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González-Contreras, A. Fernández-Galilea, C. León-Moya" "autores" => array:3 [ 0 => array:2 [ "nombre" => "J.J." "apellidos" => "González-Contreras" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Fernández-Galilea" ] 2 => array:2 [ "nombre" => "C." 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Caramello, A.V. De Salve, A. Macciotta, A. Boccuzzi" "autores" => array:4 [ 0 => array:2 [ "nombre" => "V." "apellidos" => "Caramello" ] 1 => array:2 [ "nombre" => "A.V." "apellidos" => "De Salve" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Macciotta" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Boccuzzi" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357272200217X?idApp=WMIE" "url" => "/21735727/0000004600000011/v1_202211050704/S217357272200217X/v1_202211050704/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Intensive Medicine</span>" "titulo" => "Pneumomediastinum in critically ill adult with COVID-19" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "663" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "N. Collercandy, A. Guillon" "autores" => array:2 [ 0 => array:4 [ "nombre" => "N." "apellidos" => "Collercandy" "email" => array:1 [ 0 => "nived.collercandy@yahoo.fr" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:4 [ "nombre" => "A." "apellidos" => "Guillon" "email" => array:1 [ 0 => "antoine.guillon@univ-tours.fr" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "CHU de Tours, service de médecine intensive réanimation, université de Tours, Tours, France" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "INSERM, Centre d’Etude des Pathologies Respiratoires (CEPR), Université de Tours, France" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Neumomediastino en adultos en estado critico con COVID-19" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 609 "Ancho" => 1250 "Tamanyo" => 132160 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 77-year-old man was admitted for moderate acute respiratory distress syndrome (ARDS) requiring invasive mechanical ventilation, with PCR confirmed SARS-Cov-2 infection. Protective ventilation strategy included: tidal volume of 6<span class="elsevierStyleHsp" style=""></span>mL/kg (ideal body weight), Positive End Expiratory Pressure (PEEP) titration with plateau pressure inferior to 28<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O, neuromuscular blockers, and prone position. At day 5 of ventilation, we observed acute chest and collar subcutaneous emphysema associated with bradycardia at 47<span class="elsevierStyleHsp" style=""></span>bpm. Chest CT scan revealed diffuse pneumomediastinum (white arrows) with diffuse subcutaneous emphysema (black arrows) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). There was no pneumothorax and no evidence for tracheal or esophageal perforation. No intervention was required. Pneumomediastinum are observed in critically ill coronavirus disease 2019 (COVID-19) patients. Whether or not this complication is related to the mechanical ventilation or to the COVID-19 pathogeny <span class="elsevierStyleItalic">per se</span> remains an unanswered question.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 609 "Ancho" => 1250 "Tamanyo" => 132160 ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack634231" "titulo" => "Acknowledgements" "texto" => "<p id="par0020" class="elsevierStylePara elsevierViewall">The authors thank the patient, whom relative gave full written permission for this report.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/21735727/0000004600000011/v1_202211050704/S2173572722002661/v1_202211050704/en/main.assets" "Apartado" => array:4 [ "identificador" => "64602" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Intensive Medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735727/0000004600000011/v1_202211050704/S2173572722002661/v1_202211050704/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572722002661?idApp=WMIE" ]
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