array:23 [
  "pii" => "S0210569120302643"
  "issn" => "02105691"
  "doi" => "10.1016/j.medin.2020.07.010"
  "estado" => "S300"
  "fechaPublicacion" => "2021-12-01"
  "aid" => "1570"
  "copyright" => "Elsevier España, S.L.U. y SEMICYUC"
  "copyrightAnyo" => "2020"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Med Intensiva. 2021;45:e53-e55"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S021056912030276X"
    "issn" => "02105691"
    "doi" => "10.1016/j.medin.2020.08.011"
    "estado" => "S300"
    "fechaPublicacion" => "2021-12-01"
    "aid" => "1582"
    "copyright" => "Elsevier España, S.L.U. y SEMICYUC"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Med Intensiva. 2021;45:e56-e58"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">CARTA CIENT&#205;FICA</span>"
      "titulo" => "Eficacia de la ventilaci&#243;n no invasiva en pacientes ingresados por neumon&#237;a por SARS-CoV-2 en una unidad de cuidados intensivos"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "e56"
          "paginaFinal" => "e58"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Effectiveness of non-invasive ventilation in intensive care unit admitted patients due to SARS-CoV-2 pneumonia"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "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" => 1742
              "Ancho" => 2167
              "Tamanyo" => 112271
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Evoluci&#243;n cociente SatcO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span> entre VNI &#40;n &#61; 15 pacientes&#41; y VMI &#40;n &#61; 4 pacientes&#41; durante primeras horas de ventilaci&#243;n</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">&#42; p &#60; 0&#44;002 SatcO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span> inicio ventilaci&#243;n vs&#46; 24 horas ventilaci&#243;n&#46;</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">SatcO<span class="elsevierStyleInf">2</span>&#44; saturaci&#243;n transcut&#225;nea de ox&#237;geno&#59; FiO<span class="elsevierStyleInf">2</span>&#44; fracci&#243;n inspiratoria de ox&#237;geno&#59; VNI&#44; ventilaci&#243;n no invasiva&#59; VMI&#44; ventilaci&#243;n mec&#225;nica invasiva&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "A&#46; Belenguer Muncharaz, H&#46; Hern&#225;ndez-Garc&#233;s, C&#46; L&#243;pez-Chicote, S&#46; Ribes-Garc&#237;a, J&#46; Ochagav&#237;a-Barbar&#237;n, R&#46; Zaragoza-Crespo"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Belenguer Muncharaz"
            ]
            1 => array:2 [
              "nombre" => "H&#46;"
              "apellidos" => "Hern&#225;ndez-Garc&#233;s"
            ]
            2 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "L&#243;pez-Chicote"
            ]
            3 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "Ribes-Garc&#237;a"
            ]
            4 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Ochagav&#237;a-Barbar&#237;n"
            ]
            5 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Zaragoza-Crespo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173572721001429"
        "doi" => "10.1016/j.medine.2021.10.008"
        "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/S2173572721001429?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021056912030276X?idApp=WMIE"
    "url" => "/02105691/0000004500000009/v1_202111260648/S021056912030276X/v1_202111260648/es/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0210569120302679"
    "issn" => "02105691"
    "doi" => "10.1016/j.medin.2020.08.005"
    "estado" => "S300"
    "fechaPublicacion" => "2021-12-01"
    "aid" => "1573"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Med Intensiva. 2021;45:e50-e52"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">CARTA CIENT&#205;FICA</span>"
      "titulo" => "Alerta tard&#237;a a los sistemas de respuesta r&#225;pida&#58; propuesta de un nuevo indicador de calidad"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "e50"
          "paginaFinal" => "e52"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Delayed alert to rapid response systems&#58; proposal of a new quality indicator"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "S&#46; Casta&#241;o &#193;vila, F&#46; Fonseca San Miguel, J&#46;A&#46; Urturi Matos, M&#46; Iturbe Rementer&#237;a, C&#46; P&#233;rez Lejonagoitia, S&#46; Iribarren Diarasarri"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "Casta&#241;o &#193;vila"
            ]
            1 => array:2 [
              "nombre" => "F&#46;"
              "apellidos" => "Fonseca San Miguel"
            ]
            2 => array:2 [
              "nombre" => "J&#46;A&#46;"
              "apellidos" => "Urturi Matos"
            ]
            3 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Iturbe Rementer&#237;a"
            ]
            4 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "P&#233;rez Lejonagoitia"
            ]
            5 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "Iribarren Diarasarri"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173572721001375"
        "doi" => "10.1016/j.medine.2021.10.003"
        "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/S2173572721001375?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569120302679?idApp=WMIE"
    "url" => "/02105691/0000004500000009/v1_202111260648/S0210569120302679/v1_202111260648/es/main.assets"
  ]
  "en" => array:15 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
    "titulo" => "Assessment of the effect of respiratory physiotherapy techniques on end-expiratory lung volume through electrical impedance tomography in healthy subjects"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#44;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "e53"
        "paginaFinal" => "e55"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "D&#46; Gilgado, E&#46; P&#233;rez Calvo, J&#46; P&#233;rez, J&#46; Dorado, G&#46; Cardoso, C&#46; Quiroga, J&#46; Scapellato, G&#46; Plotnikow, M&#46; Accoce"
        "autores" => array:9 [
          0 => array:4 [
            "nombre" => "D&#46;"
            "apellidos" => "Gilgado"
            "email" => array:1 [
              0 => "daniela.gilgado@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" => "E&#46;"
            "apellidos" => "P&#233;rez Calvo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "P&#233;rez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Dorado"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "G&#46;"
            "apellidos" => "Cardoso"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "C&#46;"
            "apellidos" => "Quiroga"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Scapellato"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "G&#46;"
            "apellidos" => "Plotnikow"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          8 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Accoce"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Intensive Care Unit&#44; Sanatorio Anchorena San Mart&#237;n&#44; Buenos Aires&#44; Argentina"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Rehabilitation and Weaning Center&#44; Cl&#237;nica Basilea&#44; CABA&#44; Argentina"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Intensive Care Unit&#44; Sanatorio Anchorena Recoleta&#44; CABA&#44; Argentina"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Evaluaci&#243;n del efecto de las t&#233;cnicas de fisioterapia respiratoria en el volumen pulmonar de fin de espiraci&#243;n a trav&#233;s de tomograf&#237;a por impedancia el&#233;ctrica en sujetos sanos"
      ]
    ]
    "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" => 1578
            "Ancho" => 2083
            "Tamanyo" => 79517
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Regional change in end-expiratory lung impedance &#40;&#916;EELI&#41; with the different techniques&#44; expressed in units&#44; as compared to the basal value&#46; The values are expressed in mean and confidence interval of 95&#37;&#46; IPP&#58; Intermittent positive pressure&#58; 3 insufflations with a manual resuscitation bag and an oronasal interface&#44; followed by a 3-s inspiratory hold and a gentle 3-s exhalation&#46; IPPP-PEEP&#58; Intermittent positive pressure with PEEP valve&#58; same way as IPP&#44; but a PEEP valve &#40;10 cmH<span class="elsevierStyleInf">2</span>O&#41; was connected to the manual resuscitation bag&#46; PEP&#58; Positive expiratory pressure&#58; deep inhalation until total lung capacity &#40;TLC&#41;&#44; followed by a 3-s inspiratory hold and then a slow 3-s exhalation through a 100<span class="elsevierStyleHsp" style=""></span>cm plastic tube &#40;inner diameter 8&#46;8<span class="elsevierStyleHsp" style=""></span>cm&#41; connected to a bulau bottle with a 10-cm water column&#46; IS&#58; Incentive spirometry&#58; Slow and deep inhalation until reaching TLC&#46; Then&#44; a 3-s hold and a gentle 3-s exhalation&#46; The 3 ball incentive spirometer &#40;MSC&#44; <span class="elsevierStyleItalic">Maximal Satisfaction Commitment</span>&#41; provided a visual feedback&#46; DB&#58; Deep breathing&#58; 3 deep inhalation&#44; without breathing out between each of them&#44; until TLC&#44; followed by a 3-s inspiratory hold and then a gentle 3-s exhalation&#46; &#42; P &#8804; 0&#46;05 compared to the basal value&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Respiratory physiotherapy &#40;RP&#41; incorporates techniques to promote lung re-expansion and facilitate secretion clearance&#46; Different studies<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1&#8211;3</span></a> have assessed their effectiveness using as outcome variables the development of postoperative pulmonary complications &#40;PPC&#41;&#44; with contradictory findings&#46; Moreover&#44; the physiological effects produced by RP&#44; especially the changes in ventilation&#44; have been poorly studied&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4&#8211;6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The electrical impedance tomography &#40;EIT&#41; has been previously used to evaluate RP in different samples and using variable protocols which makes it difficult to extrapolate their results&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4&#8211;7</span></a> Besides&#44; their impact on the end expiratory lung volume &#40;EELV&#41; has not been compared among each other in one single study&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">To describe the effects on global and regional end-expiratory lung volume produced by five RP techniques&#44; we conducted an observational&#44; analytical&#44; cross-sectional&#44; and prospective study between April and May 2019&#46; The protocol was previously approved by the Private Hospital&#39;s Education and Research Committee&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">There were included 15 healthy respiratory therapists &#40;8 women and 7 men&#41;&#44; with no history of lung diseases or smoking&#44; with a mean age of 31&#46;6 &#40;&#177; 4&#46;2&#41; years&#44; a height of 1&#46;67 &#40;&#177; 7&#46;2&#41; m&#44; a weight of 65&#46;8 &#40;&#177; 6&#46;2&#41; kg and a BMI of 23&#46;2 &#40;&#177; 9&#46;2&#41; kg&#47;m<span class="elsevierStyleSup">2</span>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The following RP techniques were carried out&#58; Deep breathing &#40;DB&#41;&#44; Positive expiratory pressure &#40;PEP&#41;&#44; Intermittent positive pressure without PEEP valve &#40;IPP&#41;&#44; Intermittent positive pressure with PEEP valve &#40;IPPP&#41; and Incentive spirometry &#40;IS&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">To obtain the measurements an EIT &#40;PulmoVista500&#59; Drager&#44; Lubeck&#44; Germany&#41; was used together with a 16-electrode belt&#46; To analyze the results we considered the sum of regions of interest &#40;ROI&#41; 1<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>2 &#40;anterior right and left&#41; and 3<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>4 &#40;posterior right and left&#41;&#44; determining the ventral and dorsal areas&#44; respectively&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Each measurement was taken with the subject sitting at a 90-degree position&#46; The study procedure began with a 5-min ventilation period at normal volume or until obtaining a stable value&#44; which was regarded as the reference basal value&#46; Afterwards&#44; the techniques were carried out following an order that was randomly assigned&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The subjects repeated each technique 5 times followed by a 2-min rest period or until the reference values were reached&#46; This sequence was repeated 3 times for each maneuver&#46; Finally&#44; the participants were asked to order the techniques according to the level of comfort when carrying them out&#44; from the most comfortable to the least one&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The primary variable was the global and regional change in end-expiratory lung impedance &#40;&#916;EELI&#41; at the end of each technique and the secondary variable consisted of the global and regional &#916;EELI one minute after the completion of each technique&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The sample size was determined&#44; based on previous studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4&#8211;7</span></a> Continuous data were expressed as mean SD or as median and interquartile range&#46; Categorical data were expressed as absolute values and&#47;or percentages&#46; An analysis of variance for repeated measurements and a Tukey Test with Bonferroni correction were performed&#46; A value of <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 was considered significant&#46; For the statistical analysis the SPSS 25&#46;0 software was used&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">All of the assessed RP techniques resulted in an increase in end-expiratory lung impedance in relation to the basal value &#40;primary variable&#41;&#59; however&#44; the mean of the global &#916;EELI reached statistical significance only in the following&#58; PEP &#40;3&#46;74<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;36&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; IPPP &#40;2&#46;80<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;51&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and IPP &#40;1&#46;27<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;13&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; When comparing the global &#916;EELI produced by these 3 techniques&#44; a difference was found when contrasting PEP and IPPP with IPP &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">One minute after the completion of each exercise no significant changes were recorded in the global &#916;EELI when compared to the basal value &#40;Secondary variable&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; Furthermore&#44; when comparing the means of the &#916;EELI between regions &#40;ventral and dorsal&#41; a greater change was observed in ventral areas in all techniques&#44; except PEP where the &#916;EELI was similar in both areas &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; PEP technique was selected as the least comfortable followed by the IPPP and IS&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">This study provides important data that help better understand the impact of respiratory physiotherapy techniques and support the rationale for their implementation&#46; PEP&#44; IPPP and IPP produce an increase in global end-expiratory lung impedance&#44; therefore they could be appropriate techniques to reverse the pulmonary consequences of thoracico-abdominal surgeries&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The finding that PEP and IPPP techniques were the ones that produced more change could be related to the fact that both include a resistance during the expiratory phase&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">As previous studies&#44; the use of PEP revealed a uniform distribution in ventral and dorsal areas&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4&#44;5&#44;9</span></a> This finding could be explained by an increase in the redistribution of air through collateral ventilation due to the greater resistance during the expiratory phase&#46; It is probable that the tube used for its construction could have added an additional resistance&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">As reported by other authors<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4&#44;7</span></a> the global &#916;EELI produced returned to basal values one minute after the conclusion&#46; We consider this an expected behavior because the participants were healthy subjects&#46; However&#44; in posoperative patients&#44; the increase in lung volume could be of significance to recruit collapsed alveolar units&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">To our knowledge&#44; this is the first study to comparatively assess the physiological behavior of the mostly used RP techniques in relation to EELV increase&#46; All the participants were physical therapists&#44; trained in the techniques which eliminate possible confounding factors such as the learning effect or the limitations deriving from each pathology&#46; Future research should assess their impact on patients undergoing postoperative period of thoracoabdominal surgeries&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">In conclusion&#44; in healthy subjects the techniques PEP&#44; IPP and IPPP generated an increase in end-expiratory lung volume evaluated through EIT&#46; Unlike the other assessed respiratory physiotherapy exercises&#44; the PEP technique achieved a homogeneous lung volume distribution similar to the basal one&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Authors&#8217; contribution</span><p id="par0095" class="elsevierStylePara elsevierViewall">Each of the authors collaborated equally in the process &#40;literature search&#44; data collection&#44; study design&#44; analysis of data&#44; manuscript preparation and review of manuscript&#41;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of interest</span><p id="par0100" class="elsevierStylePara elsevierViewall">The authors declare that there are no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:3 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Authors&#8217; contribution"
        ]
        1 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Conflicts of interest"
        ]
        2 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "multimedia" => array:2 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1578
            "Ancho" => 2083
            "Tamanyo" => 79517
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Regional change in end-expiratory lung impedance &#40;&#916;EELI&#41; with the different techniques&#44; expressed in units&#44; as compared to the basal value&#46; The values are expressed in mean and confidence interval of 95&#37;&#46; IPP&#58; Intermittent positive pressure&#58; 3 insufflations with a manual resuscitation bag and an oronasal interface&#44; followed by a 3-s inspiratory hold and a gentle 3-s exhalation&#46; IPPP-PEEP&#58; Intermittent positive pressure with PEEP valve&#58; same way as IPP&#44; but a PEEP valve &#40;10 cmH<span class="elsevierStyleInf">2</span>O&#41; was connected to the manual resuscitation bag&#46; PEP&#58; Positive expiratory pressure&#58; deep inhalation until total lung capacity &#40;TLC&#41;&#44; followed by a 3-s inspiratory hold and then a slow 3-s exhalation through a 100<span class="elsevierStyleHsp" style=""></span>cm plastic tube &#40;inner diameter 8&#46;8<span class="elsevierStyleHsp" style=""></span>cm&#41; connected to a bulau bottle with a 10-cm water column&#46; IS&#58; Incentive spirometry&#58; Slow and deep inhalation until reaching TLC&#46; Then&#44; a 3-s hold and a gentle 3-s exhalation&#46; The 3 ball incentive spirometer &#40;MSC&#44; <span class="elsevierStyleItalic">Maximal Satisfaction Commitment</span>&#41; provided a visual feedback&#46; DB&#58; Deep breathing&#58; 3 deep inhalation&#44; without breathing out between each of them&#44; until TLC&#44; followed by a 3-s inspiratory hold and then a gentle 3-s exhalation&#46; &#42; P &#8804; 0&#46;05 compared to the basal value&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1342
            "Ancho" => 2072
            "Tamanyo" => 108415
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Regional change in end-expiratory lung impedance &#40;&#916;EELI&#41; with the different techniques&#44; expressed in units&#44; as compared to the basal value&#46; The values are expressed in mean and confidence interval of 95&#37;&#46; IPP&#58; Intermittent positive pressure&#44; IPPP&#58; Intermittent positive pressure with PEEP valve&#44; PEP&#58; Positive expiratory pressure&#44; IS&#58; Incentive spirometry&#44; DB&#58; Deep breathing&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Respiratory physiotherapy to prevent pulmonary complications after abdominal surgery&#58; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46; Pasquina"
                            1 => "M&#46;R&#46; Tram&#232;r"
                            2 => "J&#46;-M&#46; Granier"
                            3 => "B&#46; Walder"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.130.6.1887"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2006"
                        "volumen" => "130"
                        "paginaInicial" => "1887"
                        "paginaFinal" => "1899"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17167013"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incentive spirometry for prevention of postoperative pulmonary complications in upper abdominal surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46; Do Nascimento Junior"
                            1 => "N&#46;S&#46; M&#243;dolo"
                            2 => "S&#46; Andrade"
                            3 => "M&#46;M&#46; Guimar&#227;es"
                            4 => "L&#46;G&#46; Braz"
                            5 => "R&#46; El Dib"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/14651858.CD006058.pub3"
                      "Revista" => array:4 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2014"
                        "volumen" => "2"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26884379"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Chest physiotherapy in lung resec-tion patients&#58; state of the art"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46; Varela"
                            1 => "N&#46;M&#46; Novoa"
                            2 => "P&#46; Agostini"
                            3 => "E&#46; Ballesteros"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/j.semtcvs.2011.11.001"
                      "Revista" => array:5 [
                        "tituloSerie" => "Sem Thor Cardiovasc Surg"
                        "fecha" => "2012"
                        "volumen" => "23"
                        "paginaInicial" => "297"
                        "paginaFinal" => "306"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incentive spirometry and positive expiratory pressure improve ventilation and recruitment in postoperative recovery&#58; a randomized crossover study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Reychler"
                            1 => "V&#46; Uribe Rodriguez"
                            2 => "C&#46;E&#46; Hickmann"
                            3 => "B&#46; Tombal"
                            4 => "P&#46;F&#46; Laterre"
                            5 => "A&#46; Feyaerts"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/09593985.2018.1443185"
                      "Revista" => array:6 [
                        "tituloSerie" => "Physiother Theory Pract"
                        "fecha" => "2018"
                        "volumen" => "27"
                        "paginaInicial" => "1"
                        "paginaFinal" => "7"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21198401"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of different breathing aids on ventilation distribution in adults with cystic fibrosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Wettstein"
                            1 => "L&#46; Radlinger"
                            2 => "T&#46; Riedel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0106591"
                      "Revista" => array:4 [
                        "tituloSerie" => "PLOS ONE"
                        "fecha" => "2014"
                        "volumen" => "9"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25551375"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The short-term effects of intermittent positive pressure breathing treatments on ventilation in patients with neuromuscular disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46; Gu&#233;rin"
                            1 => "B&#46; Vincent"
                            2 => "T&#46; Petitjean"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Care"
                        "fecha" => "2010"
                        "volumen" => "55"
                        "paginaInicial" => "866"
                        "paginaFinal" => "872"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20587098"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Immediate effect of lung expansion techniques in neurosurgery patients detected by electrical impedance tomography&#58; a randomized crossover study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;C&#46;A&#46; Morais"
                            1 => "C&#46; Rattes"
                            2 => "M&#46; Bandeira"
                            3 => "L&#46; Monte"
                            4 => "S&#46;L&#46; Campos"
                            5 => "D&#46; Brand&#227;o"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/2197-425X-3-S1-A991"
                      "Revista" => array:3 [
                        "tituloSerie" => "Intensive Care Med Exp"
                        "fecha" => "2015"
                        "paginaInicial" => "A991"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Current devices of respiratory physiotherapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Hristara-Papadopoulou"
                            1 => "J&#46; Tsanakas"
                            2 => "G&#46; Diomou"
                            3 => "O&#46; Papadopoulou"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Hippokratia"
                        "fecha" => "2008"
                        "volumen" => "12"
                        "paginaInicial" => "211"
                        "paginaFinal" => "220"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19158964"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of end-expiratory level and tidal volume on gravitational ventilation distribution during tidal breathing in healthy adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Schnidrig"
                            1 => "C&#46; Casaulta"
                            2 => "A&#46; Schibler"
                            3 => "T&#46; Riedel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00421-012-2469-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Appl Physiol"
                        "fecha" => "2013"
                        "volumen" => "113"
                        "paginaInicial" => "591"
                        "paginaFinal" => "598"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22872368"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Optimum design parameters for a therapist-constructed positive-expiratory-pressure therapy bottle device"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46;G&#46; Mestriner"
                            1 => "R&#46;O&#46; Fernandes"
                            2 => "L&#46;C&#46; Steffen"
                            3 => "M&#46;V&#46;F&#46; Donadio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Care"
                        "fecha" => "2009"
                        "volumen" => "54"
                        "paginaInicial" => "504"
                        "paginaFinal" => "508"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19327187"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/02105691/0000004500000009/v1_202111260648/S0210569120302643/v1_202111260648/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "53"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Cartas cient&#237;ficas"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/02105691/0000004500000009/v1_202111260648/S0210569120302643/v1_202111260648/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569120302643?idApp=WMIE"
]
Compartir
Información de la revista

Estadísticas

Siga este enlace para acceder al texto completo del artículo

Scientific Letter
Assessment of the effect of respiratory physiotherapy techniques on end-expiratory lung volume through electrical impedance tomography in healthy subjects
Evaluación del efecto de las técnicas de fisioterapia respiratoria en el volumen pulmonar de fin de espiración a través de tomografía por impedancia eléctrica en sujetos sanos
D. Gilgadoa,
Autor para correspondencia
daniela.gilgado@gmail.com

Corresponding author.
, E. Pérez Calvob, J. Péreza, J. Doradoa, G. Cardosoa, C. Quirogac, J. Scapellatoc, G. Plotnikowc, M. Accocea
a Intensive Care Unit, Sanatorio Anchorena San Martín, Buenos Aires, Argentina
b Rehabilitation and Weaning Center, Clínica Basilea, CABA, Argentina
c Intensive Care Unit, Sanatorio Anchorena Recoleta, CABA, Argentina
Leído
2925
Veces
se ha leído el artículo
1348
Total PDF
1577
Total HTML
Compartir estadísticas
 array:23 [
  "pii" => "S0210569120302643"
  "issn" => "02105691"
  "doi" => "10.1016/j.medin.2020.07.010"
  "estado" => "S300"
  "fechaPublicacion" => "2021-12-01"
  "aid" => "1570"
  "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
  "copyrightAnyo" => "2020"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Med Intensiva. 2021;45:e53-e55"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S021056912030276X"
    "issn" => "02105691"
    "doi" => "10.1016/j.medin.2020.08.011"
    "estado" => "S300"
    "fechaPublicacion" => "2021-12-01"
    "aid" => "1582"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Med Intensiva. 2021;45:e56-e58"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">CARTA CIENT&#205;FICA</span>"
      "titulo" => "Eficacia de la ventilaci&#243;n no invasiva en pacientes ingresados por neumon&#237;a por SARS-CoV-2 en una unidad de cuidados intensivos"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "e56"
          "paginaFinal" => "e58"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Effectiveness of non-invasive ventilation in intensive care unit admitted patients due to SARS-CoV-2 pneumonia"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "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" => 1742
              "Ancho" => 2167
              "Tamanyo" => 112271
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Evoluci&#243;n cociente SatcO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span> entre VNI &#40;n &#61; 15 pacientes&#41; y VMI &#40;n &#61; 4 pacientes&#41; durante primeras horas de ventilaci&#243;n</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">&#42; p &#60; 0&#44;002 SatcO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span> inicio ventilaci&#243;n vs&#46; 24 horas ventilaci&#243;n&#46;</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">SatcO<span class="elsevierStyleInf">2</span>&#44; saturaci&#243;n transcut&#225;nea de ox&#237;geno&#59; FiO<span class="elsevierStyleInf">2</span>&#44; fracci&#243;n inspiratoria de ox&#237;geno&#59; VNI&#44; ventilaci&#243;n no invasiva&#59; VMI&#44; ventilaci&#243;n mec&#225;nica invasiva&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "A&#46; Belenguer Muncharaz, H&#46; Hern&#225;ndez-Garc&#233;s, C&#46; L&#243;pez-Chicote, S&#46; Ribes-Garc&#237;a, J&#46; Ochagav&#237;a-Barbar&#237;n, R&#46; Zaragoza-Crespo"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Belenguer Muncharaz"
            ]
            1 => array:2 [
              "nombre" => "H&#46;"
              "apellidos" => "Hern&#225;ndez-Garc&#233;s"
            ]
            2 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "L&#243;pez-Chicote"
            ]
            3 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "Ribes-Garc&#237;a"
            ]
            4 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Ochagav&#237;a-Barbar&#237;n"
            ]
            5 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Zaragoza-Crespo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173572721001429"
        "doi" => "10.1016/j.medine.2021.10.008"
        "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/S2173572721001429?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021056912030276X?idApp=WMIE"
    "url" => "/02105691/0000004500000009/v1_202111260648/S021056912030276X/v1_202111260648/es/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S0210569120302679"
    "issn" => "02105691"
    "doi" => "10.1016/j.medin.2020.08.005"
    "estado" => "S300"
    "fechaPublicacion" => "2021-12-01"
    "aid" => "1573"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; y SEMICYUC"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Med Intensiva. 2021;45:e50-e52"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">CARTA CIENT&#205;FICA</span>"
      "titulo" => "Alerta tard&#237;a a los sistemas de respuesta r&#225;pida&#58; propuesta de un nuevo indicador de calidad"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "e50"
          "paginaFinal" => "e52"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Delayed alert to rapid response systems&#58; proposal of a new quality indicator"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "S&#46; Casta&#241;o &#193;vila, F&#46; Fonseca San Miguel, J&#46;A&#46; Urturi Matos, M&#46; Iturbe Rementer&#237;a, C&#46; P&#233;rez Lejonagoitia, S&#46; Iribarren Diarasarri"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "Casta&#241;o &#193;vila"
            ]
            1 => array:2 [
              "nombre" => "F&#46;"
              "apellidos" => "Fonseca San Miguel"
            ]
            2 => array:2 [
              "nombre" => "J&#46;A&#46;"
              "apellidos" => "Urturi Matos"
            ]
            3 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Iturbe Rementer&#237;a"
            ]
            4 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "P&#233;rez Lejonagoitia"
            ]
            5 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "Iribarren Diarasarri"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S2173572721001375"
        "doi" => "10.1016/j.medine.2021.10.003"
        "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/S2173572721001375?idApp=WMIE"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569120302679?idApp=WMIE"
    "url" => "/02105691/0000004500000009/v1_202111260648/S0210569120302679/v1_202111260648/es/main.assets"
  ]
  "en" => array:15 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
    "titulo" => "Assessment of the effect of respiratory physiotherapy techniques on end-expiratory lung volume through electrical impedance tomography in healthy subjects"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#44;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "e53"
        "paginaFinal" => "e55"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "D&#46; Gilgado, E&#46; P&#233;rez Calvo, J&#46; P&#233;rez, J&#46; Dorado, G&#46; Cardoso, C&#46; Quiroga, J&#46; Scapellato, G&#46; Plotnikow, M&#46; Accoce"
        "autores" => array:9 [
          0 => array:4 [
            "nombre" => "D&#46;"
            "apellidos" => "Gilgado"
            "email" => array:1 [
              0 => "daniela.gilgado@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" => "E&#46;"
            "apellidos" => "P&#233;rez Calvo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "P&#233;rez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Dorado"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "G&#46;"
            "apellidos" => "Cardoso"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "C&#46;"
            "apellidos" => "Quiroga"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Scapellato"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "G&#46;"
            "apellidos" => "Plotnikow"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          8 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Accoce"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Intensive Care Unit&#44; Sanatorio Anchorena San Mart&#237;n&#44; Buenos Aires&#44; Argentina"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Rehabilitation and Weaning Center&#44; Cl&#237;nica Basilea&#44; CABA&#44; Argentina"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Intensive Care Unit&#44; Sanatorio Anchorena Recoleta&#44; CABA&#44; Argentina"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Evaluaci&#243;n del efecto de las t&#233;cnicas de fisioterapia respiratoria en el volumen pulmonar de fin de espiraci&#243;n a trav&#233;s de tomograf&#237;a por impedancia el&#233;ctrica en sujetos sanos"
      ]
    ]
    "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" => 1578
            "Ancho" => 2083
            "Tamanyo" => 79517
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Regional change in end-expiratory lung impedance &#40;&#916;EELI&#41; with the different techniques&#44; expressed in units&#44; as compared to the basal value&#46; The values are expressed in mean and confidence interval of 95&#37;&#46; IPP&#58; Intermittent positive pressure&#58; 3 insufflations with a manual resuscitation bag and an oronasal interface&#44; followed by a 3-s inspiratory hold and a gentle 3-s exhalation&#46; IPPP-PEEP&#58; Intermittent positive pressure with PEEP valve&#58; same way as IPP&#44; but a PEEP valve &#40;10 cmH<span class="elsevierStyleInf">2</span>O&#41; was connected to the manual resuscitation bag&#46; PEP&#58; Positive expiratory pressure&#58; deep inhalation until total lung capacity &#40;TLC&#41;&#44; followed by a 3-s inspiratory hold and then a slow 3-s exhalation through a 100<span class="elsevierStyleHsp" style=""></span>cm plastic tube &#40;inner diameter 8&#46;8<span class="elsevierStyleHsp" style=""></span>cm&#41; connected to a bulau bottle with a 10-cm water column&#46; IS&#58; Incentive spirometry&#58; Slow and deep inhalation until reaching TLC&#46; Then&#44; a 3-s hold and a gentle 3-s exhalation&#46; The 3 ball incentive spirometer &#40;MSC&#44; <span class="elsevierStyleItalic">Maximal Satisfaction Commitment</span>&#41; provided a visual feedback&#46; DB&#58; Deep breathing&#58; 3 deep inhalation&#44; without breathing out between each of them&#44; until TLC&#44; followed by a 3-s inspiratory hold and then a gentle 3-s exhalation&#46; &#42; P &#8804; 0&#46;05 compared to the basal value&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Respiratory physiotherapy &#40;RP&#41; incorporates techniques to promote lung re-expansion and facilitate secretion clearance&#46; Different studies<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1&#8211;3</span></a> have assessed their effectiveness using as outcome variables the development of postoperative pulmonary complications &#40;PPC&#41;&#44; with contradictory findings&#46; Moreover&#44; the physiological effects produced by RP&#44; especially the changes in ventilation&#44; have been poorly studied&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4&#8211;6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The electrical impedance tomography &#40;EIT&#41; has been previously used to evaluate RP in different samples and using variable protocols which makes it difficult to extrapolate their results&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4&#8211;7</span></a> Besides&#44; their impact on the end expiratory lung volume &#40;EELV&#41; has not been compared among each other in one single study&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">To describe the effects on global and regional end-expiratory lung volume produced by five RP techniques&#44; we conducted an observational&#44; analytical&#44; cross-sectional&#44; and prospective study between April and May 2019&#46; The protocol was previously approved by the Private Hospital&#39;s Education and Research Committee&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">There were included 15 healthy respiratory therapists &#40;8 women and 7 men&#41;&#44; with no history of lung diseases or smoking&#44; with a mean age of 31&#46;6 &#40;&#177; 4&#46;2&#41; years&#44; a height of 1&#46;67 &#40;&#177; 7&#46;2&#41; m&#44; a weight of 65&#46;8 &#40;&#177; 6&#46;2&#41; kg and a BMI of 23&#46;2 &#40;&#177; 9&#46;2&#41; kg&#47;m<span class="elsevierStyleSup">2</span>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The following RP techniques were carried out&#58; Deep breathing &#40;DB&#41;&#44; Positive expiratory pressure &#40;PEP&#41;&#44; Intermittent positive pressure without PEEP valve &#40;IPP&#41;&#44; Intermittent positive pressure with PEEP valve &#40;IPPP&#41; and Incentive spirometry &#40;IS&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">To obtain the measurements an EIT &#40;PulmoVista500&#59; Drager&#44; Lubeck&#44; Germany&#41; was used together with a 16-electrode belt&#46; To analyze the results we considered the sum of regions of interest &#40;ROI&#41; 1<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>2 &#40;anterior right and left&#41; and 3<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>4 &#40;posterior right and left&#41;&#44; determining the ventral and dorsal areas&#44; respectively&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Each measurement was taken with the subject sitting at a 90-degree position&#46; The study procedure began with a 5-min ventilation period at normal volume or until obtaining a stable value&#44; which was regarded as the reference basal value&#46; Afterwards&#44; the techniques were carried out following an order that was randomly assigned&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The subjects repeated each technique 5 times followed by a 2-min rest period or until the reference values were reached&#46; This sequence was repeated 3 times for each maneuver&#46; Finally&#44; the participants were asked to order the techniques according to the level of comfort when carrying them out&#44; from the most comfortable to the least one&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The primary variable was the global and regional change in end-expiratory lung impedance &#40;&#916;EELI&#41; at the end of each technique and the secondary variable consisted of the global and regional &#916;EELI one minute after the completion of each technique&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The sample size was determined&#44; based on previous studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4&#8211;7</span></a> Continuous data were expressed as mean SD or as median and interquartile range&#46; Categorical data were expressed as absolute values and&#47;or percentages&#46; An analysis of variance for repeated measurements and a Tukey Test with Bonferroni correction were performed&#46; A value of <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 was considered significant&#46; For the statistical analysis the SPSS 25&#46;0 software was used&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">All of the assessed RP techniques resulted in an increase in end-expiratory lung impedance in relation to the basal value &#40;primary variable&#41;&#59; however&#44; the mean of the global &#916;EELI reached statistical significance only in the following&#58; PEP &#40;3&#46;74<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;36&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; IPPP &#40;2&#46;80<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#46;51&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; and IPP &#40;1&#46;27<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;13&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; When comparing the global &#916;EELI produced by these 3 techniques&#44; a difference was found when contrasting PEP and IPPP with IPP &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">One minute after the completion of each exercise no significant changes were recorded in the global &#916;EELI when compared to the basal value &#40;Secondary variable&#41; &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; Furthermore&#44; when comparing the means of the &#916;EELI between regions &#40;ventral and dorsal&#41; a greater change was observed in ventral areas in all techniques&#44; except PEP where the &#916;EELI was similar in both areas &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; PEP technique was selected as the least comfortable followed by the IPPP and IS&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">This study provides important data that help better understand the impact of respiratory physiotherapy techniques and support the rationale for their implementation&#46; PEP&#44; IPPP and IPP produce an increase in global end-expiratory lung impedance&#44; therefore they could be appropriate techniques to reverse the pulmonary consequences of thoracico-abdominal surgeries&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The finding that PEP and IPPP techniques were the ones that produced more change could be related to the fact that both include a resistance during the expiratory phase&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">As previous studies&#44; the use of PEP revealed a uniform distribution in ventral and dorsal areas&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4&#44;5&#44;9</span></a> This finding could be explained by an increase in the redistribution of air through collateral ventilation due to the greater resistance during the expiratory phase&#46; It is probable that the tube used for its construction could have added an additional resistance&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">As reported by other authors<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4&#44;7</span></a> the global &#916;EELI produced returned to basal values one minute after the conclusion&#46; We consider this an expected behavior because the participants were healthy subjects&#46; However&#44; in posoperative patients&#44; the increase in lung volume could be of significance to recruit collapsed alveolar units&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">To our knowledge&#44; this is the first study to comparatively assess the physiological behavior of the mostly used RP techniques in relation to EELV increase&#46; All the participants were physical therapists&#44; trained in the techniques which eliminate possible confounding factors such as the learning effect or the limitations deriving from each pathology&#46; Future research should assess their impact on patients undergoing postoperative period of thoracoabdominal surgeries&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">In conclusion&#44; in healthy subjects the techniques PEP&#44; IPP and IPPP generated an increase in end-expiratory lung volume evaluated through EIT&#46; Unlike the other assessed respiratory physiotherapy exercises&#44; the PEP technique achieved a homogeneous lung volume distribution similar to the basal one&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Authors&#8217; contribution</span><p id="par0095" class="elsevierStylePara elsevierViewall">Each of the authors collaborated equally in the process &#40;literature search&#44; data collection&#44; study design&#44; analysis of data&#44; manuscript preparation and review of manuscript&#41;&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts of interest</span><p id="par0100" class="elsevierStylePara elsevierViewall">The authors declare that there are no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:3 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Authors&#8217; contribution"
        ]
        1 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Conflicts of interest"
        ]
        2 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "multimedia" => array:2 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1578
            "Ancho" => 2083
            "Tamanyo" => 79517
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Regional change in end-expiratory lung impedance &#40;&#916;EELI&#41; with the different techniques&#44; expressed in units&#44; as compared to the basal value&#46; The values are expressed in mean and confidence interval of 95&#37;&#46; IPP&#58; Intermittent positive pressure&#58; 3 insufflations with a manual resuscitation bag and an oronasal interface&#44; followed by a 3-s inspiratory hold and a gentle 3-s exhalation&#46; IPPP-PEEP&#58; Intermittent positive pressure with PEEP valve&#58; same way as IPP&#44; but a PEEP valve &#40;10 cmH<span class="elsevierStyleInf">2</span>O&#41; was connected to the manual resuscitation bag&#46; PEP&#58; Positive expiratory pressure&#58; deep inhalation until total lung capacity &#40;TLC&#41;&#44; followed by a 3-s inspiratory hold and then a slow 3-s exhalation through a 100<span class="elsevierStyleHsp" style=""></span>cm plastic tube &#40;inner diameter 8&#46;8<span class="elsevierStyleHsp" style=""></span>cm&#41; connected to a bulau bottle with a 10-cm water column&#46; IS&#58; Incentive spirometry&#58; Slow and deep inhalation until reaching TLC&#46; Then&#44; a 3-s hold and a gentle 3-s exhalation&#46; The 3 ball incentive spirometer &#40;MSC&#44; <span class="elsevierStyleItalic">Maximal Satisfaction Commitment</span>&#41; provided a visual feedback&#46; DB&#58; Deep breathing&#58; 3 deep inhalation&#44; without breathing out between each of them&#44; until TLC&#44; followed by a 3-s inspiratory hold and then a gentle 3-s exhalation&#46; &#42; P &#8804; 0&#46;05 compared to the basal value&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1342
            "Ancho" => 2072
            "Tamanyo" => 108415
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Regional change in end-expiratory lung impedance &#40;&#916;EELI&#41; with the different techniques&#44; expressed in units&#44; as compared to the basal value&#46; The values are expressed in mean and confidence interval of 95&#37;&#46; IPP&#58; Intermittent positive pressure&#44; IPPP&#58; Intermittent positive pressure with PEEP valve&#44; PEP&#58; Positive expiratory pressure&#44; IS&#58; Incentive spirometry&#44; DB&#58; Deep breathing&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Respiratory physiotherapy to prevent pulmonary complications after abdominal surgery&#58; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46; Pasquina"
                            1 => "M&#46;R&#46; Tram&#232;r"
                            2 => "J&#46;-M&#46; Granier"
                            3 => "B&#46; Walder"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.130.6.1887"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2006"
                        "volumen" => "130"
                        "paginaInicial" => "1887"
                        "paginaFinal" => "1899"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17167013"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incentive spirometry for prevention of postoperative pulmonary complications in upper abdominal surgery"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "P&#46; Do Nascimento Junior"
                            1 => "N&#46;S&#46; M&#243;dolo"
                            2 => "S&#46; Andrade"
                            3 => "M&#46;M&#46; Guimar&#227;es"
                            4 => "L&#46;G&#46; Braz"
                            5 => "R&#46; El Dib"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/14651858.CD006058.pub3"
                      "Revista" => array:4 [
                        "tituloSerie" => "Cochrane Database Syst Rev"
                        "fecha" => "2014"
                        "volumen" => "2"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26884379"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Chest physiotherapy in lung resec-tion patients&#58; state of the art"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46; Varela"
                            1 => "N&#46;M&#46; Novoa"
                            2 => "P&#46; Agostini"
                            3 => "E&#46; Ballesteros"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1053/j.semtcvs.2011.11.001"
                      "Revista" => array:5 [
                        "tituloSerie" => "Sem Thor Cardiovasc Surg"
                        "fecha" => "2012"
                        "volumen" => "23"
                        "paginaInicial" => "297"
                        "paginaFinal" => "306"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incentive spirometry and positive expiratory pressure improve ventilation and recruitment in postoperative recovery&#58; a randomized crossover study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Reychler"
                            1 => "V&#46; Uribe Rodriguez"
                            2 => "C&#46;E&#46; Hickmann"
                            3 => "B&#46; Tombal"
                            4 => "P&#46;F&#46; Laterre"
                            5 => "A&#46; Feyaerts"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/09593985.2018.1443185"
                      "Revista" => array:6 [
                        "tituloSerie" => "Physiother Theory Pract"
                        "fecha" => "2018"
                        "volumen" => "27"
                        "paginaInicial" => "1"
                        "paginaFinal" => "7"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21198401"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of different breathing aids on ventilation distribution in adults with cystic fibrosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Wettstein"
                            1 => "L&#46; Radlinger"
                            2 => "T&#46; Riedel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0106591"
                      "Revista" => array:4 [
                        "tituloSerie" => "PLOS ONE"
                        "fecha" => "2014"
                        "volumen" => "9"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25551375"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The short-term effects of intermittent positive pressure breathing treatments on ventilation in patients with neuromuscular disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46; Gu&#233;rin"
                            1 => "B&#46; Vincent"
                            2 => "T&#46; Petitjean"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Care"
                        "fecha" => "2010"
                        "volumen" => "55"
                        "paginaInicial" => "866"
                        "paginaFinal" => "872"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20587098"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Immediate effect of lung expansion techniques in neurosurgery patients detected by electrical impedance tomography&#58; a randomized crossover study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;C&#46;A&#46; Morais"
                            1 => "C&#46; Rattes"
                            2 => "M&#46; Bandeira"
                            3 => "L&#46; Monte"
                            4 => "S&#46;L&#46; Campos"
                            5 => "D&#46; Brand&#227;o"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/2197-425X-3-S1-A991"
                      "Revista" => array:3 [
                        "tituloSerie" => "Intensive Care Med Exp"
                        "fecha" => "2015"
                        "paginaInicial" => "A991"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Current devices of respiratory physiotherapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Hristara-Papadopoulou"
                            1 => "J&#46; Tsanakas"
                            2 => "G&#46; Diomou"
                            3 => "O&#46; Papadopoulou"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Hippokratia"
                        "fecha" => "2008"
                        "volumen" => "12"
                        "paginaInicial" => "211"
                        "paginaFinal" => "220"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19158964"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Influence of end-expiratory level and tidal volume on gravitational ventilation distribution during tidal breathing in healthy adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Schnidrig"
                            1 => "C&#46; Casaulta"
                            2 => "A&#46; Schibler"
                            3 => "T&#46; Riedel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00421-012-2469-7"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Appl Physiol"
                        "fecha" => "2013"
                        "volumen" => "113"
                        "paginaInicial" => "591"
                        "paginaFinal" => "598"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22872368"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Optimum design parameters for a therapist-constructed positive-expiratory-pressure therapy bottle device"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46;G&#46; Mestriner"
                            1 => "R&#46;O&#46; Fernandes"
                            2 => "L&#46;C&#46; Steffen"
                            3 => "M&#46;V&#46;F&#46; Donadio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Respir Care"
                        "fecha" => "2009"
                        "volumen" => "54"
                        "paginaInicial" => "504"
                        "paginaFinal" => "508"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19327187"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/02105691/0000004500000009/v1_202111260648/S0210569120302643/v1_202111260648/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "53"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Cartas cient&#237;ficas"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/02105691/0000004500000009/v1_202111260648/S0210569120302643/v1_202111260648/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569120302643?idApp=WMIE"
]
Información del artículo
ISSN: 02105691
Idioma original: Inglés
Datos actualizados diariamente
año/Mes Html Pdf Total
2024 Noviembre 3 6 9
2024 Octubre 67 53 120
2024 Septiembre 54 30 84
2024 Agosto 62 44 106
2024 Julio 48 42 90
2024 Junio 65 60 125
2024 Mayo 56 49 105
2024 Abril 42 48 90
2024 Marzo 58 32 90
2024 Febrero 41 41 82
2024 Enero 31 33 64
2023 Diciembre 32 39 71
2023 Noviembre 60 50 110
2023 Octubre 51 36 87
2023 Septiembre 42 44 86
2023 Agosto 38 19 57
2023 Julio 54 29 83
2023 Junio 41 19 60
2023 Mayo 41 32 73
2023 Abril 41 25 66
2023 Marzo 34 36 70
2023 Febrero 33 28 61
2023 Enero 24 34 58
2022 Diciembre 50 58 108
2022 Noviembre 59 51 110
2022 Octubre 44 38 82
2022 Septiembre 55 41 96
2022 Agosto 59 57 116
2022 Julio 43 47 90
2022 Junio 41 31 72
2022 Mayo 67 45 112
2022 Abril 56 75 131
2022 Marzo 74 64 138
2022 Enero 1 0 1
2021 Diciembre 8 10 18
2021 Noviembre 1 0 1
2021 Marzo 0 2 2
2020 Noviembre 1 0 1
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?