Suscríbase a la Revista
Búsqueda avanzada
 array:24 [
  "pii" => "S021056911830069X"
  "issn" => "02105691"
  "doi" => "10.1016/j.medin.2018.02.015"
  "estado" => "S300"
  "fechaPublicacion" => "2019-05-01"
  "aid" => "1193"
  "copyright" => "Elsevier España, S.L.U. y SEMICYUC"
  "copyrightAnyo" => "2018"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Med Intensiva. 2019;43:197-206"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2945
    "formatos" => array:3 [
      "EPUB" => 85
      "HTML" => 2248
      "PDF" => 612
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S2173572719300566"
      "issn" => "21735727"
      "doi" => "10.1016/j.medine.2019.03.001"
      "estado" => "S300"
      "fechaPublicacion" => "2019-05-01"
      "aid" => "1193"
      "copyright" => "Elsevier España, S.L.U. and SEMICYUC"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "Med Intensiva. 2019;43:197-206"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 348
        "formatos" => array:3 [
          "EPUB" => 66
          "HTML" => 157
          "PDF" => 125
        ]
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
        "titulo" => "Conventional monitoring is not sufficient to assess respiratory effort during assisted ventilation"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "es"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "197"
            "paginaFinal" => "206"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "La monitorizaci&#243;n convencional no es suficiente para valorar el esfuerzo respiratorio durante la ventilaci&#243;n asistida"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "es" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0010"
            "etiqueta" => "Figure 2"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr2.jpeg"
                "Alto" => 3389
                "Ancho" => 2420
                "Tamanyo" => 293303
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Linear regression analysis and 95&#37; confidence interval with Bland&#8211;Altman diagram&#58; mean difference between the two signals and limits of agreement &#40;confidence interval&#41;&#46;</p> <p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Delta Pe-Pmus&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "F&#46; Ruiz Ferr&#243;n, J&#46;M&#46; Serrano Sim&#243;n"
            "autores" => array:2 [
              0 => array:2 [
                "nombre" => "F&#46;"
                "apellidos" => "Ruiz Ferr&#243;n"
              ]
              1 => array:2 [
                "nombre" => "J&#46;M&#46;"
                "apellidos" => "Serrano Sim&#243;n"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "es" => array:9 [
          "pii" => "S021056911830069X"
          "doi" => "10.1016/j.medin.2018.02.015"
          "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/S021056911830069X?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719300566?idApp=WMIE"
      "url" => "/21735727/0000004300000004/v2_201905020913/S2173572719300566/v2_201905020913/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0210569118300512"
    "issn" => "02105691"
    "doi" => "10.1016/j.medin.2018.02.005"
    "estado" => "S300"
    "fechaPublicacion" => "2019-05-01"
    "aid" => "1183"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Med Intensiva. 2019;43:207-16"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2236
      "formatos" => array:3 [
        "EPUB" => 104
        "HTML" => 1629
        "PDF" => 503
      ]
    ]
    "es" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
      "titulo" => "Aplicaci&#243;n de un programa de <span class="elsevierStyleItalic">mindfulness</span> en profesionales de un servicio de medicina intensiva&#46; Efecto sobre el <span class="elsevierStyleItalic">burnout</span>&#44; la empat&#237;a y la autocompasi&#243;n"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "207"
          "paginaFinal" => "216"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Application of a mindfulness program among healthcare professionals in an intensive care unit&#58; Effect on burnout&#44; empathy and self-compassion"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figura 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1551
              "Ancho" => 2583
              "Tamanyo" => 272532
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Puntuaciones medias pre-post de las escalas y subescalas y grado de significaci&#243;n estad&#237;stica&#46;</p> <p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">&#42; Nivel de significaci&#243;n&#58; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "R&#46;M&#46; Gracia Gozalo, J&#46;M&#46; Ferrer Tarr&#233;s, A&#46; Ayora Ayora, M&#46; Alonso Herrero, A&#46; Amutio Kareaga, R&#46; Ferrer Roca"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "R&#46;M&#46;"
              "apellidos" => "Gracia Gozalo"
            ]
            1 => array:2 [
              "nombre" => "J&#46;M&#46;"
              "apellidos" => "Ferrer Tarr&#233;s"
            ]
            2 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Ayora Ayora"
            ]
            3 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Alonso Herrero"
            ]
            4 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Amutio Kareaga"
            ]
            5 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Ferrer Roca"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173572719300621"
        "doi" => "10.1016/j.medine.2019.03.006"
        "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/S2173572719300621?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569118300512?idApp=WMIE"
    "url" => "/02105691/0000004300000004/v4_201907180823/S0210569118300512/v4_201907180823/es/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S021056911930018X"
    "issn" => "02105691"
    "doi" => "10.1016/j.medin.2019.01.002"
    "estado" => "S300"
    "fechaPublicacion" => "2019-05-01"
    "aid" => "1306"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Med Intensiva. 2019;43:195-6"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1318
      "formatos" => array:3 [
        "EPUB" => 122
        "HTML" => 754
        "PDF" => 442
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
      "titulo" => "Pr&#225;cticas de analgosedaci&#243;n y delirium en las UCI espa&#241;olas"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "195"
          "paginaFinal" => "196"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Analgosedation and delirium practices in Spanish ICUs"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "N&#46; Nin Vaeza"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "N&#46;"
              "apellidos" => "Nin Vaeza"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173572719300712"
        "doi" => "10.1016/j.medine.2019.01.006"
        "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/S2173572719300712?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021056911930018X?idApp=WMIE"
    "url" => "/02105691/0000004300000004/v4_201907180823/S021056911930018X/v4_201907180823/es/main.assets"
  ]
  "es" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
    "titulo" => "La monitorizaci&#243;n convencional no es suficiente para valorar el esfuerzo respiratorio durante la ventilaci&#243;n asistida"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "197"
        "paginaFinal" => "206"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "F&#46; Ruiz Ferr&#243;n, J&#46;M&#46; Serrano Sim&#243;n"
        "autores" => array:2 [
          0 => array:4 [
            "nombre" => "F&#46;"
            "apellidos" => "Ruiz Ferr&#243;n"
            "email" => array:1 [
              0 => "fruizferron@gmail.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;M&#46;"
            "apellidos" => "Serrano Sim&#243;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Unidad de Cuidados Intensivos&#44; Hospital Universitario San Cecilio&#44; Granada&#44; Espa&#241;a"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Unidad de Cuidados Intensivos&#44; Hospital Reina Sof&#237;a&#44; C&#243;rdoba&#44; Espa&#241;a"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspondencia&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Conventional monitoring is not sufficient to assess respiratory effort during assisted ventilation"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2608
            "Ancho" => 2969
            "Tamanyo" => 470558
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Ejemplo representativo&#44; se&#241;ales registradas &#40;Pva&#44;Pes&#44;Fl&#41; y calculadas &#40;Pmus&#44; vol&#41; en CPAP&#44; ACV y PS&#46; Con baja asistencia la variaci&#243;n respiratoria de la presi&#243;n esof&#225;gica y muscular calculada son evidentes y de mayor amplitud que con alta asistencia&#46; Pero la amplitud de ambas es diferente&#46; En este caso la medida es dif&#237;cil&#44; en la presi&#243;n esof&#225;gica por la oscilaci&#243;n producida por el latido cardiaco y en la presi&#243;n muscular calculada por oscilaciones o &#171;espigas&#187; producidas por cambios en el flujo inspiratorio&#46; ACV1&#58; asistida controlada por volumen con flujo 0&#44;95<span class="elsevierStyleHsp" style=""></span>l&#47;s&#59; ACV5&#58; asistida controlada por volumen con flujo 0&#44;75<span class="elsevierStyleHsp" style=""></span>l&#47;s&#59; CPAP&#58; presi&#243;n positiva continua de 5<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#59; F&#58; flujo &#40;l&#47;s&#41;&#59; Pes&#58; presi&#243;n esof&#225;gica&#59; Pmus&#58; presi&#243;n muscular calculada &#40;cmH<span class="elsevierStyleInf">2</span>O&#41;&#59; PS5&#58; presi&#243;n soporte de 8&#59; PS1&#58; 16<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O con PEEP 4<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#59; Pva&#58; presi&#243;n en la v&#237;a a&#233;rea&#59; Vol&#58; volumen &#40;l&#41;&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">En la pr&#225;ctica diaria programar los par&#225;metros del respirador en ventilaci&#243;n asistida suponen un reto&#44; una excesiva asistencia produce disfunci&#243;n diafragm&#225;tica por reposo muscular y facilita el fallo de trigger&#46; Por otro lado&#44; un excesivo esfuerzo produce disnea<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">1</span></a>&#44; asincron&#237;a e incluso fatiga y lesi&#243;n muscular<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">2</span></a>&#44; con el riesgo de prolongar la duraci&#243;n de la ventilaci&#243;n mec&#225;nica<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">3</span></a>&#46; Por tanto&#44; parece aconsejable objetivar el esfuerzo muscular y recientes revisiones recuerdan este tema&#44; as&#237; como la dificultad en la incorporaci&#243;n a las pr&#225;cticas de monitorizaci&#243;n en UCI<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">4</span></a>&#46; &#171;A pie de cama&#187; valoramos el trabajo respiratorio mediante el examen cl&#237;nico y por la monitorizaci&#243;n de las se&#241;ales respiratorias ofrecidas por el respirador&#46; La valoraci&#243;n cl&#237;nica de la dificultad respiratoria est&#225; basada en un conjunto de signos cl&#237;nicos&#44; pero la observaci&#243;n y cuantificaci&#243;n muestra una amplia variabilidad interobservador<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">5</span></a>&#46; En nuestro conocimiento no hay estudios cl&#237;nicos que comparen la exploraci&#243;n cl&#237;nica con medidas objetivas del esfuerzo muscular respiratorio&#46; La interpretaci&#243;n de las curvas de la pantalla del respirador depende de la experiencia del m&#233;dico&#44; pero incluso facultativos experimentados tienen dificultades en su interpretaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">6</span></a>&#46; Los cambios que el esfuerzo muscular respiratorio produce en la curva de presi&#243;n en v&#237;a a&#233;rea&#44; en ventilaci&#243;n asistida controlada por volumen y en el flujo inspiratorio en ventilaci&#243;n con presi&#243;n soporte&#44; permiten inferir la intensidad del esfuerzo respiratorio<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">7&#44;8</span></a>&#46; En estos casos estamos asumiendo que el esfuerzo que realiza el paciente modifica la presi&#243;n en ventilaci&#243;n controlada por volumen &#40;ACV&#41; o el flujo en presi&#243;n soporte &#40;PS&#41; y por tanto la diferente morfolog&#237;a respecto a la ventilaci&#243;n controlada o pasiva representa la presi&#243;n muscular &#40;Pmus&#41; respiratoria calculada<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">9&#44;10</span></a>&#46; La incorporaci&#243;n de esta se&#241;al a la monitorizaci&#243;n del paciente con ventilaci&#243;n mec&#225;nica permite mejorar la interacci&#243;n con el respirador<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">8&#44;11</span></a>&#44; pero hay poca informaci&#243;n sobre la capacidad de estimar la amplitud de la presi&#243;n pleural en modos de ventilaci&#243;n asistida<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">12</span></a>&#46; En este sentido&#44; ha sido utilizada en ventilaci&#243;n con PS para optimizar el nivel de asistencia&#44; mostrando una buena correlaci&#243;n con la presi&#243;n esof&#225;gica &#40;Pes&#41;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">8</span></a>&#44; pero no se ha establecido la concordancia entre ambas se&#241;ales y por tanto si son equivalentes para medir el trabajo respiratorio<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">13</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">El objetivo de este estudio es evaluar la concordancia entre la medida invasiva del esfuerzo respiratorio con sonda de Pes y la no invasiva con las curvas que muestra el respirador&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Material y m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Pacientes</span><p id="par0015" class="elsevierStylePara elsevierViewall">Estudiamos a un grupo de pacientes que precisaron ventilaci&#243;n mec&#225;nica por diferentes causas&#44; ingresados en UCI medicoquir&#250;rgica de 2 centros hospitalarios de tercer nivel&#44; con criterios para iniciar la retirada de la ventilaci&#243;n mec&#225;nica y que aceptan la participaci&#243;n en el estudio&#46; Excluimos a pacientes con fuga pleural activa&#44; cirug&#237;a o sangrado digestivo reciente y deformidades de la caja tor&#225;cica&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Monitorizados con electrocardiograma&#44; pulsioximetr&#237;a y presi&#243;n arterial no invasiva&#46; El protocolo fue aprobado por el comit&#233; de investigaci&#243;n del hospital y el consentimiento para participar fue obtenido del paciente o familiar&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Se&#241;ales registradas</span>&#46; El flujo respiratorio &#40;V&#8216;&#41; es medido con un neumotac&#243;grafo &#40;Fleisch n&#46;<span class="elsevierStyleSup">o</span> 2&#41; interpuesto entre el tubo endotraqueal y la conexi&#243;n en Y del circuito del respirador&#46; El volumen &#40;V&#41; es obtenido por integraci&#243;n de la se&#241;al de flujo&#46; La presi&#243;n de la v&#237;a a&#233;rea &#40;Pva&#41; es registrada de una conexi&#243;n entre el tubo endotraqueal y el circuito del respirador&#46; La Pes fue medida con un cat&#233;ter bal&#243;n tras insuflar 0&#44;5<span class="elsevierStyleHsp" style=""></span>ml de aire&#44; la posici&#243;n fue confirmada con un test de oclusi&#243;n&#46; Las presiones son medidas con un transductor de presi&#243;n diferencial&#44; procesadas y almacenadas en un ordenador para un posterior an&#225;lisis utilizando el software Anadat&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">La mec&#225;nica respiratoria</span> fue calculada en ventilaci&#243;n asistida controlada por volumen con alta asistencia &#40;ACV1&#41;&#44; sin maniobras adicionales&#46; Por regresi&#243;n lineal m&#250;ltiple&#44; con el m&#233;todo de los m&#237;nimos cuadrados&#44; ajustando los valores de presi&#243;n&#44; volumen y flujo&#44; durante todo el ciclo respiratorio&#44; a un modelo mec&#225;nico de un compartimento con un valor de elastancia y resistencias&#46; B&#225;sicamente con la se&#241;ales de volumen y flujo buscamos 2 constantes &#40;Esr&#44; Rsr&#41; que permitan reproducir la presi&#243;n medida en la v&#237;a a&#233;rea&#44; considerando que esta es la suma de una presi&#243;n el&#225;stica y otra resistiva&#46; La variable dependiente es la Pva y las independientes el flujo y volumen &#91;Pva&#40;t&#41;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>Esr V&#40;t&#41;<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Rsr &#40;V&#769;&#41;<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Pesp&#93;&#46; Esr&#44; es la elastancia din&#225;mica y Rsr&#44; son las resistencias totales del sistema respiratorio respectivamente&#46; Pesp representa la PEEP din&#225;mica o punto de la curva de presi&#243;n en el que comienza la integraci&#243;n del flujo<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">14</span></a>&#46; Utilizamos el valor medio de los ciclos respiratorios incluidos en el tiempo de registro &#40;40<span class="elsevierStyleHsp" style=""></span>s&#41;&#44; si el coeficiente de determinaci&#243;n del ajuste es superior a 0&#44;95&#46; En casos con altos niveles de PEEPi utilizamos el m&#233;todo de oclusi&#243;n inspiratoria y espiratoria&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Pmus calculada</span>&#46; Utilizamos el mismo modelo de an&#225;lisis de la mec&#225;nica respiratoria&#44; asumiendo que la presi&#243;n en el sistema es el resultado de la presi&#243;n ejercida por el respirador y la musculatura respiratoria &#91;Rsr&#183;V&#8217;<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Esr&#183;V<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Pesp<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>Pva<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>Pmus&#93;&#46; Conociendo las anteriores variables calculamos Pmus &#91;Pmus<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>Rsr&#183;V&#769;<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Esr&#183;V<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Pesp<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>Pva&#93;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">7&#44;15</span></a>&#46; El valor de Pmus durante la fase espiratoria est&#225; relacionado con la PEEP&#44; pero no representa el verdadero valor que no puede ser calculado&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Procedimiento</span><p id="par0040" class="elsevierStylePara elsevierViewall">El paciente en posici&#243;n reclinada&#44; previo al registro de las se&#241;ales retiramos el humidificador y se aspiran secreciones bronquiales&#46; Al comienzo del estudio realizamos una prueba de CPAP y a los 30<span class="elsevierStyleHsp" style=""></span>min tras el registro&#44; iniciamos ventilaci&#243;n asistida controlada por volumen con asistencia respiratoria alta &#40;ACV1&#41;&#46; Para esto el trigger inspiratorio es programado al m&#225;ximo de sensibilidad&#44; sin autotrigger&#44; la PEEP seg&#250;n la PEEPi y la frecuencia respiratoria que permita que el disparo del respirador sea realizado por el paciente&#46; El volumen corriente de 6-8<span class="elsevierStyleHsp" style=""></span>ml&#47;kg de peso ideal y aumentamos el flujo inspiratorio &#40;cuadrado&#41; para que el esfuerzo respiratorio sea m&#237;nimo&#44; valorado en la curva de Pes&#46; Si es necesario el volumen corriente fue aumentado transitoriamente para reducir el esfuerzo&#46; Despu&#233;s de registrar las se&#241;ales&#44; el flujo inspiratorio fue reducido seg&#250;n el nivel de esfuerzo hasta un 50&#37; y repetimos el registro &#40;ACV5&#41;&#46; En ventilaci&#243;n en soporte de presi&#243;n&#44; la sensibilidad del trigger inspiratorio&#44; espiratorio y PEEP no fue modificada&#46; El nivel de asistencia fue aumentado en pasos de 2-5<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O hasta que el esfuerzo fue m&#237;nimo &#40;PS1&#41;&#59; tras el registro&#44; la asistencia fue reducida en un 50&#37; &#40;PS5&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">&#205;ndices fisiol&#243;gicos medidos en la presi&#243;n esof&#225;gica y muscular</span><p id="par0045" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Amplitud respiratoria de Pes y Pmus &#40;delta Pes&#44; delta Pmus&#41;</span> medidas como la diferencia entre el inicio del descenso inspiratorio de Pes y Pmus hasta el m&#225;ximo descenso o nadir de cada se&#241;al&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Producto presi&#243;n tiempo inspiratorio &#40;PTP&#41;</span><a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">16&#44;17</span></a> cuantificado como el &#225;rea entre la presi&#243;n de retroceso el&#225;stica de la pared tor&#225;cica &#40;Pre&#46;pt&#41; y la Pes o Pmus inspiratoria&#46; Consideramos el final del esfuerzo inspiratorio el punto de presi&#243;n equivalente al flujo igual a cero&#46; Pre&#46;pt medida a partir de la elastancia de la pared tor&#225;cica durante la ventilaci&#243;n pasiva y el volumen corriente durante la ventilaci&#243;n asistida&#46; Esta presi&#243;n es extrapolada al inicio del esfuerzo inspiratorio en Pes y Pmus &#91;Pre&#46;pt<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#40;Ept&#183;v&#41;<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Pes&#46;esp&#93;&#44; donde Pes&#46;esp es la Pes o Pmus al final de la espiraci&#243;n&#44; Ept es la elastancia de la pared tor&#225;cica medida en ACV1&#44; relaci&#243;n entre la variaci&#243;n respiratoria de la Pes y el volumen corriente&#46; El &#225;rea fue medida por integraci&#243;n de la presi&#243;n &#40;Pes&#44; Pmus&#41; en funci&#243;n del tiempo&#59; medimos 3 ciclos representativos del patr&#243;n respiratorio del paciente en cada modo de ventilaci&#243;n y obtenemos el valor medio&#44; este es expresado por minuto&#44; considerando la frecuencia respiratoria medida en la se&#241;al de flujo&#46; Estas medidas son realizadas en cada modo de ventilaci&#243;n y CPAP&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">An&#225;lisis estad&#237;stico</span><p id="par0055" class="elsevierStylePara elsevierViewall">Utilizamos el test de Kolmogorov-Smirnov para analizar si las variables estudiadas siguen una distribuci&#243;n normal&#46; Los datos se expresan como medias con desviaci&#243;n est&#225;ndar &#40;DE&#41; y medianas con cuartiles 25-75&#37;&#46; Se comparan con t-test&#44; o no param&#233;tricos de sumas de rangos Mann-Whitney&#44; seg&#250;n proceda&#46; Para medias repetidas se realiz&#243; test ANOVA&#46; La relaci&#243;n entre variables se evalu&#243; mediante regresi&#243;n lineal simple y el ajuste entre los 2 m&#233;todos de medida aplicando an&#225;lisis de concordancia de Bland-Altman&#46; El porcentaje de error fue calculado como los l&#237;mites de ajustes &#40;2DE&#41; de las diferencias de medias dividido por la media de los 2 m&#233;todos<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">18</span></a>&#46; Se consider&#243; el nivel de significaci&#243;n estad&#237;stica valor de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Resultados</span><p id="par0060" class="elsevierStylePara elsevierViewall">Estudiamos a 10 pacientes&#59; sus caracter&#237;sticas son resumidas en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; Se realizaron 50 registros&#44; de estos&#44; 41 fueron adecuados para el an&#225;lisis&#44; el resto se descartaron por artefactos en la se&#241;al de Pes&#46; El nivel de CPAP aplicada fue de 5<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#44; excepto en un caso que precis&#243; 18<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O por PEEPi de 20<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#46; En este modo el pico de flujo inspiratorio &#40;V&#8216;m&#225;x&#41; fue de 0&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;1<span class="elsevierStyleHsp" style=""></span>l&#47;s y el volumen minuto &#40;VE&#41; de 9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>l&#47;m&#46; En ACV1 el volumen corriente 0&#44;42<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;04 l&#44; VE de 9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>l&#47;m y V&#769;I de 1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;2<span class="elsevierStyleHsp" style=""></span>l&#47;s&#46; El flujo inspiratorio fue disminuido a 0&#44;49<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;1<span class="elsevierStyleHsp" style=""></span>l&#47;s para ACV5&#44; con VE de 9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46; En PS la asistencia para reposo muscular m&#225;ximo &#40;PS1&#41; fue de 15<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O y disminuida a 9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O en PS5&#44; sin cambios significativos en V&#769;I 0&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;1 vs&#46; 0&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;04<span class="elsevierStyleHsp" style=""></span>l&#47;s&#44; VE fue m&#225;s alto que con los otro modos 10<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3<span class="elsevierStyleHsp" style=""></span>l&#47;m &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Las variables medidas en Pes y Pmus se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#59; el aumento de la asistencia respiratoria disminuye el esfuerzo medido y el calculado de forma significativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Comparando estas medidas en cada modo de ventilaci&#243;n&#44; la diferencia media no es significativa&#44; pero el an&#225;lisis de concordancia muestra una amplia dispersi&#243;n &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46; As&#237; la variaci&#243;n que podemos encontrar entre la medida y el c&#225;lculo del esfuerzo puede ser de 16<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O para la variaci&#243;n respiratoria y de 264<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#183;s&#47;m en el PTPm &#40;<a class="elsevierStyleCrossRefs" href="#fig0010">figs&#46; 2 y 3</a>&#41;&#46; Estas diferencias no est&#225;n influidas por la amplitud del esfuerzo&#44; pero el porcentaje de error entre la medida y el c&#225;lculo es menor con bajos niveles de asistencia &#40;CPAP&#44; ACV5&#44; PS5&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Discusi&#243;n</span><p id="par0070" class="elsevierStylePara elsevierViewall">Los resultados del estudio indican que el esfuerzo respiratorio calculado no permite inferir el valor medido en la Pes&#46; Estas diferencias se pueden deber a varios factores&#44; especialmente los par&#225;metros que intervienen en el c&#225;lculo de la Pmus&#44; la exactitud de las medidas de mec&#225;nica respiratoria y su validez cuando hay esfuerzo muscular&#46; Tambi&#233;n puede influir la medida de la Pes y la transmisi&#243;n del esfuerzo a la v&#237;a a&#233;rea&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">La se&#241;al de Pmus calculada depende de los par&#225;metros de mec&#225;nica respiratoria &#40;E y R&#41; que intervienen en la ecuaci&#243;n de movimiento<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">19&#44;20</span></a>&#46; Cualquier m&#233;todo de medida tiene limitaciones&#44; ya que estos par&#225;metros pueden cambiar de unos ciclos respiratorios a otros&#44; incluso con sedaci&#243;n profunda<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">21</span></a>&#46; En la pr&#225;ctica el m&#233;todo m&#225;s utilizado es la oclusi&#243;n inspiratoria y espiratoria&#44; basado en un modelo matem&#225;tico que asume la ausencia de esfuerzo<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">22</span></a>&#46; Nosotros utilizamos un m&#233;todo previamente validado en respiraci&#243;n espont&#225;nea<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">23</span></a>&#44; ventilaci&#243;n asistida<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">13&#44;24</span></a> y controlada<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">25</span></a>&#46; Las diferencias que encontramos entre la medida y el c&#225;lculo del esfuerzo son similares a las previamente publicadas utilizando este m&#233;todo basado en un modelo mec&#225;nico simple<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">26</span></a>&#46; Con m&#233;todos m&#225;s complicados no han mejorado los resultados&#46; En ventilaci&#243;n con PS<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">27&#44;28</span></a>&#44; el trabajo respiratorio calculado con Pmus y otras variables de ventilaci&#243;n puede diferir respecto al medido hasta 7<span class="elsevierStyleHsp" style=""></span>j&#47;m &#40;normal 5-10<span class="elsevierStyleHsp" style=""></span>j&#47;m&#41;&#46; Estudios experimentales utilizando complejos algoritmos matem&#225;ticos refieren diferencias de 0&#44;3<span class="elsevierStyleHsp" style=""></span>j&#47;l<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">29</span></a>&#46; En pacientes con ventilaci&#243;n asistida proporcional&#44; las diferencias en el esfuerzo respiratorio medido y calculado pueden ser de 5<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#47;s<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">11</span></a>&#44; valor elevado si consideramos el l&#237;mite aceptable en ventilaci&#243;n mec&#225;nica &#40;4<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#47;s<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">17</span></a>&#41;&#46; En este modo de ventilaci&#243;n era de esperar una mayor semejanza entre ambas se&#241;ales&#46; Por definici&#243;n en ventilaci&#243;n asistida proporcional&#44; la presi&#243;n y el flujo son proporcionales al esfuerzo respiratorio calculado<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">30</span></a> y las medidas de mec&#225;nica respiratoria son peri&#243;dicas<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">18</span></a>&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Las condiciones de medida de la mec&#225;nica respiratoria pueden influir&#46; Estos par&#225;metros son estimados en ventilaci&#243;n pasiva y pueden cambiar en respiraci&#243;n espont&#225;nea<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">31</span></a>&#44; limitando su utilidad para calcular el esfuerzo muscular<a class="elsevierStyleCrossRefs" href="#bib0370"><span class="elsevierStyleSup">32&#44;33</span></a>&#46; As&#237; despu&#233;s de una desconexi&#243;n fallida del respirador&#44; se ha demostrado un descenso de compliancia&#44; aumento de resistencias y PEEPi<a class="elsevierStyleCrossRefs" href="#bib0380"><span class="elsevierStyleSup">34&#44;35</span></a>&#46; Pero estos resultados no han sido confirmados en otros estudios de pacientes que precisaron ventilaci&#243;n mec&#225;nica por EPOC y SDRA<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">36</span></a>&#46; Diferencias en el patr&#243;n respiratorio pueden cambiar la mec&#225;nica respiratoria en ventilaci&#243;n asistida&#44; por la dependencia de la elastancia y resistencias del volumen y flujo respectivamente<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">37</span></a>&#46; El alto flujo inspiratorio utilizado para una ventilaci&#243;n pasiva puede sobreestimar el valor de resistencias inspiratorias y por tanto la Pmus calculada ser&#225; mayor que la Pes&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Otros factores pueden influir en las diferencias entre el c&#225;lculo y la medida del esfuerzo muscular respiratorio&#46; Que la Pes no represente adecuadamente la presi&#243;n pleural y&#47;o el esfuerzo respiratorio no modifique la Pva&#46; La Pes es un valor de presi&#243;n puntual y puede no reflejar la globalidad de la superficie pulmonar&#46; As&#237; en presencia de zonas del pulm&#243;n con diferentes caracter&#237;sticas mec&#225;nicas&#44; la presi&#243;n pleural tendr&#225; una distribuci&#243;n no solamente gravitacional y ser&#225; m&#225;s heterog&#233;nea&#44; como se ha demostrado en pacientes con EPOC<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">38</span></a> y recientemente en SDRA<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">39</span></a>&#46; En estos casos&#44; el esfuerzo respiratorio produce una redistribuci&#243;n del aire al inicio de la inspiraci&#243;n&#44; sin cambios de volumen y la Pes no representa la presi&#243;n pleural&#44; especialmente en zonas dependientes&#46; Por otro lado&#44; el esfuerzo respiratorio puede no generar un cambio de presi&#243;n proporcional en la v&#237;a a&#233;rea y por tanto la Pmus calculada no representa el cambio de presi&#243;n pleural o esof&#225;gica&#46; En sujetos sanos el cambio de presi&#243;n alveolar durante la inspiraci&#243;n es similar al cambio de Pva&#44; si bien puede haber diferencias entre sujetos de hasta un 12&#37;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">40</span></a>&#46; Pero cuando las resistencias de las v&#237;as a&#233;reas est&#225;n aumentadas &#40;EPOC&#41;&#44; el esfuerzo respiratorio no se transmite adecuadamente a la v&#237;a a&#233;rea&#44; como se ha demostrado tras la estimulaci&#243;n el&#233;ctrica del nervio fr&#233;nico<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">41</span></a> e infraestima el esfuerzo respiratorio<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">19&#44;38</span></a>&#46; De igual modo en presencia de baja compliancia pulmonar&#44; el esfuerzo respiratorio produce compresi&#243;n del gas inspirado&#44; con poco cambio de volumen pulmonar y desproporci&#243;n entre la Pes y la v&#237;a a&#233;rea<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">42</span></a>&#46; Nuestros resultados muestran que en presencia de alta asistencia y esfuerzo d&#233;bil&#44; la Pes medida es superior a la calculada&#46; Esto es&#44; con alta asistencia&#44; un esfuerzo peque&#241;o cambia poco la Pva en ACV o el flujo inspiratorio en PS&#46; Por el contrario&#44; en presencia de baja asistencia&#44; con esfuerzo muscular elevado&#44; la presi&#243;n calculada es superior a la medida&#44; por las causas referidas anteriormente&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">La limitaci&#243;n principal del estudio es la heterogeneidad del grupo de pacientes estudiado&#46; Si bien est&#225;n en fase de retirada del respirador&#44; la mec&#225;nica respiratoria y d&#237;as de ventilaci&#243;n mec&#225;nica es muy variable&#46; Un grupo m&#225;s amplio y&#47;o estratificado podr&#237;a mejorar los resultados&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; las curvas del respirador de presi&#243;n y flujo permiten valorar los cambios de esfuerzo muscular respiratorio cuando modificamos los par&#225;metros de ventilaci&#243;n&#44; pero no cuantificar su amplitud&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Contribuci&#243;n de los autores</span><p id="par0100" class="elsevierStylePara elsevierViewall">Francisco Ruiz Ferr&#243;n&#58; Preparaci&#243;n del protocolo&#44; registro realizado en 5 pacientes&#44; an&#225;lisis de los datos y preparaci&#243;n del manuscrito&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Jose Manuel Serrano Sim&#243;n&#58; Preparaci&#243;n del protocolo&#44; registro realizado en 5 pacientes&#44; an&#225;lisis de los datos y preparaci&#243;n del manuscrito&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Financiaci&#243;n</span><p id="par0110" class="elsevierStylePara elsevierViewall">Ninguna&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Conflicto de intereses</span><p id="par0115" class="elsevierStylePara elsevierViewall">Ninguno&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:12 [
        0 => array:3 [
          "identificador" => "xres1220562"
          "titulo" => "Resumen"
          "secciones" => array:7 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Objetivo"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Dise&#241;o"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "&#193;mbito"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Pacientes"
            ]
            4 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Intervenciones"
            ]
            5 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Resultados"
            ]
            6 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1135234"
          "titulo" => "Palabras clave"
        ]
        2 => array:3 [
          "identificador" => "xres1220563"
          "titulo" => "Abstract"
          "secciones" => array:6 [
            0 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Objective"
            ]
            1 => array:2 [
              "identificador" => "abst0045"
              "titulo" => "Design"
            ]
            2 => array:2 [
              "identificador" => "abst0050"
              "titulo" => "Ambit"
            ]
            3 => array:2 [
              "identificador" => "abst0055"
              "titulo" => "Procedure"
            ]
            4 => array:2 [
              "identificador" => "abst0060"
              "titulo" => "Results"
            ]
            5 => array:2 [
              "identificador" => "abst0065"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1135235"
          "titulo" => "Keywords"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introducci&#243;n"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Material y m&#233;todos"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Pacientes"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Procedimiento"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "&#205;ndices fisiol&#243;gicos medidos en la presi&#243;n esof&#225;gica y muscular"
            ]
            3 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "An&#225;lisis estad&#237;stico"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Resultados"
        ]
        7 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Discusi&#243;n"
        ]
        8 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "Contribuci&#243;n de los autores"
        ]
        9 => array:2 [
          "identificador" => "sec0050"
          "titulo" => "Financiaci&#243;n"
        ]
        10 => array:2 [
          "identificador" => "sec0055"
          "titulo" => "Conflicto de intereses"
        ]
        11 => array:1 [
          "titulo" => "Bibliograf&#237;a"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2017-08-29"
    "fechaAceptado" => "2018-02-14"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1135234"
          "palabras" => array:3 [
            0 => "Ventilaci&#243;n mec&#225;nica"
            1 => "Trabajo respiratorio"
            2 => "Mec&#225;nica respiratoria"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1135235"
          "palabras" => array:3 [
            0 => "Mechanical ventilation"
            1 => "Respiratory work of breathing"
            2 => "Respiratory mechanics"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Analizar la relaci&#243;n y concordancia entre el esfuerzo respiratorio calculado con las se&#241;ales del respirador &#40;Pmus&#41; y el medido con presi&#243;n esof&#225;gica &#40;Pes&#41;&#44; en ventilaci&#243;n mec&#225;nica con diferentes niveles de asistencia respiratoria&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Dise&#241;o</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo de una cohorte&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">&#193;mbito</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Unidad de cuidados intensivos polivalente en 2 hospitales terciarios&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Pacientes</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Pacientes en fase de retirada de la ventilaci&#243;n mec&#225;nica&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Intervenciones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La presi&#243;n en la v&#237;a a&#233;rea&#44; esof&#225;gica y flujo respiratorio se registraron en CPAP&#44; ventilaci&#243;n asistida controlada por volumen &#40;ACV&#41; y presi&#243;n soporte &#40;PS&#41; con asistencia respiratoria completa &#40;ACV1&#44; PS1&#41; y parcial &#40;ACV5&#44; PS5&#41;&#46; Variables medidas en Pes y Pmus&#58; amplitud respiratoria &#40;&#916;&#58; cmH<span class="elsevierStyleInf">2</span>O&#41; y el producto presi&#243;n tiempo por minuto &#40;PTPm&#58; cmH<span class="elsevierStyleInf">2</span>O&#183;s&#47;m&#41;&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Resultados</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">En 10 pacientes se estudiaron 41 registros&#46; La asistencia en CPAP fue de 5<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#44; PS1 15<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5 y PS5<span class="elsevierStyleHsp" style=""></span>9&#177;<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#46; En ACV1 el flujo inspiratorio fue 1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;2<span class="elsevierStyleHsp" style=""></span>l&#47;s&#44; reducido a 0&#44;49<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;1<span class="elsevierStyleHsp" style=""></span>l&#47;s para ACV5&#46; El esfuerzo respiratorio disminuy&#243; con el aumento de la asistencia respiratoria&#58; &#916;Pes &#40;CPAP&#44; ACV5&#44; ACV1&#44; PS5&#44; PS1&#41;&#58; 11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44; 6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44; 5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44; 9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44; 7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7 y en &#916;Pmus 16<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44; 10<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44; 5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44; 10<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44; 5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; PTPm Pes&#58; 213<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>87&#44; 96<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>91&#44; 23<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>24&#44; 206<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>121&#44; 108<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>100 &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y en Pmus&#58; 293<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>117&#44; 156<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>84&#44; 24<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>32&#44; 233<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>121&#44; 79<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>90<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#183;s&#47;m &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Las medidas en Pes y Pmus mostraron una correlaci&#243;n &#916;&#58;0&#44;72 y PTPm&#58; 0&#44;87&#46; El an&#225;lisis de Bland-Altman demostr&#243; que la diferencia &#916;Pes-Pmus puede ser de 16<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O y el PTPm de 264 y el error sistem&#225;tico en &#916;&#58; &#8722;0&#44;98<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;4 y PTPm &#8722;23&#44;69<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>66&#44;3<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#183;s&#47;m&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusiones</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Los par&#225;metros calculados de esfuerzo respiratorio y los medidos directamente presentan diferencias que no son aceptables en la pr&#225;ctica cl&#237;nica&#46;</p></span>"
        "secciones" => array:7 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objetivo"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Dise&#241;o"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "&#193;mbito"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Pacientes"
          ]
          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Intervenciones"
          ]
          5 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Resultados"
          ]
          6 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Objective</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Study the relationship and concordance between calculated respiratory effort using the signals of the ventilator &#40;Pmus&#41; and that measured in esophageal pressure &#40;Pes&#41; on mechanical ventilation with different levels of respiratory assistance&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Design</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Prospective cohort study&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Ambit</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Intensive Care Unit of 2 universitary hospitals&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Patients Patients on weaning time&#46;</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Procedure</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Airway&#44; esophageal and respiratory flow were recorded on CPAP&#44; assist volume control &#40;ACV&#41; and pressure support &#40;PS&#41;&#44; with complete &#40;ACV1&#44;PS1&#41; and partial assistance &#40;ACV5&#44;PS5&#41;&#46; Measurement&#58; respiratory variations of Pes and Pmus &#40;&#916;&#58; cmH<span class="elsevierStyleInf">2</span>O&#41; and pressure time product &#40;PTPm&#58; cmH<span class="elsevierStyleInf">2</span>O&#183;s&#47;m&#41;&#46;</p></span> <span id="abst0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Results</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Fourty one records were studied&#44; the assistance was in CPAP of 5<span class="elsevierStyleHsp" style=""></span>cmH2O&#44; PS1 of 15<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5 reduced to 9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#46; In ACV1 the inspiratory flow was 1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;2<span class="elsevierStyleHsp" style=""></span>l&#47;s&#44; reduced to 0&#46;49<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;1<span class="elsevierStyleHsp" style=""></span>l&#47;s for ACV5&#46; The increase in respiratory assistance decreases respiratory effort&#44; measured in Delta Pes &#40;CPAP&#44; ACV5&#44; ACV1&#44; PS5&#44; PS1&#41;&#58; 11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44; 6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44; 5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44; 9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44; 7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7 and in Pmus 16<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44; 10<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44; 5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44; 10<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44; 5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; The PTP per minute measured in Pes&#58; 213<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>87&#44; 96<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>91&#44; 23<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>24&#44; 206<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>121&#44; 108<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>100 &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; and in Pmus&#58; 293<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>117&#44; 156<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>84&#44; 24<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>32&#44; 233<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>121&#44; 79<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>90 &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; The measurements in Pes and Pmus showed the following correlation&#44; in Delta&#58; 0&#46;72 and PTPm&#44; 0&#46;87&#46; The Bland-Altman analysis indicates that the difference between Delta Pes-Pmus can be 16 and the PTPm of 264 and the systematic error in Delta&#58; &#8722;0&#46;98<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;4 and PTPm &#8722;23&#46;69<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>66&#46;3<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#183;s&#47;m&#46;</p></span> <span id="abst0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Conclusions</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Calculated and measured parameters of respiratory effort showed unacceptable differences in clinical practice&#46;</p></span>"
        "secciones" => array:6 [
          0 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Objective"
          ]
          1 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Design"
          ]
          2 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Ambit"
          ]
          3 => array:2 [
            "identificador" => "abst0055"
            "titulo" => "Procedure"
          ]
          4 => array:2 [
            "identificador" => "abst0060"
            "titulo" => "Results"
          ]
          5 => array:2 [
            "identificador" => "abst0065"
            "titulo" => "Conclusions"
          ]
        ]
      ]
    ]
    "multimedia" => array:6 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2608
            "Ancho" => 2969
            "Tamanyo" => 470558
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Ejemplo representativo&#44; se&#241;ales registradas &#40;Pva&#44;Pes&#44;Fl&#41; y calculadas &#40;Pmus&#44; vol&#41; en CPAP&#44; ACV y PS&#46; Con baja asistencia la variaci&#243;n respiratoria de la presi&#243;n esof&#225;gica y muscular calculada son evidentes y de mayor amplitud que con alta asistencia&#46; Pero la amplitud de ambas es diferente&#46; En este caso la medida es dif&#237;cil&#44; en la presi&#243;n esof&#225;gica por la oscilaci&#243;n producida por el latido cardiaco y en la presi&#243;n muscular calculada por oscilaciones o &#171;espigas&#187; producidas por cambios en el flujo inspiratorio&#46; ACV1&#58; asistida controlada por volumen con flujo 0&#44;95<span class="elsevierStyleHsp" style=""></span>l&#47;s&#59; ACV5&#58; asistida controlada por volumen con flujo 0&#44;75<span class="elsevierStyleHsp" style=""></span>l&#47;s&#59; CPAP&#58; presi&#243;n positiva continua de 5<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#59; F&#58; flujo &#40;l&#47;s&#41;&#59; Pes&#58; presi&#243;n esof&#225;gica&#59; Pmus&#58; presi&#243;n muscular calculada &#40;cmH<span class="elsevierStyleInf">2</span>O&#41;&#59; PS5&#58; presi&#243;n soporte de 8&#59; PS1&#58; 16<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O con PEEP 4<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#59; Pva&#58; presi&#243;n en la v&#237;a a&#233;rea&#59; Vol&#58; volumen &#40;l&#41;&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 3382
            "Ancho" => 2412
            "Tamanyo" => 302942
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Regresi&#243;n lineal e intervalo de confianza al 95&#37; y diagrama de Bland-Altman&#58; diferencia media entre ambas se&#241;ales y l&#237;mites de concordancia&#46;</p> <p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Delta Pe-Pmus&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figura 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 3379
            "Ancho" => 2348
            "Tamanyo" => 275825
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Regresi&#243;n lineal e intervalo de confianza al 95&#37; y diagrama de Bland-Altman&#58; diferencia media entre ambas se&#241;ales y l&#237;mites de concordancia&#46;</p> <p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">PTPPe-Pmus&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">abd&#58; abdominal&#59; Ept&#58; elastancia de la pared tor&#225;cica cmH<span class="elsevierStyleInf">2</span>O&#47;l&#59; Esr&#58; elastancia del sistema respiratorio &#40;cmH<span class="elsevierStyleInf">2</span>O&#47;l&#41;&#59; IRCA&#58; insuficiencia respiratoria cr&#243;nica agudizada&#59; PEEPi&#58; autoPEEP din&#225;mica &#40;cmH<span class="elsevierStyleInf">2</span>O&#41;&#59; PostQco&#58; posquir&#250;rgico&#59; Rpt&#58; resistencias de la pared tor&#225;cica &#40;cmH<span class="elsevierStyleInf">2</span>O&#47;l&#47;s&#41;&#59; Rsr&#58; resistencias totales del sistema respiratorio &#40;cmH<span class="elsevierStyleInf">2</span>O&#47;l&#47;s&#41;&#59; SDRA&#58; s&#237;ndrome de dificultad respiratoria aguda del adulto&#59; VM&#58; ventilaci&#243;n mec&#225;nica&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&#46;<span class="elsevierStyleSup">o</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sexo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Edad &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Apache IIal ingreso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">D&#237;as VM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Diagn&#243;stico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">EsrcmH<span class="elsevierStyleInf">2</span>O&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">RsrcmH<span class="elsevierStyleInf">2</span>O&#47;l&#47;s&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">EptcmH<span class="elsevierStyleInf">2</span>O&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">RptcmH<span class="elsevierStyleInf">2</span>O&#47;l&#47;s&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PEEPicmH<span class="elsevierStyleInf">2</span>O&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Evoluci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PostQco abd-SDRA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Peritonitis 3&#46;<span class="elsevierStyleSup">a</span>-SDRA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Exitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pancreatitis-SDRA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IRCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IRCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Asma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PostQco neurocirug&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sepsis abd&#46; SDRA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Neumon&#237;a SDRA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Neumon&#237;a SDRA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2084205.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas de los pacientes&#44; mec&#225;nica respiratoria y pron&#243;stico</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabla 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Delta&#58; variaci&#243;n respiratoria&#59; Pes&#58; presi&#243;n esof&#225;gica&#59; Pmus&#58; presi&#243;n muscular calculada &#40;cmH<span class="elsevierStyleInf">2</span>O&#41;&#59; PTP&#44; producto presi&#243;n tiempo por ciclo &#40;cmH<span class="elsevierStyleInf">2</span>O&#47;s&#41;&#59; PTPm&#58; producto presi&#243;n tiempo por minuto &#40;cmH<span class="elsevierStyleInf">2</span>O&#183;s&#47;m&#41;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CPAP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ACV5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ACV1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PS5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PS1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#916;Pes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#916;Pmus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PTPes&#46;es&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">213<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">96<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">206<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>121&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">108<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PTPmus&#46; m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">293<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>117&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">156<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">233<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>121&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">79<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2084203.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Variables de esfuerzo medidas en todos los datos&#44; asistencia 100&#37; &#40;ACV1 y PS1&#41; y asistencia<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleUnderline">&#60;</span><span class="elsevierStyleHsp" style=""></span>50&#37; &#40;CPAP&#44; PS5&#44; ACV5&#41;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Tabla 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">Bias o error sistem&#225;tico&#59; DE&#58; desviaci&#243;n est&#225;ndar&#59; Delta&#58; variaci&#243;n respiratoria&#59; Pes&#58; presi&#243;n esof&#225;gica&#59; Pmus&#58; presi&#243;n muscular calculada &#40;cmH<span class="elsevierStyleInf">2</span>O&#41;&#59; PTP&#44; producto presi&#243;n tiempo por ciclo &#40;cmH<span class="elsevierStyleInf">2</span>O&#47;s&#41;&#59; PTPm&#58; producto presi&#243;n tiempo por minuto &#40;cmH<span class="elsevierStyleInf">2</span>O&#183;s&#47;m&#41;&#59; R&#58; coeficiente de correlaci&#243;n&#46; L&#237;mites de concordancia o error aleatorio&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PTP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PTPm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Delta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Todos los datos</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pes&#44; media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE<span class="elsevierStyleHsp" style=""></span>Cuartil 25-75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#40;1-9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">130<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>110<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&#40;22-223&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#40;3-10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pmus&#44; media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE<span class="elsevierStyleHsp" style=""></span>Cuartil 25-75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#40;1-11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">155<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>133&#40;23-256&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#40;3-14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Bias &#40;media de las diferencias<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;23<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;23&#44;69<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>66&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;98<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>DE &#40;95&#37; l&#237;mites de concordancia&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;17&#8722;13&#44;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">108&#44;91&#8722;156&#44;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;82&#8722;9&#44;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Asistencia 100&#37;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pes&#44; media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE<span class="elsevierStyleHsp" style=""></span>Cuartil 25-75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>24&#40;0&#44;8-7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>83&#40;22-223&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#40;3-10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pmus &#40;media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE&#41;<span class="elsevierStyleHsp" style=""></span>Cuartil 25-75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>19&#40;0&#44;5-8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>71&#40;23-256&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#40;3-14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Bias &#40;media de las diferencias<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;2&#44;14<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;14&#44;25<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>62&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;1&#44;08<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>DE &#40;95&#37; l&#237;mites de concordancia&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;86&#8722;20&#44;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">110&#44;93&#8722;139&#44;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;16&#8722;10&#44;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Asistencia</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">50&#37;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pes &#40;media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE&#41;<span class="elsevierStyleHsp" style=""></span>Cuartil &#40;25-75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&#40;4-10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">176<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>108<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&#40;74-268&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&#40;6-11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pmus &#40;media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE&#41;<span class="elsevierStyleHsp" style=""></span>Cuartil 25-75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#40;6-11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">234<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>119&#40;119-344&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#40;8-16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Bias &#40;media de las diferencias&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;50<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57&#44;85<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>49&#44;62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;2&#44;95<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>DE &#40;95&#37; l&#237;mites de concordancia&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;1&#44;566&#44;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;41&#44;39157&#44;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;3&#44;719&#44;61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2084204.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Estad&#237;stica descriptiva y concordancia</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:42 [
            0 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of assisted ventilator modes on triggering&#44; patient effort&#44; and dyspnea"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Leung"
                            1 => "A&#46; Jubran"
                            2 => "M&#46;J&#46; Tobin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.155.6.9196100"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1997"
                        "volumen" => "155"
                        "paginaInicial" => "1940"
                        "paginaFinal" => "1948"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9196100"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Load dependence of secondary diaphragm inflammation and injury after acute inspiratory loading"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46;X&#46; Jiang"
                            1 => "W&#46;D&#46; Reid"
                            2 => "A&#46; Belcastro"
                            3 => "J&#46;L&#46; Road"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.157.1.9702051"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1998"
                        "volumen" => "157"
                        "paginaInicial" => "230"
                        "paginaFinal" => "236"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9445304"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patient-ventilator asynchrony during assisted mechanical ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46;W&#46; Thille"
                            1 => "P&#46; Rodriguez"
                            2 => "B&#46; Cabello"
                            3 => "F&#46; Lellouche"
                            4 => "L&#46; Brochard"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2006"
                        "volumen" => "32"
                        "paginaInicial" => "1515"
                        "paginaFinal" => "1522"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessing effort and work of breathing"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46; Bellani"
                            1 => "A&#46; Pesenti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Curr Opin Crit Care Med"
                        "fecha" => "2014"
                        "volumen" => "20"
                        "paginaInicial" => "352"
                        "paginaFinal" => "358"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The validity and reliability of the clinical assessment of increased work of breathing in acutely ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Tulaimat"
                            1 => "A&#46; Patel"
                            2 => "M&#46; Wisniewski"
                            3 => "R&#46; Gueret"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jcrc.2011.03.002"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Crit Care"
                        "fecha" => "2016"
                        "paginaInicial" => "111"
                        "paginaFinal" => "115"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21482346"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy of ventilador waveform observation in detecting patient-ventilator asynchrony"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Colombo"
                            1 => "G&#46; Cammarota"
                            2 => "M&#46; Alemani"
                            3 => "L&#46; Carenzo"
                            4 => "F&#46;L&#46; Barra"
                            5 => "R&#46; Vaschetto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/CCM.0b013e318225753c"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2011"
                        "volumen" => "39"
                        "paginaInicial" => "2452"
                        "paginaFinal" => "2457"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21705886"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The inspiratory workload of patient-initiated mechanical ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;J&#46; Marini"
                            1 => "R&#46;M&#46; Rodriguez"
                            2 => "V&#46; Lamb"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/arrd.1986.134.5.902"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Rev Respir Dis&#46;"
                        "fecha" => "1986"
                        "volumen" => "134"
                        "paginaInicial" => "902"
                        "paginaFinal" => "909"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3096177"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Respiratory muscle pressure analysis in pressure-support ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Y&#46; Yamada"
                            1 => "M&#46; Shigeta"
                            2 => "K&#46; Suwa"
                            3 => "K&#46; Hanaoka"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1152/jappl.1994.77.5.2237"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Appl Physiol&#46;"
                        "fecha" => "1994"
                        "volumen" => "77"
                        "paginaInicial" => "2237"
                        "paginaFinal" => "2243"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7868440"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dynamics of breathing"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Mead"
                            1 => "E&#46; Agostoni"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "editores" => "W&#46;O&#46;Fenn, H&#46;Rahn"
                        "titulo" => "Handbook of physiology&#46; Section 3&#44; vol I&#58; Respiration&#46;"
                        "paginaInicial" => "411"
                        "paginaFinal" => "427"
                        "serieFecha" => "1964"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Real-time computation of a patient&#39;s respiratory effort during ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;H&#46; Schott"
                            1 => "J&#46;A&#46; Blom"
                            2 => "H&#46;H&#46; Korsten"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10877-006-9020-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Monit Comput&#46;"
                        "fecha" => "2006"
                        "volumen" => "20"
                        "paginaInicial" => "193"
                        "paginaFinal" => "200"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16718588"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estimation of inspiratory muscle pressure in critically ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46; Kondili"
                            1 => "C&#46; Alexopoulou"
                            2 => "N&#46; Xirouchaki"
                            3 => "K&#46; Vaporidi"
                            4 => "D&#46; Georgopoulos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-010-1753-4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2010"
                        "volumen" => "36"
                        "paginaInicial" => "648"
                        "paginaFinal" => "655"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20107765"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Realistic human muscle pressure for driving a mechanical lung"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46; Fresnel"
                            1 => "J&#46;F&#46; Muir"
                            2 => "C&#46; Letellier"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "EPJ Nonlinear Biomed Phys&#46;"
                        "fecha" => "2014"
                        "volumen" => "2"
                        "paginaInicial" => "7"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patient work of breathing during pressure support and volume-cycled mechanical ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Kreit"
                            1 => "M&#46;W&#46; Capper"
                            2 => "W&#46;L&#46; Eschenbacher"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.149.5.8173745"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1994"
                        "volumen" => "149"
                        "paginaInicial" => "1085"
                        "paginaFinal" => "1091"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8173745"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Respiratory mechanics by least square fitting in mechanically ventilated patients&#58; Applications during paralysis and during pressure support ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46;A&#46; Iotti"
                            1 => "A&#46; Braschi"
                            2 => "J&#46;X&#46; Brunner"
                            3 => "T&#46; Smits"
                            4 => "M&#46; Olivei"
                            5 => "A&#46; Palo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "1995"
                        "volumen" => "21"
                        "paginaInicial" => "406"
                        "paginaFinal" => "413"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7665750"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Proportional assist ventilation&#44; a new approach to ventilatory support theory"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46; Younes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm/145.1.114"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Rev Respir Dis"
                        "fecha" => "1992"
                        "volumen" => "145"
                        "paginaInicial" => "114"
                        "paginaFinal" => "120"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1731573"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment of neural inspiratory time in ventilator-supported patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Parthasarathy"
                            1 => "A&#46; Jubran"
                            2 => "M&#46;J&#46; Tobin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.162.2.9901024"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2000"
                        "volumen" => "162"
                        "paginaInicial" => "546"
                        "paginaFinal" => "552"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10934085"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Variability of patient-ventilator interaction with pressure support ventilation in patients with COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Jubran"
                            1 => "W&#46;B&#46; van de Graaff"
                            2 => "M&#46;J&#46; Tobin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Respir Crit Med"
                        "fecha" => "1995"
                        "volumen" => "152"
                        "paginaInicial" => "129"
                        "paginaFinal" => "136"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A meta-analysis of studies using bias and precision statistics to compare cardiac output measurement techniques"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "L&#46;A&#46;H&#46; Critchley"
                            1 => "J&#46;A&#46;J&#46;H&#46; Critchley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Clin Monitor"
                        "fecha" => "1999"
                        "volumen" => "15"
                        "paginaInicial" => "85"
                        "paginaFinal" => "91"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A method for monitoring and improving patient&#58; Ventilator interaction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Younes"
                            1 => "L&#46; Brochard"
                            2 => "S&#46; Grasso"
                            3 => "J&#46; Kun"
                            4 => "J&#46; Mancebo"
                            5 => "M&#46; Ranieri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2007"
                        "volumen" => "33"
                        "paginaInicial" => "1337"
                        "paginaFinal" => "1346"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of ventilator flow rate on respiratory timing in normal human"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Fernandez"
                            1 => "M&#46; Mendez"
                            2 => "M&#46; Younes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.159.3.9709090"
                      "Revista" => array:7 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1999"
                        "volumen" => "159"
                        "paginaInicial" => "710"
                        "paginaFinal" => "719"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10051241"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674910008183"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Breath to breath respiratory mechanics variation&#58; How much variation should we expect"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "K&#46;T&#46; Kim"
                            1 => "Y&#46;S&#46; Chiew"
                            2 => "C&#46; Pretty"
                            3 => "G&#46;M&#46; Shaw"
                            4 => "T&#46; Desaive"
                            5 => "J&#46;G&#46; Chasel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2015"
                        "volumen" => "9"
                        "numero" => "Suppl 1"
                        "paginaInicial" => "s91"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Analysis of the behaviour of the respiratory system with constant inspiratory flow"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;H&#46; Bates"
                            1 => "A&#46; Rossi"
                            2 => "L&#46; Milic-Emili"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1152/jappl.1985.58.6.1840"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Appl Physiol"
                        "fecha" => "1985"
                        "volumen" => "58"
                        "paginaInicial" => "1840"
                        "paginaFinal" => "1848"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4008404"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "On-line monitoring of lung mechanics during spontaneous breathing&#58; A physiological study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Khirani"
                            1 => "G&#46; Polese"
                            2 => "A&#46; Aliverti"
                            3 => "L&#46; Appendini"
                            4 => "G&#46; Nucci"
                            5 => "A&#46; Pedotti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Respir Med"
                        "fecha" => "2010"
                        "volumen" => "104"
                        "paginaInicial" => "463"
                        "paginaFinal" => "471"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of nonlinearities on estimates of respiratory mechanics using multilinear regression analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Kano"
                            1 => "C&#46;J&#46; Lanteri"
                            2 => "A&#46;W&#46; Duncan"
                            3 => "P&#46;D&#46; Sly"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1152/jappl.1994.77.3.1185"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Appl Physiol"
                        "fecha" => "1994"
                        "volumen" => "77"
                        "paginaInicial" => "1185"
                        "paginaFinal" => "1197"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7836121"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of static and dynamic measurements of intrinsic PEEP in anesthetized cats"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "P&#46; Hernandez"
                            1 => "P&#46; Navalesi"
                            2 => "F&#46; Maltais"
                            3 => "A&#46; Gursahaney"
                            4 => "B&#46; Gottfried"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Appl Physiol"
                        "fecha" => "1994"
                        "volumen" => "76"
                        "paginaInicial" => "2437"
                        "paginaFinal" => "2442"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A model lung with direct representation of respiratory muscle activity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;S&#46; Mecklenburgh"
                            1 => "T&#46;A&#46;A&#46; al-Obaidi"
                            2 => "W&#46;W&#46; Mapleson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/bja/68.6.603"
                      "Revista" => array:7 [
                        "tituloSerie" => "Br J Anaesth"
                        "fecha" => "1992"
                        "volumen" => "68"
                        "paginaInicial" => "603"
                        "paginaFinal" => "612"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1610636"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674917305894"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Power of breathing determined noninvasively with use of an artificial neural network in patients with respiratory failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;J&#46; Banner"
                            1 => "N&#46;R&#46; Eulinao"
                            2 => "V&#46; Brennan"
                            3 => "C&#46; Peters"
                            4 => "J&#46; Layon"
                            5 => "A&#46; Babrielli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.CCM.0000206288.90613.1C"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2006"
                        "volumen" => "34"
                        "paginaInicial" => "1052"
                        "paginaFinal" => "1059"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16484913"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Real time noninvasive estimation of work of breathing using facemask leak-corrected tidal volume during noninvasive pressure support&#58; Validation study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;J&#46; Banner"
                            1 => "C&#46;G&#46; Tams"
                            2 => "N&#46;R&#46; Euliano"
                            3 => "P&#46;J&#46; Stephan"
                            4 => "T&#46;J&#46; Leavitt"
                            5 => "A&#46;D&#46; Martin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10877-015-9716-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Monit Comput"
                        "fecha" => "2016"
                        "volumen" => "30"
                        "paginaInicial" => "285"
                        "paginaFinal" => "294"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26070542"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0355"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Constrained optimization for noninvasive estimation of work of breathing"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "F&#46; Vicario"
                            1 => "A&#46; Albanese"
                            2 => "D&#46; Wang"
                            3 => "N&#46; Karamolegkos"
                            4 => "N&#46;W&#46; Chbat"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "IEEE Trans Biomed Eng"
                        "fecha" => "2015"
                        "paginaInicial" => "5327"
                        "paginaFinal" => "5330"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0360"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Proportional assist ventilation&#46; Results of an initial clinical trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Younes"
                            1 => "A&#46; Puddy"
                            2 => "D&#46; Roberts"
                            3 => "B&#46; Light"
                            4 => "A&#46; Quesada"
                            5 => "K&#46; Taylor"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm/145.1.121"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Rev Respir Dis"
                        "fecha" => "1992"
                        "volumen" => "145"
                        "paginaInicial" => "121"
                        "paginaFinal" => "129"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1731574"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0365"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of pressure assist on ventilation and respiratory mechanics in heavy exercise"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;G&#46; Gallather"
                            1 => "M&#46; Younes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Appl Physiol"
                        "fecha" => "1989"
                        "volumen" => "66"
                        "paginaInicial" => "1824"
                        "paginaFinal" => "1837"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0370"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A method for measuring passive elastance during proportional assist ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Younes"
                            1 => "K&#46; Webster"
                            2 => "J&#46; Kun"
                            3 => "D&#46; Roberts"
                            4 => "B&#46; Masiowski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.164.1.2010068"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med&#46;"
                        "fecha" => "2001"
                        "volumen" => "164"
                        "paginaInicial" => "50"
                        "paginaFinal" => "60"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11435238"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0375"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A method&#46; for noninvasive determination of inspiratory resistance during&#46; proportional assist ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Younes"
                            1 => "J&#46; Kun"
                            2 => "B&#46; Masiowski"
                            3 => "K&#46; Webster"
                            4 => "D&#46; Roberts"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.163.4.2005063"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2001"
                        "volumen" => "163"
                        "paginaInicial" => "829"
                        "paginaFinal" => "839"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11282753"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0380"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The tension-time index and the frequency&#47;tidal volume ratio are the major pathophysiologic determinants of weaning failure and success"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46; Vassilakopoulos"
                            1 => "S&#46; Zakynthinos"
                            2 => "C&#46; Roussos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.158.2.9710084"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1998"
                        "volumen" => "158"
                        "paginaInicial" => "378"
                        "paginaFinal" => "385"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9700110"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0385"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Passive mechanics of lung and chest wall in patients who faied or succeeded in trials of weaning"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Jubran"
                            1 => "M&#46;J&#46; Tobin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.155.3.9117026"
                      "Revista" => array:7 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1997"
                        "volumen" => "155"
                        "paginaInicial" => "916"
                        "paginaFinal" => "921"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9117026"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674909017345"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0390"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Determinants of weaning success in patients with prolonged mechanical ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Carlucci"
                            1 => "P&#46; Ceriana"
                            2 => "G&#46; Prinianakis"
                            3 => "F&#46; Fanfulla"
                            4 => "R&#46; Colombo"
                            5 => "S&#46; Nava"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/cc7927"
                      "Revista" => array:5 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2009"
                        "volumen" => "13"
                        "paginaInicial" => "R97"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19549301"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0395"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Respiratory mechanics during halothane anesthesia and anesthesia-paralysis in humans"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "P&#46;K&#46; Behrakis"
                            1 => "B&#46;D&#46; Higgs"
                            2 => "A&#46; Baydur"
                            3 => "W&#46;A&#46; Zin"
                            4 => "J&#46; Milic-Emili"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1152/jappl.1983.55.4.1085"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Appl Physiol"
                        "fecha" => "1983"
                        "volumen" => "55"
                        "paginaInicial" => "1085"
                        "paginaFinal" => "1092"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6629937"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0400"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Difference between mouth and esophageal occlusion pressure during CO2&#44; rebreathing in chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "L&#46; Marazzini"
                            1 => "R&#46; Cavestri"
                            2 => "D&#46; Gori"
                            3 => "L&#46; Gatti"
                            4 => "E&#46; Longhini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/arrd.1978.118.6.1027"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Rev Respir Dis"
                        "fecha" => "1978"
                        "volumen" => "118"
                        "paginaInicial" => "1027"
                        "paginaFinal" => "1033"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/369409"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0405"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spontaneous effort causes occult pendelluft during mechanical ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Yoshida"
                            1 => "V&#46; Torsani"
                            2 => "S&#46; Gomes"
                            3 => "R&#46; de Santis"
                            4 => "M&#46;A&#46; Beraldo"
                            5 => "E&#46; Costa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.201303-0539OC"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2013"
                        "volumen" => "188"
                        "paginaInicial" => "1420"
                        "paginaFinal" => "1427"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24199628"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib0410"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Noninvasive work of breathing improves prediction of post-extubation outcome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;J&#46; Banner"
                            1 => "N&#46;R&#46; Euliano"
                            2 => "A&#46;D&#46; Martin"
                            3 => "N&#46; Al-Rawas"
                            4 => "A&#46;J&#46; Layon"
                            5 => "A&#46; Gabrielli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-011-2402-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2012"
                        "volumen" => "38"
                        "paginaInicial" => "248"
                        "paginaFinal" => "255"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22113814"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib0415"
              "etiqueta" => "41"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Measurement of twitch transdiaphragmatic&#44; esophageal&#44; and endotracheal tube pressure with bilateral anterolateral magnetic phrenic nerve stimulation in patients in the intensive care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;C&#46; Watson"
                            1 => "P&#46;D&#46; Hughes"
                            2 => "L&#46; Harris"
                            3 => "N&#46; Hart"
                            4 => "T&#46;J&#46; Ware"
                            5 => "J&#46; Wendon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/00003246-200107000-00005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2001"
                        "volumen" => "29"
                        "paginaInicial" => "1325"
                        "paginaFinal" => "1339"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11445679"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib0420"
              "etiqueta" => "42"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Inaccuracy of oesophageal pressure for pleural pressure estimation in supine anesthetized subjects"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;B&#46; Drummond"
                            1 => "A&#46;D&#46;G&#46; Wright"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/bja/55.7.585"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Anaesth"
                        "fecha" => "1983"
                        "volumen" => "55"
                        "paginaInicial" => "585"
                        "paginaFinal" => "593"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6871051"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/02105691/0000004300000004/v4_201907180823/S021056911830069X/v4_201907180823/es/main.assets"
  "Apartado" => array:4 [
    "identificador" => "434"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Originales"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/02105691/0000004300000004/v4_201907180823/S021056911830069X/v4_201907180823/es/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021056911830069X?idApp=WMIE"
]
Compartir
Número actual
Información de la revista
Volver al artículo

Estadísticas

Siga este enlace para acceder al texto completo del artículo

Original
La monitorización convencional no es suficiente para valorar el esfuerzo respiratorio durante la ventilación asistida
Conventional monitoring is not sufficient to assess respiratory effort during assisted ventilation
F. Ruiz Ferróna,
Autor para correspondencia
fruizferron@gmail.com

Autor para correspondencia.
, J.M. Serrano Simónb
a Unidad de Cuidados Intensivos, Hospital Universitario San Cecilio, Granada, España
b Unidad de Cuidados Intensivos, Hospital Reina Sofía, Córdoba, España
Leído
16112
Veces
se ha leído el artículo
4377
Total PDF
11735
Total HTML
Compartir estadísticas
 array:24 [
  "pii" => "S021056911830069X"
  "issn" => "02105691"
  "doi" => "10.1016/j.medin.2018.02.015"
  "estado" => "S300"
  "fechaPublicacion" => "2019-05-01"
  "aid" => "1193"
  "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
  "copyrightAnyo" => "2018"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "cita" => "Med Intensiva. 2019;43:197-206"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2945
    "formatos" => array:3 [
      "EPUB" => 85
      "HTML" => 2248
      "PDF" => 612
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S2173572719300566"
      "issn" => "21735727"
      "doi" => "10.1016/j.medine.2019.03.001"
      "estado" => "S300"
      "fechaPublicacion" => "2019-05-01"
      "aid" => "1193"
      "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "cita" => "Med Intensiva. 2019;43:197-206"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 348
        "formatos" => array:3 [
          "EPUB" => 66
          "HTML" => 157
          "PDF" => 125
        ]
      ]
      "en" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
        "titulo" => "Conventional monitoring is not sufficient to assess respiratory effort during assisted ventilation"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "tieneResumen" => array:2 [
          0 => "en"
          1 => "es"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "197"
            "paginaFinal" => "206"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "La monitorizaci&#243;n convencional no es suficiente para valorar el esfuerzo respiratorio durante la ventilaci&#243;n asistida"
          ]
        ]
        "contieneResumen" => array:2 [
          "en" => true
          "es" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0010"
            "etiqueta" => "Figure 2"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr2.jpeg"
                "Alto" => 3389
                "Ancho" => 2420
                "Tamanyo" => 293303
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Linear regression analysis and 95&#37; confidence interval with Bland&#8211;Altman diagram&#58; mean difference between the two signals and limits of agreement &#40;confidence interval&#41;&#46;</p> <p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Delta Pe-Pmus&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "F&#46; Ruiz Ferr&#243;n, J&#46;M&#46; Serrano Sim&#243;n"
            "autores" => array:2 [
              0 => array:2 [
                "nombre" => "F&#46;"
                "apellidos" => "Ruiz Ferr&#243;n"
              ]
              1 => array:2 [
                "nombre" => "J&#46;M&#46;"
                "apellidos" => "Serrano Sim&#243;n"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "es" => array:9 [
          "pii" => "S021056911830069X"
          "doi" => "10.1016/j.medin.2018.02.015"
          "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/S021056911830069X?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719300566?idApp=WMIE"
      "url" => "/21735727/0000004300000004/v2_201905020913/S2173572719300566/v2_201905020913/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0210569118300512"
    "issn" => "02105691"
    "doi" => "10.1016/j.medin.2018.02.005"
    "estado" => "S300"
    "fechaPublicacion" => "2019-05-01"
    "aid" => "1183"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "cita" => "Med Intensiva. 2019;43:207-16"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2236
      "formatos" => array:3 [
        "EPUB" => 104
        "HTML" => 1629
        "PDF" => 503
      ]
    ]
    "es" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
      "titulo" => "Aplicaci&#243;n de un programa de <span class="elsevierStyleItalic">mindfulness</span> en profesionales de un servicio de medicina intensiva&#46; Efecto sobre el <span class="elsevierStyleItalic">burnout</span>&#44; la empat&#237;a y la autocompasi&#243;n"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "207"
          "paginaFinal" => "216"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Application of a mindfulness program among healthcare professionals in an intensive care unit&#58; Effect on burnout&#44; empathy and self-compassion"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figura 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1551
              "Ancho" => 2583
              "Tamanyo" => 272532
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Puntuaciones medias pre-post de las escalas y subescalas y grado de significaci&#243;n estad&#237;stica&#46;</p> <p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">&#42; Nivel de significaci&#243;n&#58; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "R&#46;M&#46; Gracia Gozalo, J&#46;M&#46; Ferrer Tarr&#233;s, A&#46; Ayora Ayora, M&#46; Alonso Herrero, A&#46; Amutio Kareaga, R&#46; Ferrer Roca"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "R&#46;M&#46;"
              "apellidos" => "Gracia Gozalo"
            ]
            1 => array:2 [
              "nombre" => "J&#46;M&#46;"
              "apellidos" => "Ferrer Tarr&#233;s"
            ]
            2 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Ayora Ayora"
            ]
            3 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Alonso Herrero"
            ]
            4 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Amutio Kareaga"
            ]
            5 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Ferrer Roca"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173572719300621"
        "doi" => "10.1016/j.medine.2019.03.006"
        "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/S2173572719300621?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569118300512?idApp=WMIE"
    "url" => "/02105691/0000004300000004/v4_201907180823/S0210569118300512/v4_201907180823/es/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S021056911930018X"
    "issn" => "02105691"
    "doi" => "10.1016/j.medin.2019.01.002"
    "estado" => "S300"
    "fechaPublicacion" => "2019-05-01"
    "aid" => "1306"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "sco"
    "cita" => "Med Intensiva. 2019;43:195-6"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1318
      "formatos" => array:3 [
        "EPUB" => 122
        "HTML" => 754
        "PDF" => 442
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>"
      "titulo" => "Pr&#225;cticas de analgosedaci&#243;n y delirium en las UCI espa&#241;olas"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "195"
          "paginaFinal" => "196"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Analgosedation and delirium practices in Spanish ICUs"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "N&#46; Nin Vaeza"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "N&#46;"
              "apellidos" => "Nin Vaeza"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173572719300712"
        "doi" => "10.1016/j.medine.2019.01.006"
        "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/S2173572719300712?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021056911930018X?idApp=WMIE"
    "url" => "/02105691/0000004300000004/v4_201907180823/S021056911930018X/v4_201907180823/es/main.assets"
  ]
  "es" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original</span>"
    "titulo" => "La monitorizaci&#243;n convencional no es suficiente para valorar el esfuerzo respiratorio durante la ventilaci&#243;n asistida"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "197"
        "paginaFinal" => "206"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "F&#46; Ruiz Ferr&#243;n, J&#46;M&#46; Serrano Sim&#243;n"
        "autores" => array:2 [
          0 => array:4 [
            "nombre" => "F&#46;"
            "apellidos" => "Ruiz Ferr&#243;n"
            "email" => array:1 [
              0 => "fruizferron@gmail.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;M&#46;"
            "apellidos" => "Serrano Sim&#243;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Unidad de Cuidados Intensivos&#44; Hospital Universitario San Cecilio&#44; Granada&#44; Espa&#241;a"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Unidad de Cuidados Intensivos&#44; Hospital Reina Sof&#237;a&#44; C&#243;rdoba&#44; Espa&#241;a"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspondencia&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Conventional monitoring is not sufficient to assess respiratory effort during assisted ventilation"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2608
            "Ancho" => 2969
            "Tamanyo" => 470558
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Ejemplo representativo&#44; se&#241;ales registradas &#40;Pva&#44;Pes&#44;Fl&#41; y calculadas &#40;Pmus&#44; vol&#41; en CPAP&#44; ACV y PS&#46; Con baja asistencia la variaci&#243;n respiratoria de la presi&#243;n esof&#225;gica y muscular calculada son evidentes y de mayor amplitud que con alta asistencia&#46; Pero la amplitud de ambas es diferente&#46; En este caso la medida es dif&#237;cil&#44; en la presi&#243;n esof&#225;gica por la oscilaci&#243;n producida por el latido cardiaco y en la presi&#243;n muscular calculada por oscilaciones o &#171;espigas&#187; producidas por cambios en el flujo inspiratorio&#46; ACV1&#58; asistida controlada por volumen con flujo 0&#44;95<span class="elsevierStyleHsp" style=""></span>l&#47;s&#59; ACV5&#58; asistida controlada por volumen con flujo 0&#44;75<span class="elsevierStyleHsp" style=""></span>l&#47;s&#59; CPAP&#58; presi&#243;n positiva continua de 5<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#59; F&#58; flujo &#40;l&#47;s&#41;&#59; Pes&#58; presi&#243;n esof&#225;gica&#59; Pmus&#58; presi&#243;n muscular calculada &#40;cmH<span class="elsevierStyleInf">2</span>O&#41;&#59; PS5&#58; presi&#243;n soporte de 8&#59; PS1&#58; 16<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O con PEEP 4<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#59; Pva&#58; presi&#243;n en la v&#237;a a&#233;rea&#59; Vol&#58; volumen &#40;l&#41;&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">En la pr&#225;ctica diaria programar los par&#225;metros del respirador en ventilaci&#243;n asistida suponen un reto&#44; una excesiva asistencia produce disfunci&#243;n diafragm&#225;tica por reposo muscular y facilita el fallo de trigger&#46; Por otro lado&#44; un excesivo esfuerzo produce disnea<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">1</span></a>&#44; asincron&#237;a e incluso fatiga y lesi&#243;n muscular<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">2</span></a>&#44; con el riesgo de prolongar la duraci&#243;n de la ventilaci&#243;n mec&#225;nica<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">3</span></a>&#46; Por tanto&#44; parece aconsejable objetivar el esfuerzo muscular y recientes revisiones recuerdan este tema&#44; as&#237; como la dificultad en la incorporaci&#243;n a las pr&#225;cticas de monitorizaci&#243;n en UCI<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">4</span></a>&#46; &#171;A pie de cama&#187; valoramos el trabajo respiratorio mediante el examen cl&#237;nico y por la monitorizaci&#243;n de las se&#241;ales respiratorias ofrecidas por el respirador&#46; La valoraci&#243;n cl&#237;nica de la dificultad respiratoria est&#225; basada en un conjunto de signos cl&#237;nicos&#44; pero la observaci&#243;n y cuantificaci&#243;n muestra una amplia variabilidad interobservador<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">5</span></a>&#46; En nuestro conocimiento no hay estudios cl&#237;nicos que comparen la exploraci&#243;n cl&#237;nica con medidas objetivas del esfuerzo muscular respiratorio&#46; La interpretaci&#243;n de las curvas de la pantalla del respirador depende de la experiencia del m&#233;dico&#44; pero incluso facultativos experimentados tienen dificultades en su interpretaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">6</span></a>&#46; Los cambios que el esfuerzo muscular respiratorio produce en la curva de presi&#243;n en v&#237;a a&#233;rea&#44; en ventilaci&#243;n asistida controlada por volumen y en el flujo inspiratorio en ventilaci&#243;n con presi&#243;n soporte&#44; permiten inferir la intensidad del esfuerzo respiratorio<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">7&#44;8</span></a>&#46; En estos casos estamos asumiendo que el esfuerzo que realiza el paciente modifica la presi&#243;n en ventilaci&#243;n controlada por volumen &#40;ACV&#41; o el flujo en presi&#243;n soporte &#40;PS&#41; y por tanto la diferente morfolog&#237;a respecto a la ventilaci&#243;n controlada o pasiva representa la presi&#243;n muscular &#40;Pmus&#41; respiratoria calculada<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">9&#44;10</span></a>&#46; La incorporaci&#243;n de esta se&#241;al a la monitorizaci&#243;n del paciente con ventilaci&#243;n mec&#225;nica permite mejorar la interacci&#243;n con el respirador<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">8&#44;11</span></a>&#44; pero hay poca informaci&#243;n sobre la capacidad de estimar la amplitud de la presi&#243;n pleural en modos de ventilaci&#243;n asistida<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">12</span></a>&#46; En este sentido&#44; ha sido utilizada en ventilaci&#243;n con PS para optimizar el nivel de asistencia&#44; mostrando una buena correlaci&#243;n con la presi&#243;n esof&#225;gica &#40;Pes&#41;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">8</span></a>&#44; pero no se ha establecido la concordancia entre ambas se&#241;ales y por tanto si son equivalentes para medir el trabajo respiratorio<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">13</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">El objetivo de este estudio es evaluar la concordancia entre la medida invasiva del esfuerzo respiratorio con sonda de Pes y la no invasiva con las curvas que muestra el respirador&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Material y m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Pacientes</span><p id="par0015" class="elsevierStylePara elsevierViewall">Estudiamos a un grupo de pacientes que precisaron ventilaci&#243;n mec&#225;nica por diferentes causas&#44; ingresados en UCI medicoquir&#250;rgica de 2 centros hospitalarios de tercer nivel&#44; con criterios para iniciar la retirada de la ventilaci&#243;n mec&#225;nica y que aceptan la participaci&#243;n en el estudio&#46; Excluimos a pacientes con fuga pleural activa&#44; cirug&#237;a o sangrado digestivo reciente y deformidades de la caja tor&#225;cica&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Monitorizados con electrocardiograma&#44; pulsioximetr&#237;a y presi&#243;n arterial no invasiva&#46; El protocolo fue aprobado por el comit&#233; de investigaci&#243;n del hospital y el consentimiento para participar fue obtenido del paciente o familiar&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Se&#241;ales registradas</span>&#46; El flujo respiratorio &#40;V&#8216;&#41; es medido con un neumotac&#243;grafo &#40;Fleisch n&#46;<span class="elsevierStyleSup">o</span> 2&#41; interpuesto entre el tubo endotraqueal y la conexi&#243;n en Y del circuito del respirador&#46; El volumen &#40;V&#41; es obtenido por integraci&#243;n de la se&#241;al de flujo&#46; La presi&#243;n de la v&#237;a a&#233;rea &#40;Pva&#41; es registrada de una conexi&#243;n entre el tubo endotraqueal y el circuito del respirador&#46; La Pes fue medida con un cat&#233;ter bal&#243;n tras insuflar 0&#44;5<span class="elsevierStyleHsp" style=""></span>ml de aire&#44; la posici&#243;n fue confirmada con un test de oclusi&#243;n&#46; Las presiones son medidas con un transductor de presi&#243;n diferencial&#44; procesadas y almacenadas en un ordenador para un posterior an&#225;lisis utilizando el software Anadat&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">La mec&#225;nica respiratoria</span> fue calculada en ventilaci&#243;n asistida controlada por volumen con alta asistencia &#40;ACV1&#41;&#44; sin maniobras adicionales&#46; Por regresi&#243;n lineal m&#250;ltiple&#44; con el m&#233;todo de los m&#237;nimos cuadrados&#44; ajustando los valores de presi&#243;n&#44; volumen y flujo&#44; durante todo el ciclo respiratorio&#44; a un modelo mec&#225;nico de un compartimento con un valor de elastancia y resistencias&#46; B&#225;sicamente con la se&#241;ales de volumen y flujo buscamos 2 constantes &#40;Esr&#44; Rsr&#41; que permitan reproducir la presi&#243;n medida en la v&#237;a a&#233;rea&#44; considerando que esta es la suma de una presi&#243;n el&#225;stica y otra resistiva&#46; La variable dependiente es la Pva y las independientes el flujo y volumen &#91;Pva&#40;t&#41;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>Esr V&#40;t&#41;<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Rsr &#40;V&#769;&#41;<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Pesp&#93;&#46; Esr&#44; es la elastancia din&#225;mica y Rsr&#44; son las resistencias totales del sistema respiratorio respectivamente&#46; Pesp representa la PEEP din&#225;mica o punto de la curva de presi&#243;n en el que comienza la integraci&#243;n del flujo<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">14</span></a>&#46; Utilizamos el valor medio de los ciclos respiratorios incluidos en el tiempo de registro &#40;40<span class="elsevierStyleHsp" style=""></span>s&#41;&#44; si el coeficiente de determinaci&#243;n del ajuste es superior a 0&#44;95&#46; En casos con altos niveles de PEEPi utilizamos el m&#233;todo de oclusi&#243;n inspiratoria y espiratoria&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Pmus calculada</span>&#46; Utilizamos el mismo modelo de an&#225;lisis de la mec&#225;nica respiratoria&#44; asumiendo que la presi&#243;n en el sistema es el resultado de la presi&#243;n ejercida por el respirador y la musculatura respiratoria &#91;Rsr&#183;V&#8217;<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Esr&#183;V<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Pesp<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>Pva<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>Pmus&#93;&#46; Conociendo las anteriores variables calculamos Pmus &#91;Pmus<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>Rsr&#183;V&#769;<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Esr&#183;V<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Pesp<span class="elsevierStyleHsp" style=""></span>&#8722;<span class="elsevierStyleHsp" style=""></span>Pva&#93;<a class="elsevierStyleCrossRefs" href="#bib0245"><span class="elsevierStyleSup">7&#44;15</span></a>&#46; El valor de Pmus durante la fase espiratoria est&#225; relacionado con la PEEP&#44; pero no representa el verdadero valor que no puede ser calculado&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Procedimiento</span><p id="par0040" class="elsevierStylePara elsevierViewall">El paciente en posici&#243;n reclinada&#44; previo al registro de las se&#241;ales retiramos el humidificador y se aspiran secreciones bronquiales&#46; Al comienzo del estudio realizamos una prueba de CPAP y a los 30<span class="elsevierStyleHsp" style=""></span>min tras el registro&#44; iniciamos ventilaci&#243;n asistida controlada por volumen con asistencia respiratoria alta &#40;ACV1&#41;&#46; Para esto el trigger inspiratorio es programado al m&#225;ximo de sensibilidad&#44; sin autotrigger&#44; la PEEP seg&#250;n la PEEPi y la frecuencia respiratoria que permita que el disparo del respirador sea realizado por el paciente&#46; El volumen corriente de 6-8<span class="elsevierStyleHsp" style=""></span>ml&#47;kg de peso ideal y aumentamos el flujo inspiratorio &#40;cuadrado&#41; para que el esfuerzo respiratorio sea m&#237;nimo&#44; valorado en la curva de Pes&#46; Si es necesario el volumen corriente fue aumentado transitoriamente para reducir el esfuerzo&#46; Despu&#233;s de registrar las se&#241;ales&#44; el flujo inspiratorio fue reducido seg&#250;n el nivel de esfuerzo hasta un 50&#37; y repetimos el registro &#40;ACV5&#41;&#46; En ventilaci&#243;n en soporte de presi&#243;n&#44; la sensibilidad del trigger inspiratorio&#44; espiratorio y PEEP no fue modificada&#46; El nivel de asistencia fue aumentado en pasos de 2-5<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O hasta que el esfuerzo fue m&#237;nimo &#40;PS1&#41;&#59; tras el registro&#44; la asistencia fue reducida en un 50&#37; &#40;PS5&#41;&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">&#205;ndices fisiol&#243;gicos medidos en la presi&#243;n esof&#225;gica y muscular</span><p id="par0045" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Amplitud respiratoria de Pes y Pmus &#40;delta Pes&#44; delta Pmus&#41;</span> medidas como la diferencia entre el inicio del descenso inspiratorio de Pes y Pmus hasta el m&#225;ximo descenso o nadir de cada se&#241;al&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Producto presi&#243;n tiempo inspiratorio &#40;PTP&#41;</span><a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">16&#44;17</span></a> cuantificado como el &#225;rea entre la presi&#243;n de retroceso el&#225;stica de la pared tor&#225;cica &#40;Pre&#46;pt&#41; y la Pes o Pmus inspiratoria&#46; Consideramos el final del esfuerzo inspiratorio el punto de presi&#243;n equivalente al flujo igual a cero&#46; Pre&#46;pt medida a partir de la elastancia de la pared tor&#225;cica durante la ventilaci&#243;n pasiva y el volumen corriente durante la ventilaci&#243;n asistida&#46; Esta presi&#243;n es extrapolada al inicio del esfuerzo inspiratorio en Pes y Pmus &#91;Pre&#46;pt<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#40;Ept&#183;v&#41;<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>Pes&#46;esp&#93;&#44; donde Pes&#46;esp es la Pes o Pmus al final de la espiraci&#243;n&#44; Ept es la elastancia de la pared tor&#225;cica medida en ACV1&#44; relaci&#243;n entre la variaci&#243;n respiratoria de la Pes y el volumen corriente&#46; El &#225;rea fue medida por integraci&#243;n de la presi&#243;n &#40;Pes&#44; Pmus&#41; en funci&#243;n del tiempo&#59; medimos 3 ciclos representativos del patr&#243;n respiratorio del paciente en cada modo de ventilaci&#243;n y obtenemos el valor medio&#44; este es expresado por minuto&#44; considerando la frecuencia respiratoria medida en la se&#241;al de flujo&#46; Estas medidas son realizadas en cada modo de ventilaci&#243;n y CPAP&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">An&#225;lisis estad&#237;stico</span><p id="par0055" class="elsevierStylePara elsevierViewall">Utilizamos el test de Kolmogorov-Smirnov para analizar si las variables estudiadas siguen una distribuci&#243;n normal&#46; Los datos se expresan como medias con desviaci&#243;n est&#225;ndar &#40;DE&#41; y medianas con cuartiles 25-75&#37;&#46; Se comparan con t-test&#44; o no param&#233;tricos de sumas de rangos Mann-Whitney&#44; seg&#250;n proceda&#46; Para medias repetidas se realiz&#243; test ANOVA&#46; La relaci&#243;n entre variables se evalu&#243; mediante regresi&#243;n lineal simple y el ajuste entre los 2 m&#233;todos de medida aplicando an&#225;lisis de concordancia de Bland-Altman&#46; El porcentaje de error fue calculado como los l&#237;mites de ajustes &#40;2DE&#41; de las diferencias de medias dividido por la media de los 2 m&#233;todos<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">18</span></a>&#46; Se consider&#243; el nivel de significaci&#243;n estad&#237;stica valor de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Resultados</span><p id="par0060" class="elsevierStylePara elsevierViewall">Estudiamos a 10 pacientes&#59; sus caracter&#237;sticas son resumidas en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; Se realizaron 50 registros&#44; de estos&#44; 41 fueron adecuados para el an&#225;lisis&#44; el resto se descartaron por artefactos en la se&#241;al de Pes&#46; El nivel de CPAP aplicada fue de 5<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#44; excepto en un caso que precis&#243; 18<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O por PEEPi de 20<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#46; En este modo el pico de flujo inspiratorio &#40;V&#8216;m&#225;x&#41; fue de 0&#44;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;1<span class="elsevierStyleHsp" style=""></span>l&#47;s y el volumen minuto &#40;VE&#41; de 9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>l&#47;m&#46; En ACV1 el volumen corriente 0&#44;42<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;04 l&#44; VE de 9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>l&#47;m y V&#769;I de 1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;2<span class="elsevierStyleHsp" style=""></span>l&#47;s&#46; El flujo inspiratorio fue disminuido a 0&#44;49<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;1<span class="elsevierStyleHsp" style=""></span>l&#47;s para ACV5&#44; con VE de 9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46; En PS la asistencia para reposo muscular m&#225;ximo &#40;PS1&#41; fue de 15<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O y disminuida a 9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O en PS5&#44; sin cambios significativos en V&#769;I 0&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;1 vs&#46; 0&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;04<span class="elsevierStyleHsp" style=""></span>l&#47;s&#44; VE fue m&#225;s alto que con los otro modos 10<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3<span class="elsevierStyleHsp" style=""></span>l&#47;m &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Las variables medidas en Pes y Pmus se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#59; el aumento de la asistencia respiratoria disminuye el esfuerzo medido y el calculado de forma significativa &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Comparando estas medidas en cada modo de ventilaci&#243;n&#44; la diferencia media no es significativa&#44; pero el an&#225;lisis de concordancia muestra una amplia dispersi&#243;n &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46; As&#237; la variaci&#243;n que podemos encontrar entre la medida y el c&#225;lculo del esfuerzo puede ser de 16<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O para la variaci&#243;n respiratoria y de 264<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#183;s&#47;m en el PTPm &#40;<a class="elsevierStyleCrossRefs" href="#fig0010">figs&#46; 2 y 3</a>&#41;&#46; Estas diferencias no est&#225;n influidas por la amplitud del esfuerzo&#44; pero el porcentaje de error entre la medida y el c&#225;lculo es menor con bajos niveles de asistencia &#40;CPAP&#44; ACV5&#44; PS5&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Discusi&#243;n</span><p id="par0070" class="elsevierStylePara elsevierViewall">Los resultados del estudio indican que el esfuerzo respiratorio calculado no permite inferir el valor medido en la Pes&#46; Estas diferencias se pueden deber a varios factores&#44; especialmente los par&#225;metros que intervienen en el c&#225;lculo de la Pmus&#44; la exactitud de las medidas de mec&#225;nica respiratoria y su validez cuando hay esfuerzo muscular&#46; Tambi&#233;n puede influir la medida de la Pes y la transmisi&#243;n del esfuerzo a la v&#237;a a&#233;rea&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">La se&#241;al de Pmus calculada depende de los par&#225;metros de mec&#225;nica respiratoria &#40;E y R&#41; que intervienen en la ecuaci&#243;n de movimiento<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">19&#44;20</span></a>&#46; Cualquier m&#233;todo de medida tiene limitaciones&#44; ya que estos par&#225;metros pueden cambiar de unos ciclos respiratorios a otros&#44; incluso con sedaci&#243;n profunda<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">21</span></a>&#46; En la pr&#225;ctica el m&#233;todo m&#225;s utilizado es la oclusi&#243;n inspiratoria y espiratoria&#44; basado en un modelo matem&#225;tico que asume la ausencia de esfuerzo<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">22</span></a>&#46; Nosotros utilizamos un m&#233;todo previamente validado en respiraci&#243;n espont&#225;nea<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">23</span></a>&#44; ventilaci&#243;n asistida<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">13&#44;24</span></a> y controlada<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">25</span></a>&#46; Las diferencias que encontramos entre la medida y el c&#225;lculo del esfuerzo son similares a las previamente publicadas utilizando este m&#233;todo basado en un modelo mec&#225;nico simple<a class="elsevierStyleCrossRef" href="#bib0340"><span class="elsevierStyleSup">26</span></a>&#46; Con m&#233;todos m&#225;s complicados no han mejorado los resultados&#46; En ventilaci&#243;n con PS<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">27&#44;28</span></a>&#44; el trabajo respiratorio calculado con Pmus y otras variables de ventilaci&#243;n puede diferir respecto al medido hasta 7<span class="elsevierStyleHsp" style=""></span>j&#47;m &#40;normal 5-10<span class="elsevierStyleHsp" style=""></span>j&#47;m&#41;&#46; Estudios experimentales utilizando complejos algoritmos matem&#225;ticos refieren diferencias de 0&#44;3<span class="elsevierStyleHsp" style=""></span>j&#47;l<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">29</span></a>&#46; En pacientes con ventilaci&#243;n asistida proporcional&#44; las diferencias en el esfuerzo respiratorio medido y calculado pueden ser de 5<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#47;s<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">11</span></a>&#44; valor elevado si consideramos el l&#237;mite aceptable en ventilaci&#243;n mec&#225;nica &#40;4<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#47;s<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">17</span></a>&#41;&#46; En este modo de ventilaci&#243;n era de esperar una mayor semejanza entre ambas se&#241;ales&#46; Por definici&#243;n en ventilaci&#243;n asistida proporcional&#44; la presi&#243;n y el flujo son proporcionales al esfuerzo respiratorio calculado<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">30</span></a> y las medidas de mec&#225;nica respiratoria son peri&#243;dicas<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">18</span></a>&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Las condiciones de medida de la mec&#225;nica respiratoria pueden influir&#46; Estos par&#225;metros son estimados en ventilaci&#243;n pasiva y pueden cambiar en respiraci&#243;n espont&#225;nea<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">31</span></a>&#44; limitando su utilidad para calcular el esfuerzo muscular<a class="elsevierStyleCrossRefs" href="#bib0370"><span class="elsevierStyleSup">32&#44;33</span></a>&#46; As&#237; despu&#233;s de una desconexi&#243;n fallida del respirador&#44; se ha demostrado un descenso de compliancia&#44; aumento de resistencias y PEEPi<a class="elsevierStyleCrossRefs" href="#bib0380"><span class="elsevierStyleSup">34&#44;35</span></a>&#46; Pero estos resultados no han sido confirmados en otros estudios de pacientes que precisaron ventilaci&#243;n mec&#225;nica por EPOC y SDRA<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">36</span></a>&#46; Diferencias en el patr&#243;n respiratorio pueden cambiar la mec&#225;nica respiratoria en ventilaci&#243;n asistida&#44; por la dependencia de la elastancia y resistencias del volumen y flujo respectivamente<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">37</span></a>&#46; El alto flujo inspiratorio utilizado para una ventilaci&#243;n pasiva puede sobreestimar el valor de resistencias inspiratorias y por tanto la Pmus calculada ser&#225; mayor que la Pes&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Otros factores pueden influir en las diferencias entre el c&#225;lculo y la medida del esfuerzo muscular respiratorio&#46; Que la Pes no represente adecuadamente la presi&#243;n pleural y&#47;o el esfuerzo respiratorio no modifique la Pva&#46; La Pes es un valor de presi&#243;n puntual y puede no reflejar la globalidad de la superficie pulmonar&#46; As&#237; en presencia de zonas del pulm&#243;n con diferentes caracter&#237;sticas mec&#225;nicas&#44; la presi&#243;n pleural tendr&#225; una distribuci&#243;n no solamente gravitacional y ser&#225; m&#225;s heterog&#233;nea&#44; como se ha demostrado en pacientes con EPOC<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">38</span></a> y recientemente en SDRA<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">39</span></a>&#46; En estos casos&#44; el esfuerzo respiratorio produce una redistribuci&#243;n del aire al inicio de la inspiraci&#243;n&#44; sin cambios de volumen y la Pes no representa la presi&#243;n pleural&#44; especialmente en zonas dependientes&#46; Por otro lado&#44; el esfuerzo respiratorio puede no generar un cambio de presi&#243;n proporcional en la v&#237;a a&#233;rea y por tanto la Pmus calculada no representa el cambio de presi&#243;n pleural o esof&#225;gica&#46; En sujetos sanos el cambio de presi&#243;n alveolar durante la inspiraci&#243;n es similar al cambio de Pva&#44; si bien puede haber diferencias entre sujetos de hasta un 12&#37;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">40</span></a>&#46; Pero cuando las resistencias de las v&#237;as a&#233;reas est&#225;n aumentadas &#40;EPOC&#41;&#44; el esfuerzo respiratorio no se transmite adecuadamente a la v&#237;a a&#233;rea&#44; como se ha demostrado tras la estimulaci&#243;n el&#233;ctrica del nervio fr&#233;nico<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">41</span></a> e infraestima el esfuerzo respiratorio<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">19&#44;38</span></a>&#46; De igual modo en presencia de baja compliancia pulmonar&#44; el esfuerzo respiratorio produce compresi&#243;n del gas inspirado&#44; con poco cambio de volumen pulmonar y desproporci&#243;n entre la Pes y la v&#237;a a&#233;rea<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">42</span></a>&#46; Nuestros resultados muestran que en presencia de alta asistencia y esfuerzo d&#233;bil&#44; la Pes medida es superior a la calculada&#46; Esto es&#44; con alta asistencia&#44; un esfuerzo peque&#241;o cambia poco la Pva en ACV o el flujo inspiratorio en PS&#46; Por el contrario&#44; en presencia de baja asistencia&#44; con esfuerzo muscular elevado&#44; la presi&#243;n calculada es superior a la medida&#44; por las causas referidas anteriormente&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">La limitaci&#243;n principal del estudio es la heterogeneidad del grupo de pacientes estudiado&#46; Si bien est&#225;n en fase de retirada del respirador&#44; la mec&#225;nica respiratoria y d&#237;as de ventilaci&#243;n mec&#225;nica es muy variable&#46; Un grupo m&#225;s amplio y&#47;o estratificado podr&#237;a mejorar los resultados&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">En conclusi&#243;n&#44; las curvas del respirador de presi&#243;n y flujo permiten valorar los cambios de esfuerzo muscular respiratorio cuando modificamos los par&#225;metros de ventilaci&#243;n&#44; pero no cuantificar su amplitud&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Contribuci&#243;n de los autores</span><p id="par0100" class="elsevierStylePara elsevierViewall">Francisco Ruiz Ferr&#243;n&#58; Preparaci&#243;n del protocolo&#44; registro realizado en 5 pacientes&#44; an&#225;lisis de los datos y preparaci&#243;n del manuscrito&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Jose Manuel Serrano Sim&#243;n&#58; Preparaci&#243;n del protocolo&#44; registro realizado en 5 pacientes&#44; an&#225;lisis de los datos y preparaci&#243;n del manuscrito&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Financiaci&#243;n</span><p id="par0110" class="elsevierStylePara elsevierViewall">Ninguna&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Conflicto de intereses</span><p id="par0115" class="elsevierStylePara elsevierViewall">Ninguno&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:12 [
        0 => array:3 [
          "identificador" => "xres1220562"
          "titulo" => "Resumen"
          "secciones" => array:7 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Objetivo"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Dise&#241;o"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "&#193;mbito"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Pacientes"
            ]
            4 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Intervenciones"
            ]
            5 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Resultados"
            ]
            6 => array:2 [
              "identificador" => "abst0035"
              "titulo" => "Conclusiones"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1135234"
          "titulo" => "Palabras clave"
        ]
        2 => array:3 [
          "identificador" => "xres1220563"
          "titulo" => "Abstract"
          "secciones" => array:6 [
            0 => array:2 [
              "identificador" => "abst0040"
              "titulo" => "Objective"
            ]
            1 => array:2 [
              "identificador" => "abst0045"
              "titulo" => "Design"
            ]
            2 => array:2 [
              "identificador" => "abst0050"
              "titulo" => "Ambit"
            ]
            3 => array:2 [
              "identificador" => "abst0055"
              "titulo" => "Procedure"
            ]
            4 => array:2 [
              "identificador" => "abst0060"
              "titulo" => "Results"
            ]
            5 => array:2 [
              "identificador" => "abst0065"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1135235"
          "titulo" => "Keywords"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introducci&#243;n"
        ]
        5 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Material y m&#233;todos"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Pacientes"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Procedimiento"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "&#205;ndices fisiol&#243;gicos medidos en la presi&#243;n esof&#225;gica y muscular"
            ]
            3 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "An&#225;lisis estad&#237;stico"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Resultados"
        ]
        7 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Discusi&#243;n"
        ]
        8 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "Contribuci&#243;n de los autores"
        ]
        9 => array:2 [
          "identificador" => "sec0050"
          "titulo" => "Financiaci&#243;n"
        ]
        10 => array:2 [
          "identificador" => "sec0055"
          "titulo" => "Conflicto de intereses"
        ]
        11 => array:1 [
          "titulo" => "Bibliograf&#237;a"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2017-08-29"
    "fechaAceptado" => "2018-02-14"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1135234"
          "palabras" => array:3 [
            0 => "Ventilaci&#243;n mec&#225;nica"
            1 => "Trabajo respiratorio"
            2 => "Mec&#225;nica respiratoria"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1135235"
          "palabras" => array:3 [
            0 => "Mechanical ventilation"
            1 => "Respiratory work of breathing"
            2 => "Respiratory mechanics"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Analizar la relaci&#243;n y concordancia entre el esfuerzo respiratorio calculado con las se&#241;ales del respirador &#40;Pmus&#41; y el medido con presi&#243;n esof&#225;gica &#40;Pes&#41;&#44; en ventilaci&#243;n mec&#225;nica con diferentes niveles de asistencia respiratoria&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Dise&#241;o</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo de una cohorte&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">&#193;mbito</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Unidad de cuidados intensivos polivalente en 2 hospitales terciarios&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Pacientes</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Pacientes en fase de retirada de la ventilaci&#243;n mec&#225;nica&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Intervenciones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La presi&#243;n en la v&#237;a a&#233;rea&#44; esof&#225;gica y flujo respiratorio se registraron en CPAP&#44; ventilaci&#243;n asistida controlada por volumen &#40;ACV&#41; y presi&#243;n soporte &#40;PS&#41; con asistencia respiratoria completa &#40;ACV1&#44; PS1&#41; y parcial &#40;ACV5&#44; PS5&#41;&#46; Variables medidas en Pes y Pmus&#58; amplitud respiratoria &#40;&#916;&#58; cmH<span class="elsevierStyleInf">2</span>O&#41; y el producto presi&#243;n tiempo por minuto &#40;PTPm&#58; cmH<span class="elsevierStyleInf">2</span>O&#183;s&#47;m&#41;&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Resultados</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">En 10 pacientes se estudiaron 41 registros&#46; La asistencia en CPAP fue de 5<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#44; PS1 15<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5 y PS5<span class="elsevierStyleHsp" style=""></span>9&#177;<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#46; En ACV1 el flujo inspiratorio fue 1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;2<span class="elsevierStyleHsp" style=""></span>l&#47;s&#44; reducido a 0&#44;49<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;1<span class="elsevierStyleHsp" style=""></span>l&#47;s para ACV5&#46; El esfuerzo respiratorio disminuy&#243; con el aumento de la asistencia respiratoria&#58; &#916;Pes &#40;CPAP&#44; ACV5&#44; ACV1&#44; PS5&#44; PS1&#41;&#58; 11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44; 6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44; 5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44; 9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44; 7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7 y en &#916;Pmus 16<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44; 10<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44; 5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44; 10<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44; 5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; PTPm Pes&#58; 213<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>87&#44; 96<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>91&#44; 23<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>24&#44; 206<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>121&#44; 108<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>100 &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y en Pmus&#58; 293<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>117&#44; 156<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>84&#44; 24<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>32&#44; 233<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>121&#44; 79<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>90<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#183;s&#47;m &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Las medidas en Pes y Pmus mostraron una correlaci&#243;n &#916;&#58;0&#44;72 y PTPm&#58; 0&#44;87&#46; El an&#225;lisis de Bland-Altman demostr&#243; que la diferencia &#916;Pes-Pmus puede ser de 16<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O y el PTPm de 264 y el error sistem&#225;tico en &#916;&#58; &#8722;0&#44;98<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;4 y PTPm &#8722;23&#44;69<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>66&#44;3<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#183;s&#47;m&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conclusiones</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Los par&#225;metros calculados de esfuerzo respiratorio y los medidos directamente presentan diferencias que no son aceptables en la pr&#225;ctica cl&#237;nica&#46;</p></span>"
        "secciones" => array:7 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Objetivo"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Dise&#241;o"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "&#193;mbito"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Pacientes"
          ]
          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Intervenciones"
          ]
          5 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Resultados"
          ]
          6 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Objective</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Study the relationship and concordance between calculated respiratory effort using the signals of the ventilator &#40;Pmus&#41; and that measured in esophageal pressure &#40;Pes&#41; on mechanical ventilation with different levels of respiratory assistance&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Design</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Prospective cohort study&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Ambit</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Intensive Care Unit of 2 universitary hospitals&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Patients Patients on weaning time&#46;</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Procedure</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Airway&#44; esophageal and respiratory flow were recorded on CPAP&#44; assist volume control &#40;ACV&#41; and pressure support &#40;PS&#41;&#44; with complete &#40;ACV1&#44;PS1&#41; and partial assistance &#40;ACV5&#44;PS5&#41;&#46; Measurement&#58; respiratory variations of Pes and Pmus &#40;&#916;&#58; cmH<span class="elsevierStyleInf">2</span>O&#41; and pressure time product &#40;PTPm&#58; cmH<span class="elsevierStyleInf">2</span>O&#183;s&#47;m&#41;&#46;</p></span> <span id="abst0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Results</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Fourty one records were studied&#44; the assistance was in CPAP of 5<span class="elsevierStyleHsp" style=""></span>cmH2O&#44; PS1 of 15<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5 reduced to 9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#46; In ACV1 the inspiratory flow was 1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;2<span class="elsevierStyleHsp" style=""></span>l&#47;s&#44; reduced to 0&#46;49<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;1<span class="elsevierStyleHsp" style=""></span>l&#47;s for ACV5&#46; The increase in respiratory assistance decreases respiratory effort&#44; measured in Delta Pes &#40;CPAP&#44; ACV5&#44; ACV1&#44; PS5&#44; PS1&#41;&#58; 11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44; 6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44; 5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44; 9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44; 7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7 and in Pmus 16<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#44; 10<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44; 5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44; 10<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44; 5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; The PTP per minute measured in Pes&#58; 213<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>87&#44; 96<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>91&#44; 23<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>24&#44; 206<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>121&#44; 108<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>100 &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41; and in Pmus&#58; 293<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>117&#44; 156<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>84&#44; 24<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>32&#44; 233<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>121&#44; 79<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>90 &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; The measurements in Pes and Pmus showed the following correlation&#44; in Delta&#58; 0&#46;72 and PTPm&#44; 0&#46;87&#46; The Bland-Altman analysis indicates that the difference between Delta Pes-Pmus can be 16 and the PTPm of 264 and the systematic error in Delta&#58; &#8722;0&#46;98<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#46;4 and PTPm &#8722;23&#46;69<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>66&#46;3<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#183;s&#47;m&#46;</p></span> <span id="abst0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Conclusions</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Calculated and measured parameters of respiratory effort showed unacceptable differences in clinical practice&#46;</p></span>"
        "secciones" => array:6 [
          0 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Objective"
          ]
          1 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Design"
          ]
          2 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Ambit"
          ]
          3 => array:2 [
            "identificador" => "abst0055"
            "titulo" => "Procedure"
          ]
          4 => array:2 [
            "identificador" => "abst0060"
            "titulo" => "Results"
          ]
          5 => array:2 [
            "identificador" => "abst0065"
            "titulo" => "Conclusions"
          ]
        ]
      ]
    ]
    "multimedia" => array:6 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2608
            "Ancho" => 2969
            "Tamanyo" => 470558
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Ejemplo representativo&#44; se&#241;ales registradas &#40;Pva&#44;Pes&#44;Fl&#41; y calculadas &#40;Pmus&#44; vol&#41; en CPAP&#44; ACV y PS&#46; Con baja asistencia la variaci&#243;n respiratoria de la presi&#243;n esof&#225;gica y muscular calculada son evidentes y de mayor amplitud que con alta asistencia&#46; Pero la amplitud de ambas es diferente&#46; En este caso la medida es dif&#237;cil&#44; en la presi&#243;n esof&#225;gica por la oscilaci&#243;n producida por el latido cardiaco y en la presi&#243;n muscular calculada por oscilaciones o &#171;espigas&#187; producidas por cambios en el flujo inspiratorio&#46; ACV1&#58; asistida controlada por volumen con flujo 0&#44;95<span class="elsevierStyleHsp" style=""></span>l&#47;s&#59; ACV5&#58; asistida controlada por volumen con flujo 0&#44;75<span class="elsevierStyleHsp" style=""></span>l&#47;s&#59; CPAP&#58; presi&#243;n positiva continua de 5<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#59; F&#58; flujo &#40;l&#47;s&#41;&#59; Pes&#58; presi&#243;n esof&#225;gica&#59; Pmus&#58; presi&#243;n muscular calculada &#40;cmH<span class="elsevierStyleInf">2</span>O&#41;&#59; PS5&#58; presi&#243;n soporte de 8&#59; PS1&#58; 16<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O con PEEP 4<span class="elsevierStyleHsp" style=""></span>cmH<span class="elsevierStyleInf">2</span>O&#59; Pva&#58; presi&#243;n en la v&#237;a a&#233;rea&#59; Vol&#58; volumen &#40;l&#41;&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 3382
            "Ancho" => 2412
            "Tamanyo" => 302942
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Regresi&#243;n lineal e intervalo de confianza al 95&#37; y diagrama de Bland-Altman&#58; diferencia media entre ambas se&#241;ales y l&#237;mites de concordancia&#46;</p> <p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Delta Pe-Pmus&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figura 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 3379
            "Ancho" => 2348
            "Tamanyo" => 275825
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Regresi&#243;n lineal e intervalo de confianza al 95&#37; y diagrama de Bland-Altman&#58; diferencia media entre ambas se&#241;ales y l&#237;mites de concordancia&#46;</p> <p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">PTPPe-Pmus&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">abd&#58; abdominal&#59; Ept&#58; elastancia de la pared tor&#225;cica cmH<span class="elsevierStyleInf">2</span>O&#47;l&#59; Esr&#58; elastancia del sistema respiratorio &#40;cmH<span class="elsevierStyleInf">2</span>O&#47;l&#41;&#59; IRCA&#58; insuficiencia respiratoria cr&#243;nica agudizada&#59; PEEPi&#58; autoPEEP din&#225;mica &#40;cmH<span class="elsevierStyleInf">2</span>O&#41;&#59; PostQco&#58; posquir&#250;rgico&#59; Rpt&#58; resistencias de la pared tor&#225;cica &#40;cmH<span class="elsevierStyleInf">2</span>O&#47;l&#47;s&#41;&#59; Rsr&#58; resistencias totales del sistema respiratorio &#40;cmH<span class="elsevierStyleInf">2</span>O&#47;l&#47;s&#41;&#59; SDRA&#58; s&#237;ndrome de dificultad respiratoria aguda del adulto&#59; VM&#58; ventilaci&#243;n mec&#225;nica&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&#46;<span class="elsevierStyleSup">o</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sexo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Edad &#40;a&#241;os&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Apache IIal ingreso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">D&#237;as VM&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Diagn&#243;stico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">EsrcmH<span class="elsevierStyleInf">2</span>O&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">RsrcmH<span class="elsevierStyleInf">2</span>O&#47;l&#47;s&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">EptcmH<span class="elsevierStyleInf">2</span>O&#47;l&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">RptcmH<span class="elsevierStyleInf">2</span>O&#47;l&#47;s&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PEEPicmH<span class="elsevierStyleInf">2</span>O&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Evoluci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PostQco abd-SDRA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Peritonitis 3&#46;<span class="elsevierStyleSup">a</span>-SDRA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Exitus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pancreatitis-SDRA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IRCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IRCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Asma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PostQco neurocirug&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sepsis abd&#46; SDRA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Neumon&#237;a SDRA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Neumon&#237;a SDRA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Alta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2084205.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas de los pacientes&#44; mec&#225;nica respiratoria y pron&#243;stico</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabla 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Delta&#58; variaci&#243;n respiratoria&#59; Pes&#58; presi&#243;n esof&#225;gica&#59; Pmus&#58; presi&#243;n muscular calculada &#40;cmH<span class="elsevierStyleInf">2</span>O&#41;&#59; PTP&#44; producto presi&#243;n tiempo por ciclo &#40;cmH<span class="elsevierStyleInf">2</span>O&#47;s&#41;&#59; PTPm&#58; producto presi&#243;n tiempo por minuto &#40;cmH<span class="elsevierStyleInf">2</span>O&#183;s&#47;m&#41;&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">CPAP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ACV5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ACV1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PS5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PS1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#916;Pes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#916;Pmus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PTPes&#46;es&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">213<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">96<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">206<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>121&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">108<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PTPmus&#46; m&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">293<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>117&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">156<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">233<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>121&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">79<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2084203.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Variables de esfuerzo medidas en todos los datos&#44; asistencia 100&#37; &#40;ACV1 y PS1&#41; y asistencia<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleUnderline">&#60;</span><span class="elsevierStyleHsp" style=""></span>50&#37; &#40;CPAP&#44; PS5&#44; ACV5&#41;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Tabla 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">Bias o error sistem&#225;tico&#59; DE&#58; desviaci&#243;n est&#225;ndar&#59; Delta&#58; variaci&#243;n respiratoria&#59; Pes&#58; presi&#243;n esof&#225;gica&#59; Pmus&#58; presi&#243;n muscular calculada &#40;cmH<span class="elsevierStyleInf">2</span>O&#41;&#59; PTP&#44; producto presi&#243;n tiempo por ciclo &#40;cmH<span class="elsevierStyleInf">2</span>O&#47;s&#41;&#59; PTPm&#58; producto presi&#243;n tiempo por minuto &#40;cmH<span class="elsevierStyleInf">2</span>O&#183;s&#47;m&#41;&#59; R&#58; coeficiente de correlaci&#243;n&#46; L&#237;mites de concordancia o error aleatorio&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PTP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PTPm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Delta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Todos los datos</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pes&#44; media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE<span class="elsevierStyleHsp" style=""></span>Cuartil 25-75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#40;1-9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">130<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>110<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&#40;22-223&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#40;3-10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pmus&#44; media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE<span class="elsevierStyleHsp" style=""></span>Cuartil 25-75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14&#40;1-11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">155<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>133&#40;23-256&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#40;3-14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>R&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Bias &#40;media de las diferencias<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;23<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;23&#44;69<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>66&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#44;98<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>DE &#40;95&#37; l&#237;mites de concordancia&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;17&#8722;13&#44;63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">108&#44;91&#8722;156&#44;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;82&#8722;9&#44;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Asistencia 100&#37;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pes&#44; media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE<span class="elsevierStyleHsp" style=""></span>Cuartil 25-75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>24&#40;0&#44;8-7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>83&#40;22-223&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#40;3-10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pmus &#40;media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE&#41;<span class="elsevierStyleHsp" style=""></span>Cuartil 25-75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>19&#40;0&#44;5-8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>71&#40;23-256&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#40;3-14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Bias &#40;media de las diferencias<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;2&#44;14<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;14&#44;25<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>62&#44;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;1&#44;08<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>DE &#40;95&#37; l&#237;mites de concordancia&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;86&#8722;20&#44;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">110&#44;93&#8722;139&#44;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;16&#8722;10&#44;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Asistencia</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#60;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">50&#37;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pes &#40;media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE&#41;<span class="elsevierStyleHsp" style=""></span>Cuartil &#40;25-75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&#40;4-10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">176<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>108<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&#40;74-268&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&#40;6-11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pmus &#40;media<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DE&#41;<span class="elsevierStyleHsp" style=""></span>Cuartil 25-75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#40;6-11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">234<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>119&#40;119-344&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#40;8-16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Bias &#40;media de las diferencias&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;50<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57&#44;85<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>49&#44;62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;2&#44;95<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>DE &#40;95&#37; l&#237;mites de concordancia&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;1&#44;566&#44;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;41&#44;39157&#44;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;3&#44;719&#44;61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2084204.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "&#42;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Estad&#237;stica descriptiva y concordancia</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:42 [
            0 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of assisted ventilator modes on triggering&#44; patient effort&#44; and dyspnea"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Leung"
                            1 => "A&#46; Jubran"
                            2 => "M&#46;J&#46; Tobin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.155.6.9196100"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1997"
                        "volumen" => "155"
                        "paginaInicial" => "1940"
                        "paginaFinal" => "1948"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9196100"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Load dependence of secondary diaphragm inflammation and injury after acute inspiratory loading"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46;X&#46; Jiang"
                            1 => "W&#46;D&#46; Reid"
                            2 => "A&#46; Belcastro"
                            3 => "J&#46;L&#46; Road"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.157.1.9702051"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1998"
                        "volumen" => "157"
                        "paginaInicial" => "230"
                        "paginaFinal" => "236"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9445304"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patient-ventilator asynchrony during assisted mechanical ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46;W&#46; Thille"
                            1 => "P&#46; Rodriguez"
                            2 => "B&#46; Cabello"
                            3 => "F&#46; Lellouche"
                            4 => "L&#46; Brochard"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2006"
                        "volumen" => "32"
                        "paginaInicial" => "1515"
                        "paginaFinal" => "1522"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessing effort and work of breathing"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46; Bellani"
                            1 => "A&#46; Pesenti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Curr Opin Crit Care Med"
                        "fecha" => "2014"
                        "volumen" => "20"
                        "paginaInicial" => "352"
                        "paginaFinal" => "358"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The validity and reliability of the clinical assessment of increased work of breathing in acutely ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Tulaimat"
                            1 => "A&#46; Patel"
                            2 => "M&#46; Wisniewski"
                            3 => "R&#46; Gueret"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jcrc.2011.03.002"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Crit Care"
                        "fecha" => "2016"
                        "paginaInicial" => "111"
                        "paginaFinal" => "115"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21482346"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy of ventilador waveform observation in detecting patient-ventilator asynchrony"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Colombo"
                            1 => "G&#46; Cammarota"
                            2 => "M&#46; Alemani"
                            3 => "L&#46; Carenzo"
                            4 => "F&#46;L&#46; Barra"
                            5 => "R&#46; Vaschetto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/CCM.0b013e318225753c"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2011"
                        "volumen" => "39"
                        "paginaInicial" => "2452"
                        "paginaFinal" => "2457"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21705886"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The inspiratory workload of patient-initiated mechanical ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;J&#46; Marini"
                            1 => "R&#46;M&#46; Rodriguez"
                            2 => "V&#46; Lamb"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/arrd.1986.134.5.902"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Rev Respir Dis&#46;"
                        "fecha" => "1986"
                        "volumen" => "134"
                        "paginaInicial" => "902"
                        "paginaFinal" => "909"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3096177"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Respiratory muscle pressure analysis in pressure-support ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Y&#46; Yamada"
                            1 => "M&#46; Shigeta"
                            2 => "K&#46; Suwa"
                            3 => "K&#46; Hanaoka"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1152/jappl.1994.77.5.2237"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Appl Physiol&#46;"
                        "fecha" => "1994"
                        "volumen" => "77"
                        "paginaInicial" => "2237"
                        "paginaFinal" => "2243"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7868440"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dynamics of breathing"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Mead"
                            1 => "E&#46; Agostoni"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "editores" => "W&#46;O&#46;Fenn, H&#46;Rahn"
                        "titulo" => "Handbook of physiology&#46; Section 3&#44; vol I&#58; Respiration&#46;"
                        "paginaInicial" => "411"
                        "paginaFinal" => "427"
                        "serieFecha" => "1964"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Real-time computation of a patient&#39;s respiratory effort during ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;H&#46; Schott"
                            1 => "J&#46;A&#46; Blom"
                            2 => "H&#46;H&#46; Korsten"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10877-006-9020-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Monit Comput&#46;"
                        "fecha" => "2006"
                        "volumen" => "20"
                        "paginaInicial" => "193"
                        "paginaFinal" => "200"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16718588"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estimation of inspiratory muscle pressure in critically ill patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46; Kondili"
                            1 => "C&#46; Alexopoulou"
                            2 => "N&#46; Xirouchaki"
                            3 => "K&#46; Vaporidi"
                            4 => "D&#46; Georgopoulos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-010-1753-4"
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2010"
                        "volumen" => "36"
                        "paginaInicial" => "648"
                        "paginaFinal" => "655"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20107765"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Realistic human muscle pressure for driving a mechanical lung"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46; Fresnel"
                            1 => "J&#46;F&#46; Muir"
                            2 => "C&#46; Letellier"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "EPJ Nonlinear Biomed Phys&#46;"
                        "fecha" => "2014"
                        "volumen" => "2"
                        "paginaInicial" => "7"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Patient work of breathing during pressure support and volume-cycled mechanical ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46; Kreit"
                            1 => "M&#46;W&#46; Capper"
                            2 => "W&#46;L&#46; Eschenbacher"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.149.5.8173745"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1994"
                        "volumen" => "149"
                        "paginaInicial" => "1085"
                        "paginaFinal" => "1091"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8173745"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Respiratory mechanics by least square fitting in mechanically ventilated patients&#58; Applications during paralysis and during pressure support ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46;A&#46; Iotti"
                            1 => "A&#46; Braschi"
                            2 => "J&#46;X&#46; Brunner"
                            3 => "T&#46; Smits"
                            4 => "M&#46; Olivei"
                            5 => "A&#46; Palo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "1995"
                        "volumen" => "21"
                        "paginaInicial" => "406"
                        "paginaFinal" => "413"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7665750"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Proportional assist ventilation&#44; a new approach to ventilatory support theory"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46; Younes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm/145.1.114"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Rev Respir Dis"
                        "fecha" => "1992"
                        "volumen" => "145"
                        "paginaInicial" => "114"
                        "paginaFinal" => "120"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1731573"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment of neural inspiratory time in ventilator-supported patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Parthasarathy"
                            1 => "A&#46; Jubran"
                            2 => "M&#46;J&#46; Tobin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.162.2.9901024"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2000"
                        "volumen" => "162"
                        "paginaInicial" => "546"
                        "paginaFinal" => "552"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10934085"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Variability of patient-ventilator interaction with pressure support ventilation in patients with COPD"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Jubran"
                            1 => "W&#46;B&#46; van de Graaff"
                            2 => "M&#46;J&#46; Tobin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Respir Crit Med"
                        "fecha" => "1995"
                        "volumen" => "152"
                        "paginaInicial" => "129"
                        "paginaFinal" => "136"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A meta-analysis of studies using bias and precision statistics to compare cardiac output measurement techniques"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "L&#46;A&#46;H&#46; Critchley"
                            1 => "J&#46;A&#46;J&#46;H&#46; Critchley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Clin Monitor"
                        "fecha" => "1999"
                        "volumen" => "15"
                        "paginaInicial" => "85"
                        "paginaFinal" => "91"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A method for monitoring and improving patient&#58; Ventilator interaction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Younes"
                            1 => "L&#46; Brochard"
                            2 => "S&#46; Grasso"
                            3 => "J&#46; Kun"
                            4 => "J&#46; Mancebo"
                            5 => "M&#46; Ranieri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2007"
                        "volumen" => "33"
                        "paginaInicial" => "1337"
                        "paginaFinal" => "1346"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of ventilator flow rate on respiratory timing in normal human"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Fernandez"
                            1 => "M&#46; Mendez"
                            2 => "M&#46; Younes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.159.3.9709090"
                      "Revista" => array:7 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1999"
                        "volumen" => "159"
                        "paginaInicial" => "710"
                        "paginaFinal" => "719"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10051241"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674910008183"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Breath to breath respiratory mechanics variation&#58; How much variation should we expect"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "K&#46;T&#46; Kim"
                            1 => "Y&#46;S&#46; Chiew"
                            2 => "C&#46; Pretty"
                            3 => "G&#46;M&#46; Shaw"
                            4 => "T&#46; Desaive"
                            5 => "J&#46;G&#46; Chasel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2015"
                        "volumen" => "9"
                        "numero" => "Suppl 1"
                        "paginaInicial" => "s91"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Analysis of the behaviour of the respiratory system with constant inspiratory flow"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;H&#46; Bates"
                            1 => "A&#46; Rossi"
                            2 => "L&#46; Milic-Emili"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1152/jappl.1985.58.6.1840"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Appl Physiol"
                        "fecha" => "1985"
                        "volumen" => "58"
                        "paginaInicial" => "1840"
                        "paginaFinal" => "1848"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4008404"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "On-line monitoring of lung mechanics during spontaneous breathing&#58; A physiological study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Khirani"
                            1 => "G&#46; Polese"
                            2 => "A&#46; Aliverti"
                            3 => "L&#46; Appendini"
                            4 => "G&#46; Nucci"
                            5 => "A&#46; Pedotti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Respir Med"
                        "fecha" => "2010"
                        "volumen" => "104"
                        "paginaInicial" => "463"
                        "paginaFinal" => "471"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of nonlinearities on estimates of respiratory mechanics using multilinear regression analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Kano"
                            1 => "C&#46;J&#46; Lanteri"
                            2 => "A&#46;W&#46; Duncan"
                            3 => "P&#46;D&#46; Sly"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1152/jappl.1994.77.3.1185"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Appl Physiol"
                        "fecha" => "1994"
                        "volumen" => "77"
                        "paginaInicial" => "1185"
                        "paginaFinal" => "1197"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7836121"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of static and dynamic measurements of intrinsic PEEP in anesthetized cats"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "P&#46; Hernandez"
                            1 => "P&#46; Navalesi"
                            2 => "F&#46; Maltais"
                            3 => "A&#46; Gursahaney"
                            4 => "B&#46; Gottfried"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Appl Physiol"
                        "fecha" => "1994"
                        "volumen" => "76"
                        "paginaInicial" => "2437"
                        "paginaFinal" => "2442"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A model lung with direct representation of respiratory muscle activity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;S&#46; Mecklenburgh"
                            1 => "T&#46;A&#46;A&#46; al-Obaidi"
                            2 => "W&#46;W&#46; Mapleson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/bja/68.6.603"
                      "Revista" => array:7 [
                        "tituloSerie" => "Br J Anaesth"
                        "fecha" => "1992"
                        "volumen" => "68"
                        "paginaInicial" => "603"
                        "paginaFinal" => "612"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1610636"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674917305894"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Power of breathing determined noninvasively with use of an artificial neural network in patients with respiratory failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;J&#46; Banner"
                            1 => "N&#46;R&#46; Eulinao"
                            2 => "V&#46; Brennan"
                            3 => "C&#46; Peters"
                            4 => "J&#46; Layon"
                            5 => "A&#46; Babrielli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.CCM.0000206288.90613.1C"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2006"
                        "volumen" => "34"
                        "paginaInicial" => "1052"
                        "paginaFinal" => "1059"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16484913"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Real time noninvasive estimation of work of breathing using facemask leak-corrected tidal volume during noninvasive pressure support&#58; Validation study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;J&#46; Banner"
                            1 => "C&#46;G&#46; Tams"
                            2 => "N&#46;R&#46; Euliano"
                            3 => "P&#46;J&#46; Stephan"
                            4 => "T&#46;J&#46; Leavitt"
                            5 => "A&#46;D&#46; Martin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s10877-015-9716-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Monit Comput"
                        "fecha" => "2016"
                        "volumen" => "30"
                        "paginaInicial" => "285"
                        "paginaFinal" => "294"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26070542"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0355"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Constrained optimization for noninvasive estimation of work of breathing"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "F&#46; Vicario"
                            1 => "A&#46; Albanese"
                            2 => "D&#46; Wang"
                            3 => "N&#46; Karamolegkos"
                            4 => "N&#46;W&#46; Chbat"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "IEEE Trans Biomed Eng"
                        "fecha" => "2015"
                        "paginaInicial" => "5327"
                        "paginaFinal" => "5330"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0360"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Proportional assist ventilation&#46; Results of an initial clinical trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Younes"
                            1 => "A&#46; Puddy"
                            2 => "D&#46; Roberts"
                            3 => "B&#46; Light"
                            4 => "A&#46; Quesada"
                            5 => "K&#46; Taylor"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm/145.1.121"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Rev Respir Dis"
                        "fecha" => "1992"
                        "volumen" => "145"
                        "paginaInicial" => "121"
                        "paginaFinal" => "129"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1731574"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0365"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of pressure assist on ventilation and respiratory mechanics in heavy exercise"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;G&#46; Gallather"
                            1 => "M&#46; Younes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Appl Physiol"
                        "fecha" => "1989"
                        "volumen" => "66"
                        "paginaInicial" => "1824"
                        "paginaFinal" => "1837"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0370"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A method for measuring passive elastance during proportional assist ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Younes"
                            1 => "K&#46; Webster"
                            2 => "J&#46; Kun"
                            3 => "D&#46; Roberts"
                            4 => "B&#46; Masiowski"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.164.1.2010068"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med&#46;"
                        "fecha" => "2001"
                        "volumen" => "164"
                        "paginaInicial" => "50"
                        "paginaFinal" => "60"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11435238"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0375"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A method&#46; for noninvasive determination of inspiratory resistance during&#46; proportional assist ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Younes"
                            1 => "J&#46; Kun"
                            2 => "B&#46; Masiowski"
                            3 => "K&#46; Webster"
                            4 => "D&#46; Roberts"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.163.4.2005063"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2001"
                        "volumen" => "163"
                        "paginaInicial" => "829"
                        "paginaFinal" => "839"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11282753"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0380"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The tension-time index and the frequency&#47;tidal volume ratio are the major pathophysiologic determinants of weaning failure and success"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46; Vassilakopoulos"
                            1 => "S&#46; Zakynthinos"
                            2 => "C&#46; Roussos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.158.2.9710084"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1998"
                        "volumen" => "158"
                        "paginaInicial" => "378"
                        "paginaFinal" => "385"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9700110"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0385"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Passive mechanics of lung and chest wall in patients who faied or succeeded in trials of weaning"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Jubran"
                            1 => "M&#46;J&#46; Tobin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.155.3.9117026"
                      "Revista" => array:7 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "1997"
                        "volumen" => "155"
                        "paginaInicial" => "916"
                        "paginaFinal" => "921"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9117026"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0091674909017345"
                          "estado" => "S300"
                          "issn" => "00916749"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0390"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Determinants of weaning success in patients with prolonged mechanical ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Carlucci"
                            1 => "P&#46; Ceriana"
                            2 => "G&#46; Prinianakis"
                            3 => "F&#46; Fanfulla"
                            4 => "R&#46; Colombo"
                            5 => "S&#46; Nava"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/cc7927"
                      "Revista" => array:5 [
                        "tituloSerie" => "Crit Care"
                        "fecha" => "2009"
                        "volumen" => "13"
                        "paginaInicial" => "R97"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19549301"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0395"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Respiratory mechanics during halothane anesthesia and anesthesia-paralysis in humans"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "P&#46;K&#46; Behrakis"
                            1 => "B&#46;D&#46; Higgs"
                            2 => "A&#46; Baydur"
                            3 => "W&#46;A&#46; Zin"
                            4 => "J&#46; Milic-Emili"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1152/jappl.1983.55.4.1085"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Appl Physiol"
                        "fecha" => "1983"
                        "volumen" => "55"
                        "paginaInicial" => "1085"
                        "paginaFinal" => "1092"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6629937"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0400"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Difference between mouth and esophageal occlusion pressure during CO2&#44; rebreathing in chronic obstructive pulmonary disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "L&#46; Marazzini"
                            1 => "R&#46; Cavestri"
                            2 => "D&#46; Gori"
                            3 => "L&#46; Gatti"
                            4 => "E&#46; Longhini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/arrd.1978.118.6.1027"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Rev Respir Dis"
                        "fecha" => "1978"
                        "volumen" => "118"
                        "paginaInicial" => "1027"
                        "paginaFinal" => "1033"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/369409"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0405"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spontaneous effort causes occult pendelluft during mechanical ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Yoshida"
                            1 => "V&#46; Torsani"
                            2 => "S&#46; Gomes"
                            3 => "R&#46; de Santis"
                            4 => "M&#46;A&#46; Beraldo"
                            5 => "E&#46; Costa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.201303-0539OC"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2013"
                        "volumen" => "188"
                        "paginaInicial" => "1420"
                        "paginaFinal" => "1427"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24199628"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib0410"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Noninvasive work of breathing improves prediction of post-extubation outcome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;J&#46; Banner"
                            1 => "N&#46;R&#46; Euliano"
                            2 => "A&#46;D&#46; Martin"
                            3 => "N&#46; Al-Rawas"
                            4 => "A&#46;J&#46; Layon"
                            5 => "A&#46; Gabrielli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00134-011-2402-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "2012"
                        "volumen" => "38"
                        "paginaInicial" => "248"
                        "paginaFinal" => "255"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22113814"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib0415"
              "etiqueta" => "41"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Measurement of twitch transdiaphragmatic&#44; esophageal&#44; and endotracheal tube pressure with bilateral anterolateral magnetic phrenic nerve stimulation in patients in the intensive care unit"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;C&#46; Watson"
                            1 => "P&#46;D&#46; Hughes"
                            2 => "L&#46; Harris"
                            3 => "N&#46; Hart"
                            4 => "T&#46;J&#46; Ware"
                            5 => "J&#46; Wendon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/00003246-200107000-00005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "2001"
                        "volumen" => "29"
                        "paginaInicial" => "1325"
                        "paginaFinal" => "1339"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11445679"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib0420"
              "etiqueta" => "42"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Inaccuracy of oesophageal pressure for pleural pressure estimation in supine anesthetized subjects"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;B&#46; Drummond"
                            1 => "A&#46;D&#46;G&#46; Wright"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/bja/55.7.585"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Anaesth"
                        "fecha" => "1983"
                        "volumen" => "55"
                        "paginaInicial" => "585"
                        "paginaFinal" => "593"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6871051"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/02105691/0000004300000004/v4_201907180823/S021056911830069X/v4_201907180823/es/main.assets"
  "Apartado" => array:4 [
    "identificador" => "434"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Originales"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/02105691/0000004300000004/v4_201907180823/S021056911830069X/v4_201907180823/es/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021056911830069X?idApp=WMIE"
]
Información del artículo
ISSN: 02105691
Idioma original: Español
DOI:10.1016/j.medin.2018.02.015
Datos actualizados diariamente
año/Mes Html Pdf Total
2024 Noviembre 13 12 25
2024 Octubre 149 66 215
2024 Septiembre 163 75 238
2024 Agosto 180 76 256
2024 Julio 160 56 216
2024 Junio 203 100 303
2024 Mayo 193 39 232
2024 Abril 235 54 289
2024 Marzo 187 65 252
2024 Febrero 144 72 216
2024 Enero 208 66 274
2023 Diciembre 218 89 307
2023 Noviembre 642 363 1005
2023 Octubre 208 72 280
2023 Septiembre 210 68 278
2023 Agosto 156 35 191
2023 Julio 164 66 230
2023 Junio 172 40 212
2023 Mayo 209 69 278
2023 Abril 149 52 201
2023 Marzo 232 80 312
2023 Febrero 165 66 231
2023 Enero 193 76 269
2022 Diciembre 212 103 315
2022 Noviembre 197 84 281
2022 Octubre 209 70 279
2022 Septiembre 174 54 228
2022 Agosto 163 55 218
2022 Julio 161 65 226
2022 Junio 116 44 160
2022 Mayo 117 60 177
2022 Abril 203 66 269
2022 Marzo 150 65 215
2022 Febrero 168 25 193
2022 Enero 179 79 258
2021 Diciembre 154 76 230
2021 Noviembre 167 83 250
2021 Octubre 262 102 364
2021 Septiembre 109 50 159
2021 Agosto 125 52 177
2021 Julio 66 42 108
2021 Junio 63 41 104
2021 Mayo 76 84 160
2021 Abril 289 162 451
2021 Marzo 142 70 212
2021 Febrero 131 46 177
2021 Enero 126 50 176
2020 Diciembre 122 52 174
2020 Noviembre 104 40 144
2020 Octubre 101 49 150
2020 Septiembre 94 37 131
2020 Agosto 81 18 99
2020 Julio 85 36 121
2020 Junio 91 29 120
2020 Mayo 119 25 144
2020 Abril 167 59 226
2020 Marzo 124 17 141
2020 Febrero 246 49 295
2020 Enero 228 44 272
2019 Diciembre 562 183 745
2019 Noviembre 209 52 261
2019 Octubre 298 39 337
2019 Septiembre 110 52 162
2019 Agosto 327 152 479
2019 Julio 305 16 321
2019 Junio 5 10 15
2019 Mayo 19 18 37
2019 Abril 13 4 17
2019 Marzo 1 3 4
2019 Febrero 4 3 7
2019 Enero 0 2 2
2018 Octubre 1 0 1
2018 Mayo 0 1 1
2018 Abril 7 2 9
Mostrar todo

Siga este enlace para acceder al texto completo del artículo

Suscríbase a la newsletter

Publique en
Medicina Intensiva
Multimedia
Monitorización de la ventilación con tomografía de impedancia
Más imágenes
Vídeos
Maniobra de prono en paciente con ECMO
Maniobra de prono en paciente con ECMO
Idiomas
Medicina Intensiva
es en

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

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