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La marca redondeada indica la localización craneal. Se observa derrame pleural (*) con signos de compartimentación (flechas) y diferentes ecogenicidades. Se aprecia atelectasia pulmonar (AP) y el «signo de la medusa» (**) descrito en el texto. D<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>diafragma; B<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>bazo.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.A. Álvarez-Fernández, F. Muñoz Ramírez, C. Rendón Jiménez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "J.A." "apellidos" => "Álvarez-Fernández" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Muñoz Ramírez" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Rendón Jiménez" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569115002107?idApp=WMIE" "url" => "/02105691/0000004000000009/v1_201612020641/S0210569115002107/v1_201612020641/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0210569116300638" "issn" => "02105691" "doi" => "10.1016/j.medin.2016.04.007" "estado" => "S300" "fechaPublicacion" => "2016-12-01" "aid" => "927" "copyright" => "Elsevier España, S.L.U. y SEMICYUC" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Med Intensiva. 2016;40:595-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2595 "formatos" => array:3 [ "EPUB" => 177 "HTML" => 1484 "PDF" => 934 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Sepsis biomarkers in severe burn patients: Cut-off point or time profile?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "595" "paginaFinal" => "596" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Biomarcadores de sepsis en pacientes quemados graves: ¿punto de corte o perfil temporal?" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.J. Egea-Guerrero, A. Rodríguez-Rodríguez" "autores" => array:2 [ 0 => array:2 [ "nombre" => "J.J." "apellidos" => "Egea-Guerrero" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Rodríguez-Rodríguez" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569116300638?idApp=WMIE" "url" => "/02105691/0000004000000009/v1_201612020641/S0210569116300638/v1_201612020641/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Author's reply" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "596" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "F. Hidalgo, D. Mas, M. Rubio" "autores" => array:3 [ 0 => array:4 [ "nombre" => "F." "apellidos" => "Hidalgo" "email" => array:1 [ 0 => "fhidalgos@salud.madrid.org" ] "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:3 [ "nombre" => "D." "apellidos" => "Mas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "M." "apellidos" => "Rubio" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Department of Critical Care Medicine, Hospital Universitario de Getafe, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Plastic Surgery, Hospital Universitario de Getafe, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Respuesta de los autores" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with interest the letter sent by JJ Egea-Guerrero et al. The authors agree to the comment of the review<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">1</span></a> that the routine use of biomarkers cannot be recommended in the differential diagnosis of inflammation from sepsis. The same conclusion has been achieved by Seoane et al. in a recent article.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Egea-Guerrero et al. refer to one preliminary report about the diagnostic value of C-Reactive Protein and Procalcitonin<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">3</span></a> in this population. The authors processed and analyzed 157 samples of 17 severe burn patients. The authors suggested that changes in Procalcitonin over time differentiated patients with sepsis and patients without sepsis only based in the ROC curves, but they did not provide data of sensitivity, specificity and likelihood ratios of different cut-off values that could help clinicians in differential diagnosis. We agree with them that it is necessary new well-designed studies to provide new insights on this topic.</p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflict of interest" ] 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:3 [ 0 => array:3 [ "identificador" => "bib0020" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Infections in critically ill burn patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "F. Hidalgo" 1 => "D. Mas" 2 => "M. Rubio" 3 => "P. Garcia-Hierro" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medin.2016.02.001" "Revista" => array:7 [ "tituloSerie" => "Med Intensiva" "fecha" => "2016" "volumen" => "40" "numero" => "3" "paginaInicial" => "179" "paginaFinal" => "185" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27013315" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0025" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Procalcitonin in the burn unit and the diagnosis of infection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L. Seoane" 1 => "S. Pértega" 2 => "R. Galeiras" 3 => "I. Astola" 4 => "T. Bouza" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.burns.2013.11.018" "Revista" => array:6 [ "tituloSerie" => "Burns" "fecha" => "2014" "volumen" => "40" "paginaInicial" => "223" "paginaFinal" => "229" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24439927" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0030" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The utility of C-reactive protein and procalcitonin for sepsis diagnosis in critically burned patients: a preliminary study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.J. Egea-Guerrrero" 1 => "C. Martínez-Fernández" 2 => "A. Rodríguez-Rodríguez" 3 => "A. Bohórquez-López" 4 => "A. Vilches-Arenas" 5 => "M. Pacheco-Sánchez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Plast Surg (Oakv)" "fecha" => "2015" "volumen" => "23" "paginaInicial" => "239" "paginaFinal" => "243" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26665138" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/02105691/0000004000000009/v1_201612020641/S0210569116300614/v1_201612020641/en/main.assets" "Apartado" => array:4 [ "identificador" => "18743" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Cartas al Director" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/02105691/0000004000000009/v1_201612020641/S0210569116300614/v1_201612020641/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569116300614?idApp=WMIE" ]
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