array:22 [
  "pii" => "S2173572724002236"
  "issn" => "21735727"
  "doi" => "10.1016/j.medine.2024.09.002"
  "estado" => "S200"
  "fechaPublicacion" => "2024-09-16"
  "aid" => "2077"
  "copyright" => "Elsevier España, S.L.U. and SEMICYUC"
  "copyrightAnyo" => "2024"
  "documento" => "simple-article"
  "crossmark" => 0
  "subdocumento" => "cor"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S2173572724002315"
    "issn" => "21735727"
    "doi" => "10.1016/j.medine.2024.09.007"
    "estado" => "S200"
    "fechaPublicacion" => "2024-09-27"
    "aid" => "2091"
    "copyright" => "Elsevier España, S.L.U. and SEMICYUC"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "sco"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Update in intensive care medicine&#58; Critical patient safety</span>"
      "titulo" => "Patient safety in the intensive care department"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "La seguridad del paciente en los servicios de medicina intensiva"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Mar&#237;a Cruz Mart&#237;n-Delgado, Mar&#237;a Bod&#237;"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "Mar&#237;a Cruz"
              "apellidos" => "Mart&#237;n-Delgado"
            ]
            1 => array:2 [
              "nombre" => "Mar&#237;a"
              "apellidos" => "Bod&#237;"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0210569124003115"
        "doi" => "10.1016/j.medin.2024.07.010"
        "estado" => "S200"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569124003115?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572724002315?idApp=WMIE"
    "url" => "/21735727/unassign/S2173572724002315/v1_202409270422/en/main.assets"
  ]
  "itemAnterior" => array:17 [
    "pii" => "S2173572724000274"
    "issn" => "21735727"
    "doi" => "10.1016/j.medine.2024.02.003"
    "estado" => "S200"
    "fechaPublicacion" => "2024-02-25"
    "aid" => "1976"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Fractional excretion of sodium and potassium and urinary strong ion difference in the evaluation of persistent AKI in sepsis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Excreci&#243;n fraccional de sodio y potasio&#44; y brecha ani&#243;nica urinaria en la evaluaci&#243;n de la IRA persistente en sepsis"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1448
              "Ancho" => 1675
              "Tamanyo" => 110835
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0135"
              "detalle" => "Figure "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">ROC curve showing the area under de curve of FENa&#44; FEK and uSID&#46;</p> <p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">FENa&#58; fractional excretion of sodium&#59; FEK&#58; fractional excretion of potassium&#59; uSID&#58; urinary strong ion difference&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Nicol&#225;s Contrera Rol&#243;n, Joaqu&#237;n Cantos, Iv&#225;n Huespe, Eduardo Prado, Griselda I&#46; Bratti, Carlos Schreck, Sergio Giannasi, Guillermo Rosa Diez, Carlos F&#46; Varela"
          "autores" => array:9 [
            0 => array:2 [
              "nombre" => "Nicol&#225;s"
              "apellidos" => "Contrera Rol&#243;n"
            ]
            1 => array:2 [
              "nombre" => "Joaqu&#237;n"
              "apellidos" => "Cantos"
            ]
            2 => array:2 [
              "nombre" => "Iv&#225;n"
              "apellidos" => "Huespe"
            ]
            3 => array:2 [
              "nombre" => "Eduardo"
              "apellidos" => "Prado"
            ]
            4 => array:2 [
              "nombre" => "Griselda I&#46;"
              "apellidos" => "Bratti"
            ]
            5 => array:2 [
              "nombre" => "Carlos"
              "apellidos" => "Schreck"
            ]
            6 => array:2 [
              "nombre" => "Sergio"
              "apellidos" => "Giannasi"
            ]
            7 => array:2 [
              "nombre" => "Guillermo"
              "apellidos" => "Rosa Diez"
            ]
            8 => array:2 [
              "nombre" => "Carlos F&#46;"
              "apellidos" => "Varela"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572724000274?idApp=WMIE"
    "url" => "/21735727/unassign/S2173572724000274/v1_202402251056/en/main.assets"
  ]
  "en" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "High flow in tracheostomized patients on their first attempt to wean from mechanical ventilation&#58; more questions on the table"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#44;"
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Adri&#225;n Gallardo, Aldana Silvero, Santiago Saavedra"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "Adri&#225;n"
            "apellidos" => "Gallardo"
            "email" => array:1 [
              0 => "adriankgallardo@gmail.com"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              2 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Aldana"
            "apellidos" => "Silvero"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Santiago"
            "apellidos" => "Saavedra"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Servicio de Kinesiolog&#237;a&#44; Sanatorio Cl&#237;nica Modelo de Mor&#243;n&#44; Mor&#243;n&#44; Buenos Aires&#44; Argentina"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Universidad Nacional de La Matanza&#44; Departamento de Ciencias de la Salud&#44; Kinesiolog&#237;a y Fisiatr&#237;a&#44; San Justo&#44; Argentina"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Servicio de Medicina F&#237;sica y Rehabilitaci&#243;n&#44; Hospital Alem&#225;n&#44; CABA&#44; Buenos Aires&#46; Argentina"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Alto flujo en pacientes traqueostomizados en su primer intento de desvinculaci&#243;n de la ventilacion mecanica&#58; m&#225;s preguntas sobre la mesa"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We have read with enthusiasm the recently published case series where the authors evaluated the dynamic changes in inspiratory effort at the beginning and end of a spontaneous breathing trial&#44; comparing the use of high-flow therapy and conventional oxygen therapy in tracheostomized patients&#44; without finding statistically significant differences between both therapies&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Of interest in daily clinical practice&#44; we would like to highlight and share with the authors some points and questions that we believe are relevant&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Previous studies have shown that at the time of the first spontaneous breathing trial &#40;SBT&#41;&#44; 63&#37; of patients may suffer from diaphragmatic dysfunction&#44; 34&#37; may show limb muscle weakness and over 20&#37; may also suffer from both clinical scenarios&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The reported case series shows a median of Medical Research Council score &#40;MRC&#41; of 41 &#40;interquartile range&#44; IQR 37&#8211;58&#41;&#44; while the median mechanical ventilation duration was 17 days &#40;IQR 12&#8211;25&#41; and the median age was 70 &#40;IQR 64&#8211;75&#41;&#46; Do you think these variables could negatively influence the results by including patients with and without peripheral muscle weakness &#40;cutoff point to diagnose muscle weakness is 48&#41; and with such disparate mechanical ventilation times as 12 days and 25 days&#63;</p><p id="par0015" class="elsevierStylePara elsevierViewall">On the other hand&#44; Li and colleagues showed that optimization of the effects of high-flow therapy was observed with flow rates between 1&#46;34 and 1&#46;67 times the peak inspiratory tidal flow&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> and in the case series only a flow of 60&#8239;L&#47;min was used&#46; Considering that the reported patients used pressure support ventilation before disconnection &#40;the authors could quantify the peak inspiratory tidal flow&#41;&#44; is it possible that some patients did not receive the necessary flow rate to optimize the benefits of the therapy&#63; Although Li and colleagues&#39; study was not conducted in tracheostomized patients&#44; the analysis of the results showed a reduction in effects if the flow rate was above or below the described range&#46; Since&#44; to our knowledge&#44; to date no similar study has been reported in patients with tracheostomy&#44; we think that the results of Li and colleagues could be used in these cases&#46; Moreover&#44; this cohort of patients were in their first attempt of SBT when receiving high-flow therapy&#44; but there is evidence of benefits in patients with prolonged mechanical ventilation&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Finally&#44; the authors state that they did not consider the evaluation of arterial blood gases&#44; so we are unaware of the carbon dioxide partial pressure at the time of evaluation&#46; Different reports show that high-flow therapy reduces respiratory rate&#44; without producing major changes in CO<span class="elsevierStyleInf">2</span> concentration&#44;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a> so it would be reasonable to assume that this therapy reduces respiratory work&#46; Is it possible that in this cohort there were no significant changes in respiratory rate &#40;not reported by the authors&#41;&#44; because of an inadequate flow rate&#44; which directly impacts diaphragmatic function and modifies the results&#63;</p><p id="par0025" class="elsevierStylePara elsevierViewall">We would like to thank the authors in advance for the opportunity to debate and exchange different points of view on a topic of interest to us and one that we believe still has a long way to go&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interests</span><p id="par0030" class="elsevierStylePara elsevierViewall">None&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflict of interests"
        ]
        1 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "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" => "High flow Tracheal oxygen&#58; assessment of diaphragmatic functionality by ultrasonography in adults during weaning from mechanical ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46; Fern&#225;ndez Ceballos"
                            1 => "I&#46;A&#46; Huespe"
                            2 => "M&#46;S&#46; Venuti"
                            3 => "B&#46;L&#46; Ferreyro"
                            4 => "J&#46;M&#46; Dianti"
                            5 => "R&#46; Famiglietti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.medine.2024.06.006"
                      "Revista" => array:2 [
                        "tituloSerie" => "Med Intensiva &#40;Engl Ed&#41;"
                        "fecha" => "2024"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    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"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Dres"
                            1 => "B&#46;P&#46; Dub&#233;"
                            2 => "J&#46; Mayaux"
                            3 => "J&#46; Delemazure"
                            4 => "D&#46; Reuter"
                            5 => "L&#46; Brochard"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.201602-0367OC"
                      "Revista" => array:7 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2017"
                        "volumen" => "195"
                        "numero" => "1"
                        "paginaInicial" => "57"
                        "paginaFinal" => "66"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27310484"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Optimizing high-flow nasal cannula flow settings in adult hypoxemic patients based on peak inspiratory flow during tidal breathing"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46; Li"
                            1 => "J&#46;B&#46; Scott"
                            2 => "J&#46;B&#46; Fink"
                            3 => "B&#46; Reed"
                            4 => "O&#46; Roca"
                            5 => "R&#46; Dhand"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s13613-021-00949-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intensive Care"
                        "fecha" => "2021"
                        "volumen" => "11"
                        "numero" => "1"
                        "paginaInicial" => "164"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34837553"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effect of high-flow oxygen via tracheostomy on respiratory pattern and diaphragmatic function in patients with prolonged mechanical ventilation&#58; a randomized&#44; physiological&#44; crossover study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Lytra"
                            1 => "S&#46; Kokkoris"
                            2 => "I&#46; Poularas"
                            3 => "D&#46; Filippiadis"
                            4 => "D&#46; Cokkinos"
                            5 => "D&#46; Exarhoset"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jointm.2023.11.008"
                      "Revista" => array:8 [
                        "tituloSerie" => "J Intensive Med&#46;"
                        "fecha" => "2024"
                        "volumen" => "4"
                        "numero" => "2"
                        "paginaInicial" => "202"
                        "paginaFinal" => "208"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/38681788"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673620310229"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Physiological effects of high-flow oxygen in tracheostomized patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Natalini"
                            1 => "D&#46;L&#46; Grieco"
                            2 => "M&#46;T&#46; Santantonio"
                            3 => "L&#46; Mincione"
                            4 => "F&#46; Toni"
                            5 => "G&#46;M&#46; Anzellottiet"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s13613-019-0591-y"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Intensive Care"
                        "fecha" => "2019"
                        "volumen" => "9"
                        "numero" => "1"
                        "paginaInicial" => "114"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31591659"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735727/unassign/S2173572724002236/v1_202409160424/en/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/21735727/unassign/S2173572724002236/v1_202409160424/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572724002236?idApp=WMIE"
]
Share
Journal Information
Share
Share
Download PDF
More article options
Letter to the Editor
Available online 16 September 2024
High flow in tracheostomized patients on their first attempt to wean from mechanical ventilation: more questions on the table
Alto flujo en pacientes traqueostomizados en su primer intento de desvinculación de la ventilacion mecanica: más preguntas sobre la mesa
Visits
1
Adrián Gallardoa,b,
Corresponding author
adriankgallardo@gmail.com

Corresponding author.
, Aldana Silveroa, Santiago Saavedrac
a Servicio de Kinesiología, Sanatorio Clínica Modelo de Morón, Morón, Buenos Aires, Argentina
b Universidad Nacional de La Matanza, Departamento de Ciencias de la Salud, Kinesiología y Fisiatría, San Justo, Argentina
c Servicio de Medicina Física y Rehabilitación, Hospital Alemán, CABA, Buenos Aires. Argentina
This item has received
Article information
Full Text
Bibliography
Download PDF
Statistics

Article

These are the options to access the full texts of the publication Medicina Intensiva (English Edition)
Member
If you are a member of the Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias::
Go to the members area of the website of the SEMICYUC (www.semicyuc.org )and click the link to the magazine.
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Medicina Intensiva (English Edition)

Purchase
Purchase article

Purchasing article the PDF version will be downloaded

Price 19.34 €

Purchase now
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
Email
Idiomas
Medicina Intensiva (English Edition)
Article options
Tools
es en

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

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