Garc&#237;a Erce"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "K&#46;L&#46;"
              "apellidos" => "Nanwani Nanwani"
            ]
            1 => array:2 [
              "nombre" => "B&#46;"
              "apellidos" => "Est&#233;banez Montiel"
            ]
            2 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Quintana-D&#237;az"
            ]
            3 => array:2 [
              "nombre" => "J&#46;A&#46;"
              "apellidos" => "Garc&#237;a Erce"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572722001242?idApp=WMIE"
    "url" => "/21735727/0000004600000009/v2_202301310733/S2173572722001242/v2_202301310733/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2173572722001229"
    "issn" => "21735727"
    "doi" => "10.1016/j.medine.2022.06.008"
    "estado" => "S300"
    "fechaPublicacion" => "2022-09-01"
    "aid" => "1706"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Med Intensiva. 2022;46:538-9"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Blood donation from brain-dead patients&#58; Feasible and ethical&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "538"
          "paginaFinal" => "539"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Donaci&#243;n de sangre de pacientes en muerte encef&#225;lica&#58; &#191;factible y &#233;tico&#63;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "K&#46;L&#46; Nanwani Nanwani, B&#46; Est&#233;banez Montiel, J&#46;A&#46; Garc&#237;a Erce, M&#46; Quintana-D&#237;az"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "K&#46;L&#46;"
              "apellidos" => "Nanwani Nanwani"
            ]
            1 => array:2 [
              "nombre" => "B&#46;"
              "apellidos" => "Est&#233;banez Montiel"
            ]
            2 => array:2 [
              "nombre" => "J&#46;A&#46;"
              "apellidos" => "Garc&#237;a Erce"
            ]
            3 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Quintana-D&#237;az"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0210569121001959"
        "doi" => "10.1016/j.medin.2021.09.001"
        "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/S0210569121001959?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572722001229?idApp=WMIE"
    "url" => "/21735727/0000004600000009/v2_202301310733/S2173572722001229/v2_202301310733/en/main.assets"
  ]
  "en" => array:13 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "Possible adverse effects of the blood donation from brain-dead patients"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#58;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "539"
        "paginaFinal" => "540"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "E&#46; Jim&#233;nez-Guerra, J&#46; Revuelto-Rey, N&#46;S&#46; Rocchetti, J&#46;J&#46; Egea-Guerrero"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "E&#46;"
            "apellidos" => "Jim&#233;nez-Guerra"
            "email" => array:1 [
              0 => "evelin_jg@hotmail.com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Revuelto-Rey"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "N&#46;S&#46;"
            "apellidos" => "Rocchetti"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "J&#46;J&#46;"
            "apellidos" => "Egea-Guerrero"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:4 [
          0 => array:3 [
            "entidad" => "Servicio de Medicina Intensiva&#44; Hospital Universitario Puerta del Mar&#44; C&#225;diz&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Unidad de Cuidados Intensivos&#44; Hospital Eva Per&#243;n&#44; Granadero Balgorria&#44; Sante Fe&#44; Argentina"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Facultad de Ciencias M&#233;dicas&#44; Universidad Nacional de Rosario&#44; Rosario&#44; Santa Fe&#44; Argentina"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Unidad de Neurocr&#237;ticos&#44; Hospital Universitario Virgen del Roc&#237;o&#44; Sevilla&#44; Spain"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Posibles efectos adversos de la donaci&#243;n de sangre de pacientes en muerte encef&#225;lica"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We have found the article published by Nanwani Nanwani et al&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> on blood donation from brain-dead &#40;BD&#41; patients to be very interesting&#46; It has opened a valuable debate on the clinical circumstances and ethical principles which should be revised in order to view this option as feasible&#46; In our opinion&#44; we must not obviate the close relationship between the progression of severe brain damage and the generation of hypermetabolic reactions and immune-mediated processes throughout the body&#46; Brain death is the greatest stress factor to which organs&#44; tissue and cells are exposed before possible donation&#44; due to the generation of hemodynamic&#44; ventilatory&#44; endocrine and inflammatory modifications&#44; mediated by an important neuromodulated inflammatory response&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">If in addition BD is reached secondary to severe traumatic brain injury&#44; for example&#44; we know that the elevated secretion of cytokines produces an increase in the concentration of brain tissue factor&#46; This in turn activates the complement system&#44; which in combination with important catecholamine release&#44; contributes to perpetuating the coagulopathic state&#46; Such rapid release of large amounts of tissue factor following severe traumatic brain injury also induces thrombin formation&#46; Likewise&#44; the systemic proinflammatory state is responsible for the activation of fibrinogen and IL-6&#44; which together with complement activation would explain the hypercoagulability state that predominates in the first 24&#8239;h after trauma&#46; On the other hand&#44; platelet inhibition and consumption&#44; together with the excessive activation of fibrinolysis&#44; would account for the increased risk of bleeding in later stages after trauma&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Taking into account that several studies have shown high plasma IL-6 concentrations in donors to be significantly associated with reduced recipient survival at 6 months after hospital discharge&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> to what extent are we able to affirm that blood from BD patients will not be affected by this metabolic and immune cascade that is activated in patients with severe brain injury&#63; From our perspective&#44; current scientific knowledge does not allow us to be sure of the absence of immune-modulating effects in the recipients&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In turn&#44; once BD has been established&#44; it is common practice to administer amines&#44; antibiotics and several different drugs to maintain donor clinical stability - and this undoubtedly could affect the theoretical quality of the blood components&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">We also must remember that during the organ harvesting and preservation process&#44; vascular infusions are performed involving specially prepared fluids which seek to maintain homeostasis&#46; These solutions contain additives &#40;osmotic agents&#44; electrolytes&#44; colloids&#44; metabolic inhibitors&#44; metabolites&#44; antioxidants and even drugs&#41;&#44; and can have an impact on the presence of coagulation factors&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> In this way&#44; if blood extraction as suggested by the authors is performed during or after harvesting of the rest of body organs&#44; we likewise would not be able to discard potential clinically significant alterations of the extracted blood components&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Coinciding with the authors on the importance of finding new resources and seeking solutions to the more than likely shortage of blood products which we may face&#44; we believe that if this practice is finally implanted&#44; it must be done so with extreme caution&#46; Although the ethical debate is important&#44; we feel that attention should focus on demonstrating the viability of using such blood products and clarifying the doubts regarding possible adverse effects&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Jim&#233;nez-Guerra E&#44; Revuelto-Rey J&#44; Rocchetti NS&#44; Egea-Guerrero JJ&#46; Posibles efectos adversos de la donaci&#243;n de sangre de pacientes en muerte encef&#225;lica&#46; Med Intensiva&#46; 2022&#59;46&#58;539&#8211;540&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:5 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Donaci&#243;n de sangre de pacientes en muerte encef&#225;lica&#58; &#191;factible y &#233;tico&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46;L&#46; Nanwani Nanwani"
                            1 => "B&#46; Est&#233;banez Montiel"
                            2 => "J&#46;A&#46; Garc&#237;a Erce"
                            3 => "M&#46; Quintana-D&#237;az"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.medin.2021.09.001"
                      "Revista" => array:2 [
                        "tituloSerie" => "Med Intensiva&#46;"
                        "fecha" => "2022"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Muerte encef&#225;lica&#58; repercusi&#243;n sobre &#243;rganos y tejidos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Dom&#237;nguez-Rold&#225;n"
                            1 => "C&#46; Garc&#237;a-Alfaro"
                            2 => "P&#46;I&#46; Jimen&#233;z-Gonz&#225;lez"
                            3 => "F&#46; Hern&#225;ndez- Haza&#241;as"
                            4 => "M&#46;L&#46; Gasc&#243;n Castillo"
                            5 => "J&#46;J&#46; Egea Guerrero"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.medin.2009.03.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Intensiva&#46;"
                        "fecha" => "2009"
                        "volumen" => "33"
                        "paginaInicial" => "434"
                        "paginaFinal" => "441"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19922825"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Coagulation abnormalities associated with severe isolated traumatic brain injury&#58; cerebral arterio-venous differences in coagulation and inflammatory markers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Nekludov"
                            1 => "J&#46; Antovic"
                            2 => "S&#46; Bredbacka"
                            3 => "M&#46; Blomb&#228;ck"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/neu.2006.0173"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurotrauma&#46;"
                        "fecha" => "2007"
                        "volumen" => "24"
                        "paginaInicial" => "174"
                        "paginaFinal" => "180"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17263681"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Monitoring Organ Donors to Improve Transplantation Results &#40;MOnIToR&#41; Study Investigators&#46; Donor biomarkers as predictors of organ use and recipient survival after neurologically deceased donor organ transplantation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Li"
                            1 => "S&#46; Wang"
                            2 => "R&#46; Murugan"
                            3 => "A&#46; Al-Khafaji"
                            4 => "D&#46;J&#46; Lebovitz"
                            5 => "M&#46; Souter"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jcrc.2018.08.013"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Crit Care&#46;"
                        "fecha" => "2018"
                        "volumen" => "48"
                        "paginaInicial" => "42"
                        "paginaFinal" => "47"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30172032"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical effects of blood donor characteristics in transfusion recipients&#58; protocol of a framework to study the blood donor-recipient continuum"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Chass&#233;"
                            1 => "L&#46; McIntyre"
                            2 => "A&#46; Tinmouth"
                            3 => "J&#46; Acker"
                            4 => "S&#46;W&#46; English"
                            5 => "G&#46; Knoll"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "BMJ Open&#46;"
                        "fecha" => "2015"
                        "volumen" => "5"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735727/0000004600000009/v2_202301310733/S2173572722001230/v2_202301310733/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "64604"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Letters to the Editor"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735727/0000004600000009/v2_202301310733/S2173572722001230/v2_202301310733/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572722001230?idApp=WMIE"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Letter to the Editor
Possible adverse effects of the blood donation from brain-dead patients
Posibles efectos adversos de la donación de sangre de pacientes en muerte encefálica
E. Jiménez-Guerraa,
Corresponding author
evelin_jg@hotmail.com

Corresponding author.
, J. Revuelto-Reya, N.S. Rocchettib,c, J.J. Egea-Guerrerod
a Servicio de Medicina Intensiva, Hospital Universitario Puerta del Mar, Cádiz, Spain
b Unidad de Cuidados Intensivos, Hospital Eva Perón, Granadero Balgorria, Sante Fe, Argentina
c Facultad de Ciencias Médicas, Universidad Nacional de Rosario, Rosario, Santa Fe, Argentina
d Unidad de Neurocríticos, Hospital Universitario Virgen del Rocío, Sevilla, Spain
Read
2972
Times
was read the article
771
Total PDF
2201
Total HTML
Share statistics
 array:23 [
  "pii" => "S2173572722001230"
  "issn" => "21735727"
  "doi" => "10.1016/j.medine.2022.06.009"
  "estado" => "S300"
  "fechaPublicacion" => "2022-09-01"
  "aid" => "1744"
  "copyrightAnyo" => "2022"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "cor"
  "cita" => "Med Intensiva. 2022;46:539-40"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0210569122000158"
      "issn" => "02105691"
      "doi" => "10.1016/j.medin.2022.01.003"
      "estado" => "S300"
      "fechaPublicacion" => "2022-09-01"
      "aid" => "1744"
      "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "cor"
      "cita" => "Med Intensiva. 2022;46:539-40"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:1 [
        "total" => 0
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">CARTA AL EDITOR</span>"
        "titulo" => "Posibles efectos adversos de la donaci&#243;n de sangre de pacientes en muerte encef&#225;lica"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "539"
            "paginaFinal" => "540"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Possible adverse effects of the blood donation from brain-dead patients"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "E&#46; Jim&#233;nez-Guerra, J&#46; Revuelto-Rey, N&#46;S&#46; Rocchetti, J&#46;J&#46; Egea-Guerrero"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "E&#46;"
                "apellidos" => "Jim&#233;nez-Guerra"
              ]
              1 => array:2 [
                "nombre" => "J&#46;"
                "apellidos" => "Revuelto-Rey"
              ]
              2 => array:2 [
                "nombre" => "N&#46;S&#46;"
                "apellidos" => "Rocchetti"
              ]
              3 => array:2 [
                "nombre" => "J&#46;J&#46;"
                "apellidos" => "Egea-Guerrero"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173572722001230"
          "doi" => "10.1016/j.medine.2022.06.009"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572722001230?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569122000158?idApp=WMIE"
      "url" => "/02105691/0000004600000009/v1_202208290552/S0210569122000158/v1_202208290552/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S2173572722001242"
    "issn" => "21735727"
    "doi" => "10.1016/j.medine.2022.06.010"
    "estado" => "S300"
    "fechaPublicacion" => "2022-09-01"
    "aid" => "1763"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Med Intensiva. 2022;46:540-1"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Reflections and aspects to consider about blood donation in brain-dead patients"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "540"
          "paginaFinal" => "541"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Reflexiones y aspectos a considerar de la donaci&#243;n de sangre de pacientes en muerte encef&#225;lica"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "K&#46;L&#46; Nanwani Nanwani, B&#46; Est&#233;banez Montiel, M&#46; Quintana-D&#237;az, J&#46;A&#46; Garc&#237;a Erce"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "K&#46;L&#46;"
              "apellidos" => "Nanwani Nanwani"
            ]
            1 => array:2 [
              "nombre" => "B&#46;"
              "apellidos" => "Est&#233;banez Montiel"
            ]
            2 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Quintana-D&#237;az"
            ]
            3 => array:2 [
              "nombre" => "J&#46;A&#46;"
              "apellidos" => "Garc&#237;a Erce"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572722001242?idApp=WMIE"
    "url" => "/21735727/0000004600000009/v2_202301310733/S2173572722001242/v2_202301310733/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2173572722001229"
    "issn" => "21735727"
    "doi" => "10.1016/j.medine.2022.06.008"
    "estado" => "S300"
    "fechaPublicacion" => "2022-09-01"
    "aid" => "1706"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Med Intensiva. 2022;46:538-9"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Blood donation from brain-dead patients&#58; Feasible and ethical&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "538"
          "paginaFinal" => "539"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Donaci&#243;n de sangre de pacientes en muerte encef&#225;lica&#58; &#191;factible y &#233;tico&#63;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "K&#46;L&#46; Nanwani Nanwani, B&#46; Est&#233;banez Montiel, J&#46;A&#46; Garc&#237;a Erce, M&#46; Quintana-D&#237;az"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "K&#46;L&#46;"
              "apellidos" => "Nanwani Nanwani"
            ]
            1 => array:2 [
              "nombre" => "B&#46;"
              "apellidos" => "Est&#233;banez Montiel"
            ]
            2 => array:2 [
              "nombre" => "J&#46;A&#46;"
              "apellidos" => "Garc&#237;a Erce"
            ]
            3 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Quintana-D&#237;az"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0210569121001959"
        "doi" => "10.1016/j.medin.2021.09.001"
        "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/S0210569121001959?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572722001229?idApp=WMIE"
    "url" => "/21735727/0000004600000009/v2_202301310733/S2173572722001229/v2_202301310733/en/main.assets"
  ]
  "en" => array:13 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "Possible adverse effects of the blood donation from brain-dead patients"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#58;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "539"
        "paginaFinal" => "540"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "E&#46; Jim&#233;nez-Guerra, J&#46; Revuelto-Rey, N&#46;S&#46; Rocchetti, J&#46;J&#46; Egea-Guerrero"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "E&#46;"
            "apellidos" => "Jim&#233;nez-Guerra"
            "email" => array:1 [
              0 => "evelin_jg@hotmail.com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Revuelto-Rey"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "N&#46;S&#46;"
            "apellidos" => "Rocchetti"
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "J&#46;J&#46;"
            "apellidos" => "Egea-Guerrero"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:4 [
          0 => array:3 [
            "entidad" => "Servicio de Medicina Intensiva&#44; Hospital Universitario Puerta del Mar&#44; C&#225;diz&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Unidad de Cuidados Intensivos&#44; Hospital Eva Per&#243;n&#44; Granadero Balgorria&#44; Sante Fe&#44; Argentina"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Facultad de Ciencias M&#233;dicas&#44; Universidad Nacional de Rosario&#44; Rosario&#44; Santa Fe&#44; Argentina"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Unidad de Neurocr&#237;ticos&#44; Hospital Universitario Virgen del Roc&#237;o&#44; Sevilla&#44; Spain"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Posibles efectos adversos de la donaci&#243;n de sangre de pacientes en muerte encef&#225;lica"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We have found the article published by Nanwani Nanwani et al&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> on blood donation from brain-dead &#40;BD&#41; patients to be very interesting&#46; It has opened a valuable debate on the clinical circumstances and ethical principles which should be revised in order to view this option as feasible&#46; In our opinion&#44; we must not obviate the close relationship between the progression of severe brain damage and the generation of hypermetabolic reactions and immune-mediated processes throughout the body&#46; Brain death is the greatest stress factor to which organs&#44; tissue and cells are exposed before possible donation&#44; due to the generation of hemodynamic&#44; ventilatory&#44; endocrine and inflammatory modifications&#44; mediated by an important neuromodulated inflammatory response&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">If in addition BD is reached secondary to severe traumatic brain injury&#44; for example&#44; we know that the elevated secretion of cytokines produces an increase in the concentration of brain tissue factor&#46; This in turn activates the complement system&#44; which in combination with important catecholamine release&#44; contributes to perpetuating the coagulopathic state&#46; Such rapid release of large amounts of tissue factor following severe traumatic brain injury also induces thrombin formation&#46; Likewise&#44; the systemic proinflammatory state is responsible for the activation of fibrinogen and IL-6&#44; which together with complement activation would explain the hypercoagulability state that predominates in the first 24&#8239;h after trauma&#46; On the other hand&#44; platelet inhibition and consumption&#44; together with the excessive activation of fibrinolysis&#44; would account for the increased risk of bleeding in later stages after trauma&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Taking into account that several studies have shown high plasma IL-6 concentrations in donors to be significantly associated with reduced recipient survival at 6 months after hospital discharge&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> to what extent are we able to affirm that blood from BD patients will not be affected by this metabolic and immune cascade that is activated in patients with severe brain injury&#63; From our perspective&#44; current scientific knowledge does not allow us to be sure of the absence of immune-modulating effects in the recipients&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In turn&#44; once BD has been established&#44; it is common practice to administer amines&#44; antibiotics and several different drugs to maintain donor clinical stability - and this undoubtedly could affect the theoretical quality of the blood components&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">We also must remember that during the organ harvesting and preservation process&#44; vascular infusions are performed involving specially prepared fluids which seek to maintain homeostasis&#46; These solutions contain additives &#40;osmotic agents&#44; electrolytes&#44; colloids&#44; metabolic inhibitors&#44; metabolites&#44; antioxidants and even drugs&#41;&#44; and can have an impact on the presence of coagulation factors&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> In this way&#44; if blood extraction as suggested by the authors is performed during or after harvesting of the rest of body organs&#44; we likewise would not be able to discard potential clinically significant alterations of the extracted blood components&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Coinciding with the authors on the importance of finding new resources and seeking solutions to the more than likely shortage of blood products which we may face&#44; we believe that if this practice is finally implanted&#44; it must be done so with extreme caution&#46; Although the ethical debate is important&#44; we feel that attention should focus on demonstrating the viability of using such blood products and clarifying the doubts regarding possible adverse effects&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Jim&#233;nez-Guerra E&#44; Revuelto-Rey J&#44; Rocchetti NS&#44; Egea-Guerrero JJ&#46; Posibles efectos adversos de la donaci&#243;n de sangre de pacientes en muerte encef&#225;lica&#46; Med Intensiva&#46; 2022&#59;46&#58;539&#8211;540&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:5 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Donaci&#243;n de sangre de pacientes en muerte encef&#225;lica&#58; &#191;factible y &#233;tico&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46;L&#46; Nanwani Nanwani"
                            1 => "B&#46; Est&#233;banez Montiel"
                            2 => "J&#46;A&#46; Garc&#237;a Erce"
                            3 => "M&#46; Quintana-D&#237;az"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.medin.2021.09.001"
                      "Revista" => array:2 [
                        "tituloSerie" => "Med Intensiva&#46;"
                        "fecha" => "2022"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Muerte encef&#225;lica&#58; repercusi&#243;n sobre &#243;rganos y tejidos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Dom&#237;nguez-Rold&#225;n"
                            1 => "C&#46; Garc&#237;a-Alfaro"
                            2 => "P&#46;I&#46; Jimen&#233;z-Gonz&#225;lez"
                            3 => "F&#46; Hern&#225;ndez- Haza&#241;as"
                            4 => "M&#46;L&#46; Gasc&#243;n Castillo"
                            5 => "J&#46;J&#46; Egea Guerrero"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.medin.2009.03.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Intensiva&#46;"
                        "fecha" => "2009"
                        "volumen" => "33"
                        "paginaInicial" => "434"
                        "paginaFinal" => "441"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19922825"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Coagulation abnormalities associated with severe isolated traumatic brain injury&#58; cerebral arterio-venous differences in coagulation and inflammatory markers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Nekludov"
                            1 => "J&#46; Antovic"
                            2 => "S&#46; Bredbacka"
                            3 => "M&#46; Blomb&#228;ck"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1089/neu.2006.0173"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurotrauma&#46;"
                        "fecha" => "2007"
                        "volumen" => "24"
                        "paginaInicial" => "174"
                        "paginaFinal" => "180"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17263681"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Monitoring Organ Donors to Improve Transplantation Results &#40;MOnIToR&#41; Study Investigators&#46; Donor biomarkers as predictors of organ use and recipient survival after neurologically deceased donor organ transplantation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Li"
                            1 => "S&#46; Wang"
                            2 => "R&#46; Murugan"
                            3 => "A&#46; Al-Khafaji"
                            4 => "D&#46;J&#46; Lebovitz"
                            5 => "M&#46; Souter"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jcrc.2018.08.013"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Crit Care&#46;"
                        "fecha" => "2018"
                        "volumen" => "48"
                        "paginaInicial" => "42"
                        "paginaFinal" => "47"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30172032"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical effects of blood donor characteristics in transfusion recipients&#58; protocol of a framework to study the blood donor-recipient continuum"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Chass&#233;"
                            1 => "L&#46; McIntyre"
                            2 => "A&#46; Tinmouth"
                            3 => "J&#46; Acker"
                            4 => "S&#46;W&#46; English"
                            5 => "G&#46; Knoll"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "BMJ Open&#46;"
                        "fecha" => "2015"
                        "volumen" => "5"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735727/0000004600000009/v2_202301310733/S2173572722001230/v2_202301310733/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "64604"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Letters to the Editor"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735727/0000004600000009/v2_202301310733/S2173572722001230/v2_202301310733/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572722001230?idApp=WMIE"
]
Article information
ISSN: 21735727
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 4 1 5
2024 October 112 43 155
2024 September 133 28 161
2024 August 167 42 209
2024 July 158 25 183
2024 June 148 53 201
2024 May 114 29 143
2024 April 93 43 136
2024 March 104 26 130
2024 February 130 35 165
2024 January 95 26 121
2023 December 106 45 151
2023 November 98 50 148
2023 October 115 55 170
2023 September 91 41 132
2023 August 71 20 91
2023 July 59 19 78
2023 June 44 23 67
2023 May 61 21 82
2023 April 47 18 65
2023 March 74 36 110
2023 February 62 26 88
2023 January 49 20 69
2022 December 65 46 111
2022 November 1 0 1
Show all

Follow this link to access the full text of the article

Idiomas
Medicina Intensiva (English Edition)
es en

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

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