array:25 [
  "pii" => "S0210569119300178"
  "issn" => "02105691"
  "doi" => "10.1016/j.medin.2019.01.001"
  "estado" => "S300"
  "fechaPublicacion" => "2019-11-01"
  "aid" => "1305"
  "copyright" => "Elsevier España, S.L.U. y SEMICYUC"
  "copyrightAnyo" => "2019"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "cor"
  "cita" => "Med Intensiva. 2019;43:513"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 294
    "formatos" => array:3 [
      "EPUB" => 12
      "HTML" => 232
      "PDF" => 50
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S2173572719301456"
      "issn" => "21735727"
      "doi" => "10.1016/j.medine.2019.01.008"
      "estado" => "S300"
      "fechaPublicacion" => "2019-11-01"
      "aid" => "1305"
      "copyright" => "Elsevier España, S.L.U. and SEMICYUC"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "cor"
      "cita" => "Med Intensiva. 2019;43:513"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 2
        "HTML" => 2
      ]
      "en" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
        "titulo" => "Materials engineering&#44; mechanical power&#44; protective ventilation and a parachute"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:1 [
            "paginaInicial" => "513"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Ingenier&#237;a de materiales&#44; <span class="elsevierStyleItalic">mechanical power&#44;</span> ventilaci&#243;n protectora y una de paraca&#237;das"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "P&#46; Escudero-Acha, A&#46; Gonz&#225;lez-Castro, Y&#46; Pe&#241;asco, M&#46; Feo-Gonzalez"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "P&#46;"
                "apellidos" => "Escudero-Acha"
              ]
              1 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Gonz&#225;lez-Castro"
              ]
              2 => array:2 [
                "nombre" => "Y&#46;"
                "apellidos" => "Pe&#241;asco"
              ]
              3 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Feo-Gonzalez"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "es" => array:9 [
          "pii" => "S0210569119300178"
          "doi" => "10.1016/j.medin.2019.01.001"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "es"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569119300178?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719301456?idApp=WMIE"
      "url" => "/21735727/0000004300000008/v1_201910261026/S2173572719301456/v1_201910261026/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0210569119300385"
    "issn" => "02105691"
    "doi" => "10.1016/j.medin.2019.01.007"
    "estado" => "S300"
    "fechaPublicacion" => "2019-11-01"
    "aid" => "1312"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Med Intensiva. 2019;43:514-5"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 111
      "formatos" => array:3 [
        "EPUB" => 12
        "HTML" => 60
        "PDF" => 39
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>"
      "titulo" => "Respuesta a &#171;Ingenier&#237;a de materiales&#44; <span class="elsevierStyleItalic">mechanical power&#44;</span> ventilaci&#243;n protectora y una de paraca&#237;das&#187;"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "514"
          "paginaFinal" => "515"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Reply to &#171;Materials engineering&#44; mechanical power&#44; protective ventilation and a parachute&#187;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "V&#46; Modesto i Alapont, M&#46; Aguar Carrascosa, A&#46; Medina"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "V&#46;"
              "apellidos" => "Modesto i Alapont"
            ]
            1 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Aguar Carrascosa"
            ]
            2 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Medina"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173572719301468"
        "doi" => "10.1016/j.medine.2019.01.009"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719301468?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569119300385?idApp=WMIE"
    "url" => "/02105691/0000004300000008/v1_201910220814/S0210569119300385/v1_201910220814/es/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S0210569118302778"
    "issn" => "02105691"
    "doi" => "10.1016/j.medin.2018.09.015"
    "estado" => "S300"
    "fechaPublicacion" => "2019-11-01"
    "aid" => "1282"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Med Intensiva. 2019;43:510-2"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 107
      "formatos" => array:3 [
        "EPUB" => 16
        "HTML" => 49
        "PDF" => 42
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
      "titulo" => "Lymphopenic hospital acquired sepsis &#40;L-HAS&#41;&#58; An immunological phenotype conferring higher risk of mortality"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "510"
          "paginaFinal" => "512"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Sepsis nosocomial linfop&#233;nica&#58; un fenotipo inmunol&#243;gico que confiere un mayor riesgo de mortalidad"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1386
              "Ancho" => 1583
              "Tamanyo" => 63336
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Kaplan&#8211;Meier survival curve&#46; Groups were compared by the log rank test &#40;Mantel&#8211;Henzel&#41;&#46; Circulating Lymphocyte Count &#40;CLC&#41; at HAS diagnosis were divided in two groups&#44; &#8804;775<span class="elsevierStyleHsp" style=""></span>lymphocytes&#47;mm<span class="elsevierStyleSup">3</span> and greater&#46; Time was censored at 90 days following HAS diagnosis&#46; Cum&#58; cumulative&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "C&#46; L&#243;pez-Mestanza, D&#46; Andaluz-Ojeda, J&#46;R&#46; G&#243;mez-L&#243;pez, J&#46;F&#46; Bermejo-Mart&#237;n"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "L&#243;pez-Mestanza"
            ]
            1 => array:2 [
              "nombre" => "D&#46;"
              "apellidos" => "Andaluz-Ojeda"
            ]
            2 => array:2 [
              "nombre" => "J&#46;R&#46;"
              "apellidos" => "G&#243;mez-L&#243;pez"
            ]
            3 => array:2 [
              "nombre" => "J&#46;F&#46;"
              "apellidos" => "Bermejo-Mart&#237;n"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569118302778?idApp=WMIE"
    "url" => "/02105691/0000004300000008/v1_201910220814/S0210569118302778/v1_201910220814/en/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:19 [
      "pii" => "S0210569119300385"
      "issn" => "02105691"
      "doi" => "10.1016/j.medin.2019.01.007"
      "estado" => "S300"
      "fechaPublicacion" => "2019-11-01"
      "aid" => "1312"
      "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "cor"
      "cita" => "Med Intensiva. 2019;43:514-5"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 111
        "formatos" => array:3 [
          "EPUB" => 12
          "HTML" => 60
          "PDF" => 39
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>"
        "titulo" => "Respuesta a &#171;Ingenier&#237;a de materiales&#44; <span class="elsevierStyleItalic">mechanical power&#44;</span> ventilaci&#243;n protectora y una de paraca&#237;das&#187;"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "514"
            "paginaFinal" => "515"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Reply to &#171;Materials engineering&#44; mechanical power&#44; protective ventilation and a parachute&#187;"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "V&#46; Modesto i Alapont, M&#46; Aguar Carrascosa, A&#46; Medina"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "V&#46;"
                "apellidos" => "Modesto i Alapont"
              ]
              1 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Aguar Carrascosa"
              ]
              2 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Medina"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173572719301468"
          "doi" => "10.1016/j.medine.2019.01.009"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719301468?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569119300385?idApp=WMIE"
      "url" => "/02105691/0000004300000008/v1_201910220814/S0210569119300385/v1_201910220814/es/main.assets"
    ]
  ]
  "es" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>"
    "titulo" => "Ingenier&#237;a de materiales&#44; <span class="elsevierStyleItalic">mechanical power&#44;</span> ventilaci&#243;n protectora y una de paraca&#237;das"
    "tieneTextoCompleto" => true
    "saludo" => "<span class="elsevierStyleItalic">Sr&#46; Editor&#58;</span>"
    "paginas" => array:1 [
      0 => array:1 [
        "paginaInicial" => "513"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "P&#46; Escudero-Acha, A&#46; Gonz&#225;lez-Castro, Y&#46; Pe&#241;asco, M&#46; Feo-Gonzalez"
        "autores" => array:4 [
          0 => array:2 [
            "nombre" => "P&#46;"
            "apellidos" => "Escudero-Acha"
          ]
          1 => array:4 [
            "nombre" => "A&#46;"
            "apellidos" => "Gonz&#225;lez-Castro"
            "email" => array:1 [
              0 => "e409@humv.es"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          2 => array:2 [
            "nombre" => "Y&#46;"
            "apellidos" => "Pe&#241;asco"
          ]
          3 => array:2 [
            "nombre" => "M&#46;"
            "apellidos" => "Feo-Gonzalez"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servicio de Medicina Intensiva&#44; Hospital Universitario Marqu&#233;s de Valdecilla&#44; Santander&#44; Cantabria&#44; Espa&#241;a"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspondencia&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Materials engineering&#44; mechanical power&#44; protective ventilation and a parachute"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Hemos le&#237;do con atenci&#243;n y&#44; reconocemos&#44; que con cierto entusiasmo el art&#237;culo de Modesto et al&#46; publicado en su revista<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Parafraseando a los autores&#58; el hecho de interpretar la existencia de un umbral de energ&#237;a &#40;<span class="elsevierStyleItalic">mechanical power</span> &#91;MP&#93;&#41; a partir del cual se originar&#237;a el <span class="elsevierStyleItalic">ventilator induced lung injury</span> &#40;VILI&#41;&#44; es sin duda hablar del futuro pr&#243;ximo en la ventilaci&#243;n mec&#225;nica<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a>&#46; Sin embargo&#44; el cambio de paradigmas nunca fue f&#225;cil&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Esta tormenta de novedosos conceptos&#44; al menos para los firmantes&#44; abre una nueva ventana en nuestra pasi&#243;n por la ventilaci&#243;n mec&#225;nica&#46; Sin embargo&#44; antes de abrir nuevas puertas&#44; quiz&#225;s debamos reflexionar si ya hemos conseguido cerrar otras&#46; &#191;Est&#225; la ventilaci&#243;n mec&#225;nica protectora realmente instaurada en nuestra pr&#225;ctica diaria en el distr&#233;s respiratorio&#63;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a>&#46; Algunos se ver&#225;n sorprendidos por tal afirmaci&#243;n&#58; No&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Seremos m&#225;s &#171;provocadores&#187;&#44; la escalada en las medidas de soporte ventilatorio puede estar realiz&#225;ndose de forma arbitraria y caprichosa en ocasiones&#44; tentados por las modas tecnol&#243;gicas del momento&#46; La moda en estos momentos se llama t&#233;cnicas de oxigenaci&#243;n mediante sistemas de membranas extracorp&#243;rea &#40;ECMO&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">La ECMO salva vidas<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a>&#44; eso lo determinar&#225; el futuro&#46; Pero lo que est&#225; establecido en nuestro presente es que la ventilaci&#243;n protectora salva vidas&#44; la relajaci&#243;n muscular salva vidas o que la ventilaci&#243;n en posici&#243;n de prono salva vidas cuando hablamos de distr&#233;s&#46; Escalemos de manera razonable con las herramientas disponibles&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Hace ahora aproximadamente 15 a&#241;os&#44; los autores de un ingenioso art&#237;culo concluyeron que la eficacia de los paraca&#237;das no hab&#237;a sido sometida a evaluaci&#243;n rigurosa usando ensayos cl&#237;nicos aleatorizados y controlados&#46; Y analizaban que todo el mundo se podr&#237;a beneficiar si los m&#225;s radicales organizaran y participaran de un ensayo cl&#237;nico doble ciego&#44; aleatorizado y controlado por placebo sobre el uso de paraca&#237;das<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Quiz&#225;s es el momento&#46; Patrocinemos&#44; coordinemos el ensayo&#44; si es que este es viable y posible<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a>&#46; Busquemos entre aquellos en los que las modas tecnol&#243;gicas se apropian del uso racional de nuestras herramientas&#44; a los voluntarios del ensayo&#58; &#171;Escalonamiento racional de las medidas de soporte ventilatorio que han demostrado aumento en la supervivencia&#187; versus &#171;lo primero de todo&#44; la m&#225;quina de moda del momento&#187;&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:5 [
            0 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical implications of the rheological theory in the prevention of ventilator-induced lung injury Is mechanical power the solution&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "I&#46; Modesto"
                            1 => "V&#46; Alapont"
                            2 => "M&#46; Aguar Carrascosa"
                            3 => "A&#46; Medina Villanueva"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.medin.2018.06.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Intensiva"
                        "fecha" => "2019"
                        "volumen" => "43"
                        "paginaInicial" => "165"
                        "paginaFinal" => "175"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30409677"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology Patterns of Care&#44; and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "ESICM Trials Group"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Bellani"
                            1 => "J&#46;G&#46; Laffey"
                            2 => "T&#46; Pham"
                            3 => "E&#46; Fan"
                            4 => "L&#46; Brochard"
                            5 => "A&#46; Esteban"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2016.0291"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2016"
                        "volumen" => "315"
                        "paginaInicial" => "788"
                        "paginaFinal" => "800"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26903337"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Combes"
                            1 => "D&#46; Hajage"
                            2 => "G&#46; Capellier"
                            3 => "A&#46; Demoule"
                            4 => "S&#46; Lavou&#233;"
                            5 => "C&#46; Guervilly"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1800385"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2018"
                        "volumen" => "378"
                        "paginaInicial" => "1965"
                        "paginaFinal" => "1975"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29791822"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Parachute use to prevent death and major trauma related to gravitational challenge&#58; Systematic review of randomised controlled trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;C&#46; Smith"
                            1 => "J&#46;P&#46; Pell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "BMJV 327"
                        "fecha" => "2003"
                        "paginaInicial" => "1459"
                        "paginaFinal" => "1461"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Use of ECMO in ARDS&#58; Does the EOLIA trial really help&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Gattinoni"
                            1 => "F&#46; Vasques"
                            2 => "M&#46; Quintel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s13054-018-2098-6"
                      "Revista" => array:5 [
                        "tituloSerie" => "Critical Care"
                        "fecha" => "2018"
                        "volumen" => "22"
                        "paginaInicial" => "171"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29976250"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/02105691/0000004300000008/v1_201910220814/S0210569119300178/v1_201910220814/es/main.assets"
  "Apartado" => array:4 [
    "identificador" => "57221"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Cartas al Editor"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/02105691/0000004300000008/v1_201910220814/S0210569119300178/v1_201910220814/es/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569119300178?idApp=WMIE"
]
Compartir
Información de la revista

Estadísticas

Siga este enlace para acceder al texto completo del artículo

Carta al Editor
Ingeniería de materiales, mechanical power, ventilación protectora y una de paracaídas
Materials engineering, mechanical power, protective ventilation and a parachute
P. Escudero-Acha, A. González-Castro
Autor para correspondencia
e409@humv.es

Autor para correspondencia.
, Y. Peñasco, M. Feo-Gonzalez
Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España
Leído
5455
Veces
se ha leído el artículo
2001
Total PDF
3454
Total HTML
Compartir estadísticas
 array:25 [
  "pii" => "S0210569119300178"
  "issn" => "02105691"
  "doi" => "10.1016/j.medin.2019.01.001"
  "estado" => "S300"
  "fechaPublicacion" => "2019-11-01"
  "aid" => "1305"
  "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
  "copyrightAnyo" => "2019"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "cor"
  "cita" => "Med Intensiva. 2019;43:513"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 294
    "formatos" => array:3 [
      "EPUB" => 12
      "HTML" => 232
      "PDF" => 50
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S2173572719301456"
      "issn" => "21735727"
      "doi" => "10.1016/j.medine.2019.01.008"
      "estado" => "S300"
      "fechaPublicacion" => "2019-11-01"
      "aid" => "1305"
      "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and SEMICYUC"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "cor"
      "cita" => "Med Intensiva. 2019;43:513"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 2
        "HTML" => 2
      ]
      "en" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
        "titulo" => "Materials engineering&#44; mechanical power&#44; protective ventilation and a parachute"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:1 [
            "paginaInicial" => "513"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Ingenier&#237;a de materiales&#44; <span class="elsevierStyleItalic">mechanical power&#44;</span> ventilaci&#243;n protectora y una de paraca&#237;das"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "P&#46; Escudero-Acha, A&#46; Gonz&#225;lez-Castro, Y&#46; Pe&#241;asco, M&#46; Feo-Gonzalez"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "P&#46;"
                "apellidos" => "Escudero-Acha"
              ]
              1 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Gonz&#225;lez-Castro"
              ]
              2 => array:2 [
                "nombre" => "Y&#46;"
                "apellidos" => "Pe&#241;asco"
              ]
              3 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Feo-Gonzalez"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "es" => array:9 [
          "pii" => "S0210569119300178"
          "doi" => "10.1016/j.medin.2019.01.001"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "es"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569119300178?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719301456?idApp=WMIE"
      "url" => "/21735727/0000004300000008/v1_201910261026/S2173572719301456/v1_201910261026/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S0210569119300385"
    "issn" => "02105691"
    "doi" => "10.1016/j.medin.2019.01.007"
    "estado" => "S300"
    "fechaPublicacion" => "2019-11-01"
    "aid" => "1312"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Med Intensiva. 2019;43:514-5"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 111
      "formatos" => array:3 [
        "EPUB" => 12
        "HTML" => 60
        "PDF" => 39
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>"
      "titulo" => "Respuesta a &#171;Ingenier&#237;a de materiales&#44; <span class="elsevierStyleItalic">mechanical power&#44;</span> ventilaci&#243;n protectora y una de paraca&#237;das&#187;"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "514"
          "paginaFinal" => "515"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Reply to &#171;Materials engineering&#44; mechanical power&#44; protective ventilation and a parachute&#187;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "V&#46; Modesto i Alapont, M&#46; Aguar Carrascosa, A&#46; Medina"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "V&#46;"
              "apellidos" => "Modesto i Alapont"
            ]
            1 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Aguar Carrascosa"
            ]
            2 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Medina"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173572719301468"
        "doi" => "10.1016/j.medine.2019.01.009"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719301468?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569119300385?idApp=WMIE"
    "url" => "/02105691/0000004300000008/v1_201910220814/S0210569119300385/v1_201910220814/es/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S0210569118302778"
    "issn" => "02105691"
    "doi" => "10.1016/j.medin.2018.09.015"
    "estado" => "S300"
    "fechaPublicacion" => "2019-11-01"
    "aid" => "1282"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Med Intensiva. 2019;43:510-2"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 107
      "formatos" => array:3 [
        "EPUB" => 16
        "HTML" => 49
        "PDF" => 42
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
      "titulo" => "Lymphopenic hospital acquired sepsis &#40;L-HAS&#41;&#58; An immunological phenotype conferring higher risk of mortality"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "510"
          "paginaFinal" => "512"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Sepsis nosocomial linfop&#233;nica&#58; un fenotipo inmunol&#243;gico que confiere un mayor riesgo de mortalidad"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1386
              "Ancho" => 1583
              "Tamanyo" => 63336
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Kaplan&#8211;Meier survival curve&#46; Groups were compared by the log rank test &#40;Mantel&#8211;Henzel&#41;&#46; Circulating Lymphocyte Count &#40;CLC&#41; at HAS diagnosis were divided in two groups&#44; &#8804;775<span class="elsevierStyleHsp" style=""></span>lymphocytes&#47;mm<span class="elsevierStyleSup">3</span> and greater&#46; Time was censored at 90 days following HAS diagnosis&#46; Cum&#58; cumulative&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "C&#46; L&#243;pez-Mestanza, D&#46; Andaluz-Ojeda, J&#46;R&#46; G&#243;mez-L&#243;pez, J&#46;F&#46; Bermejo-Mart&#237;n"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "L&#243;pez-Mestanza"
            ]
            1 => array:2 [
              "nombre" => "D&#46;"
              "apellidos" => "Andaluz-Ojeda"
            ]
            2 => array:2 [
              "nombre" => "J&#46;R&#46;"
              "apellidos" => "G&#243;mez-L&#243;pez"
            ]
            3 => array:2 [
              "nombre" => "J&#46;F&#46;"
              "apellidos" => "Bermejo-Mart&#237;n"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569118302778?idApp=WMIE"
    "url" => "/02105691/0000004300000008/v1_201910220814/S0210569118302778/v1_201910220814/en/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:19 [
      "pii" => "S0210569119300385"
      "issn" => "02105691"
      "doi" => "10.1016/j.medin.2019.01.007"
      "estado" => "S300"
      "fechaPublicacion" => "2019-11-01"
      "aid" => "1312"
      "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "cor"
      "cita" => "Med Intensiva. 2019;43:514-5"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 111
        "formatos" => array:3 [
          "EPUB" => 12
          "HTML" => 60
          "PDF" => 39
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>"
        "titulo" => "Respuesta a &#171;Ingenier&#237;a de materiales&#44; <span class="elsevierStyleItalic">mechanical power&#44;</span> ventilaci&#243;n protectora y una de paraca&#237;das&#187;"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "514"
            "paginaFinal" => "515"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Reply to &#171;Materials engineering&#44; mechanical power&#44; protective ventilation and a parachute&#187;"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "V&#46; Modesto i Alapont, M&#46; Aguar Carrascosa, A&#46; Medina"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "V&#46;"
                "apellidos" => "Modesto i Alapont"
              ]
              1 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Aguar Carrascosa"
              ]
              2 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Medina"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173572719301468"
          "doi" => "10.1016/j.medine.2019.01.009"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719301468?idApp=WMIE"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569119300385?idApp=WMIE"
      "url" => "/02105691/0000004300000008/v1_201910220814/S0210569119300385/v1_201910220814/es/main.assets"
    ]
  ]
  "es" => array:12 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>"
    "titulo" => "Ingenier&#237;a de materiales&#44; <span class="elsevierStyleItalic">mechanical power&#44;</span> ventilaci&#243;n protectora y una de paraca&#237;das"
    "tieneTextoCompleto" => true
    "saludo" => "<span class="elsevierStyleItalic">Sr&#46; Editor&#58;</span>"
    "paginas" => array:1 [
      0 => array:1 [
        "paginaInicial" => "513"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "P&#46; Escudero-Acha, A&#46; Gonz&#225;lez-Castro, Y&#46; Pe&#241;asco, M&#46; Feo-Gonzalez"
        "autores" => array:4 [
          0 => array:2 [
            "nombre" => "P&#46;"
            "apellidos" => "Escudero-Acha"
          ]
          1 => array:4 [
            "nombre" => "A&#46;"
            "apellidos" => "Gonz&#225;lez-Castro"
            "email" => array:1 [
              0 => "e409@humv.es"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          2 => array:2 [
            "nombre" => "Y&#46;"
            "apellidos" => "Pe&#241;asco"
          ]
          3 => array:2 [
            "nombre" => "M&#46;"
            "apellidos" => "Feo-Gonzalez"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servicio de Medicina Intensiva&#44; Hospital Universitario Marqu&#233;s de Valdecilla&#44; Santander&#44; Cantabria&#44; Espa&#241;a"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspondencia&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Materials engineering&#44; mechanical power&#44; protective ventilation and a parachute"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Hemos le&#237;do con atenci&#243;n y&#44; reconocemos&#44; que con cierto entusiasmo el art&#237;culo de Modesto et al&#46; publicado en su revista<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Parafraseando a los autores&#58; el hecho de interpretar la existencia de un umbral de energ&#237;a &#40;<span class="elsevierStyleItalic">mechanical power</span> &#91;MP&#93;&#41; a partir del cual se originar&#237;a el <span class="elsevierStyleItalic">ventilator induced lung injury</span> &#40;VILI&#41;&#44; es sin duda hablar del futuro pr&#243;ximo en la ventilaci&#243;n mec&#225;nica<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a>&#46; Sin embargo&#44; el cambio de paradigmas nunca fue f&#225;cil&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Esta tormenta de novedosos conceptos&#44; al menos para los firmantes&#44; abre una nueva ventana en nuestra pasi&#243;n por la ventilaci&#243;n mec&#225;nica&#46; Sin embargo&#44; antes de abrir nuevas puertas&#44; quiz&#225;s debamos reflexionar si ya hemos conseguido cerrar otras&#46; &#191;Est&#225; la ventilaci&#243;n mec&#225;nica protectora realmente instaurada en nuestra pr&#225;ctica diaria en el distr&#233;s respiratorio&#63;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a>&#46; Algunos se ver&#225;n sorprendidos por tal afirmaci&#243;n&#58; No&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Seremos m&#225;s &#171;provocadores&#187;&#44; la escalada en las medidas de soporte ventilatorio puede estar realiz&#225;ndose de forma arbitraria y caprichosa en ocasiones&#44; tentados por las modas tecnol&#243;gicas del momento&#46; La moda en estos momentos se llama t&#233;cnicas de oxigenaci&#243;n mediante sistemas de membranas extracorp&#243;rea &#40;ECMO&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">La ECMO salva vidas<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a>&#44; eso lo determinar&#225; el futuro&#46; Pero lo que est&#225; establecido en nuestro presente es que la ventilaci&#243;n protectora salva vidas&#44; la relajaci&#243;n muscular salva vidas o que la ventilaci&#243;n en posici&#243;n de prono salva vidas cuando hablamos de distr&#233;s&#46; Escalemos de manera razonable con las herramientas disponibles&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Hace ahora aproximadamente 15 a&#241;os&#44; los autores de un ingenioso art&#237;culo concluyeron que la eficacia de los paraca&#237;das no hab&#237;a sido sometida a evaluaci&#243;n rigurosa usando ensayos cl&#237;nicos aleatorizados y controlados&#46; Y analizaban que todo el mundo se podr&#237;a beneficiar si los m&#225;s radicales organizaran y participaran de un ensayo cl&#237;nico doble ciego&#44; aleatorizado y controlado por placebo sobre el uso de paraca&#237;das<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Quiz&#225;s es el momento&#46; Patrocinemos&#44; coordinemos el ensayo&#44; si es que este es viable y posible<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a>&#46; Busquemos entre aquellos en los que las modas tecnol&#243;gicas se apropian del uso racional de nuestras herramientas&#44; a los voluntarios del ensayo&#58; &#171;Escalonamiento racional de las medidas de soporte ventilatorio que han demostrado aumento en la supervivencia&#187; versus &#171;lo primero de todo&#44; la m&#225;quina de moda del momento&#187;&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:5 [
            0 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical implications of the rheological theory in the prevention of ventilator-induced lung injury Is mechanical power the solution&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "I&#46; Modesto"
                            1 => "V&#46; Alapont"
                            2 => "M&#46; Aguar Carrascosa"
                            3 => "A&#46; Medina Villanueva"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.medin.2018.06.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Intensiva"
                        "fecha" => "2019"
                        "volumen" => "43"
                        "paginaInicial" => "165"
                        "paginaFinal" => "175"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30409677"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology Patterns of Care&#44; and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "ESICM Trials Group"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Bellani"
                            1 => "J&#46;G&#46; Laffey"
                            2 => "T&#46; Pham"
                            3 => "E&#46; Fan"
                            4 => "L&#46; Brochard"
                            5 => "A&#46; Esteban"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jama.2016.0291"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "2016"
                        "volumen" => "315"
                        "paginaInicial" => "788"
                        "paginaFinal" => "800"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26903337"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Combes"
                            1 => "D&#46; Hajage"
                            2 => "G&#46; Capellier"
                            3 => "A&#46; Demoule"
                            4 => "S&#46; Lavou&#233;"
                            5 => "C&#46; Guervilly"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMoa1800385"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2018"
                        "volumen" => "378"
                        "paginaInicial" => "1965"
                        "paginaFinal" => "1975"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29791822"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Parachute use to prevent death and major trauma related to gravitational challenge&#58; Systematic review of randomised controlled trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;C&#46; Smith"
                            1 => "J&#46;P&#46; Pell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "BMJV 327"
                        "fecha" => "2003"
                        "paginaInicial" => "1459"
                        "paginaFinal" => "1461"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Use of ECMO in ARDS&#58; Does the EOLIA trial really help&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Gattinoni"
                            1 => "F&#46; Vasques"
                            2 => "M&#46; Quintel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s13054-018-2098-6"
                      "Revista" => array:5 [
                        "tituloSerie" => "Critical Care"
                        "fecha" => "2018"
                        "volumen" => "22"
                        "paginaInicial" => "171"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29976250"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/02105691/0000004300000008/v1_201910220814/S0210569119300178/v1_201910220814/es/main.assets"
  "Apartado" => array:4 [
    "identificador" => "57221"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Cartas al Editor"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/02105691/0000004300000008/v1_201910220814/S0210569119300178/v1_201910220814/es/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569119300178?idApp=WMIE"
]
Información del artículo
ISSN: 02105691
Idioma original: Español
Datos actualizados diariamente
año/Mes Html Pdf Total
2024 Noviembre 9 8 17
2024 Octubre 57 49 106
2024 Septiembre 59 41 100
2024 Agosto 78 44 122
2024 Julio 85 25 110
2024 Junio 80 67 147
2024 Mayo 50 26 76
2024 Abril 69 39 108
2024 Marzo 82 32 114
2024 Febrero 56 29 85
2024 Enero 77 17 94
2023 Diciembre 92 36 128
2023 Noviembre 87 37 124
2023 Octubre 65 23 88
2023 Septiembre 55 34 89
2023 Agosto 34 14 48
2023 Julio 35 24 59
2023 Junio 33 25 58
2023 Mayo 41 39 80
2023 Abril 38 18 56
2023 Marzo 56 47 103
2023 Febrero 45 36 81
2023 Enero 31 23 54
2022 Diciembre 70 41 111
2022 Noviembre 60 48 108
2022 Octubre 74 41 115
2022 Septiembre 57 41 98
2022 Agosto 50 43 93
2022 Julio 50 35 85
2022 Junio 33 23 56
2022 Mayo 45 47 92
2022 Abril 44 40 84
2022 Marzo 55 40 95
2022 Febrero 54 37 91
2022 Enero 68 37 105
2021 Diciembre 61 46 107
2021 Noviembre 50 36 86
2021 Octubre 80 84 164
2021 Septiembre 51 56 107
2021 Agosto 64 48 112
2021 Julio 44 39 83
2021 Junio 47 34 81
2021 Mayo 71 78 149
2021 Abril 134 83 217
2021 Marzo 91 33 124
2021 Febrero 83 30 113
2021 Enero 68 27 95
2020 Diciembre 65 26 91
2020 Noviembre 59 22 81
2020 Octubre 27 11 38
2020 Septiembre 0 0 0
2020 Julio 36 12 48
2020 Junio 49 19 68
2020 Mayo 57 14 71
2020 Abril 57 22 79
2020 Marzo 31 18 49
2020 Febrero 35 17 52
2020 Enero 5 0 5
2019 Diciembre 149 6 155
2019 Noviembre 39 12 51
2019 Octubre 7 6 13
2019 Septiembre 1 2 3
2019 Julio 0 0 0
2019 Junio 2 0 2
2019 Mayo 2 0 2
2019 Abril 2 5 7
2019 Marzo 10 9 19
2019 Febrero 3 0 3
Mostrar todo

Siga este enlace para acceder al texto completo del artículo

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?