Airway anatomy for the bronchoscopist: An anesthesia approach

array:25 ["pii" => "S2256208714000273" "issn" => "22562087" "doi" => "10.1016/j.rcae.2014.02.005" "estado" => "S300" "fechaPublicacion" => "2014-07-01" "aid" => "123" "copyright" => "Sociedad Colombiana de Anestesiología y Reanimación" "copyrightAnyo" => "2013" "documento" => "article" "crossmark" => 0 "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "ssu" "cita" => "Rev Colomb Anestesiol. 2014;42:192-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 9718 "formatos" => array:3 [ "EPUB" => 102 "HTML" => 8857 "PDF" => 759 ] ] "Traduccion" => array:1 [ "es" => array:20 [ "pii" => "S0120334714000252" "issn" => "01203347" "doi" => "10.1016/j.rca.2014.02.001" "estado" => "S300" "fechaPublicacion" => "2014-07-01" "aid" => "123" "copyright" => "Sociedad Colombiana de Anestesiología y Reanimación" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/3.0/" "subdocumento" => "ssu" "cita" => "Rev Colomb Anestesiol. 2014;42:192-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 11457 "formatos" => array:3 [ "EPUB" => 100 "HTML" => 8178 "PDF" => 3179 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "Revisión" "titulo" => "Anatomía de la vía aérea para el broncoscopista. Una aproximación a la anestesia" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "192" "paginaFinal" => "198" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Airway anatomy for the bronchoscopist: An anesthesia approach" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 964 "Ancho" => 2332 "Tamanyo" => 208441 ] ] "descripcion" => array:1 [ "es" => "Broncoscopia en el Hospital Militar Central. Fuente: Elaboración propia de los autores." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Hans Fred García Araque, Oscar Valencia Orgaz, Ramón López Vicente, Sergio Esteban Gutiérrez Vidal" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Hans Fred" "apellidos" => "García Araque" ] 1 => array:2 [ "nombre" => "Oscar" "apellidos" => "Valencia Orgaz" ] 2 => array:2 [ "nombre" => "Ramón" "apellidos" => "López Vicente" ] 3 => array:2 [ "nombre" => "Sergio Esteban" "apellidos" => "Gutiérrez Vidal" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2256208714000273" "doi" => "10.1016/j.rcae.2014.02.005" "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/S2256208714000273?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0120334714000252?idApp=UINPBA00004N" "url" => "/01203347/0000004200000003/v2_201407240025/S0120334714000252/v2_201407240025/es/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S2256208714000297" "issn" => "22562087" "doi" => "10.1016/j.rcae.2014.02.007" "estado" => "S300" "fechaPublicacion" => "2014-07-01" "aid" => "126" "copyright" => "Sociedad Colombiana de Anestesiología y Reanimación" "documento" => "article" "crossmark" => 0 "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "ssu" "cita" => "Rev Colomb Anestesiol. 2014;42:199-204" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2342 "formatos" => array:3 [ "EPUB" => 97 "HTML" => 1595 "PDF" => 650 ] ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Review" "titulo" => "Anaesthesia in craniosynostosis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "199" "paginaFinal" => "204" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Anestesia para craneosinostosis" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Víctor Hugo González Cárdenas, María Victoria Vanegas Martínez, María Elvira Rojas Rueda, Nelly Susana Guevara, José Rolando Prada, Pablo Baquero" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Víctor Hugo" "apellidos" => "González Cárdenas" ] 1 => array:2 [ "nombre" => "María Victoria" "apellidos" => "Vanegas Martínez" ] 2 => array:2 [ "nombre" => "María Elvira" "apellidos" => "Rojas Rueda" ] 3 => array:2 [ "nombre" => "Nelly Susana" "apellidos" => "Guevara" ] 4 => array:2 [ "nombre" => "José Rolando" "apellidos" => "Prada" ] 5 => array:2 [ "nombre" => "Pablo" "apellidos" => "Baquero" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0120334714000288" "doi" => "10.1016/j.rca.2014.02.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0120334714000288?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2256208714000297?idApp=UINPBA00004N" "url" => "/22562087/0000004200000003/v2_201407220045/S2256208714000297/v2_201407220045/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S2256208714000406" "issn" => "22562087" "doi" => "10.1016/j.rcae.2014.04.002" "estado" => "S300" "fechaPublicacion" => "2014-07-01" "aid" => "129" "copyright" => "Sociedad Colombiana de Anestesiología y Reanimación" "documento" => "article" "crossmark" => 0 "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Rev Colomb Anestesiol. 2014;42:184-91" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3069 "formatos" => array:3 [ "EPUB" => 81 "HTML" => 2479 "PDF" => 509 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Scientific and Technological Research" "titulo" => "Sensitivity, specificity and predictive values of the Goldman, Detsky and Lee cardiac indices" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "184" "paginaFinal" => "191" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Sensibilidad, especificidad y valores predictivos de los índices cardiacos de Goldman, Detsky y Lee" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig3" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Authors." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1183 "Ancho" => 1500 "Tamanyo" => 65849 ] ] "descripcion" => array:1 [ "en" => "Positive and negative probability ratios of cardiac risk indices." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Hernán Javier Pantoja Muñoz, Humberto Fernández Ramos, William Leandro Guevara Tovar" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Hernán Javier Pantoja" "apellidos" => "Muñoz" ] 1 => array:2 [ "nombre" => "Humberto Fernández" "apellidos" => "Ramos" ] 2 => array:2 [ "nombre" => "William Leandro Guevara" "apellidos" => "Tovar" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0120334714000458" "doi" => "10.1016/j.rca.2014.02.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0120334714000458?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2256208714000406?idApp=UINPBA00004N" "url" => "/22562087/0000004200000003/v2_201407220045/S2256208714000406/v2_201407220045/en/main.assets" ] "en" => array:21 [ "idiomaDefecto" => true "cabecera" => "Review" "titulo" => "Airway anatomy for the bronchoscopist: An anesthesia approach" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "192" "paginaFinal" => "198" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Hans Fred García Araque, Oscar Valencia Orgaz, Ramón López Vicente, Sergio Esteban Gutiérrez Vidal" "autores" => array:4 [ 0 => array:3 [ "nombre" => "Hans Fred" "apellidos" => "García Araque" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Oscar" "apellidos" => "Valencia Orgaz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Ramón" "apellidos" => "López Vicente" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 3 => array:4 [ "nombre" => "Sergio Esteban" "apellidos" => "Gutiérrez Vidal" "email" => array:1 [ 0 => "serguvi472@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "d" "identificador" => "aff0020" ] 1 => array:2 [ "etiqueta" => "¿" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Cardiovascular Anesthesiologist, Anesthesiology and Resuscitation Department, Hospital Militar Central, Bogotá D.C., Colombia" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Anesthesiologist, FEA Anesthesiology and Resuscitation Department Hospital 12 de Octubre, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Anesthesiologist, DESA, FEA Anesthesiology and Resuscitation Department Hospital 12 de Octubre, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Medical Student, Universidad Militar Nueva Granada, Bogotá D.C., Colombia" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author at: Cra. 57 A Número 128 B 91, Bogotá, Colombia." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Anatomía de la vía aérea para el broncoscopista. Una aproximación a la anestesia" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Developed by the authors." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1622 "Ancho" => 1562 "Tamanyo" => 112241 ] ] "descripcion" => array:1 [ "en" => "Anatomical variation: tracheal bronchus. The right bronchus emerges superior to the bifurcation of the carina. Congenital anomaly present in 0.33% of the population." ] ] ] "textoCompleto" => "IntroductionBronchoscopy is a diagnostic and therapeutic procedure to visualize the airway and its pathological alterations. In the last few decades bronchoscopy has enabled complementary procedures such as biopsies that have been adopted into management protocols for specific groups of patients. Advances in this area have been led by pulmonologists, but fortunately this knowledge has been disseminated and is now part of the training of other specialties like anesthesiology and intensive care,<a class="elsevierStyleCrossRefs" href="#bib0255">1,2</a> resulting in a valuable contribution to diagnostic and therapeutic procedures. Several training programs for residents have been forced to include bronchoscopy training into their syllabus as a must-have skill. Currently, fibro-bronchoscopy in anesthesia is key for difficult airway management algorithms, as well as for pulmonary support techniques endorsed by different publications.MethodologyNon-systematic literature review both in English and Spanish, with no time restrictions, using PUBMED/MEDLINE, Science Direct, OVID and SciElo databases, complemented with articles referenced in the above search. The following words were used in English: Bronchoscopy, Anatomy, Airway, and Anesthesia, while in Spanish the terms used were: Broncoscopia, anatomía, vía aérea and anestesia. Both the search and the selection of articles were done independently, with no restrictions as to the type of publication.Characteristics of the procedure and anesthesia considerationsKnowledge of the upper and lower airway structures, including any anatomical alterations, is critical for a sound diagnostic or therapeutic practice. Particularly when pulmonary insulation is required, proper positioning of the device has to be ensured; otherwise, the surgeon may be challenged with hypoxemia, mechanical complications and surgical technique difficulties.<a class="elsevierStyleCrossRefs" href="#bib0265">3,4</a>Bronchoscopy is useful as part of the training in these disciplines and is indicated under different situations (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>In order to undertake bronchoscopy procedures, a complete work team and instrumentation are needed, including as a minimum monitoring devices and crash cart with all the pharmacological tools. The bronchoscope must be carefully operated to prevent breakage of the optical fiber. The recommendation is to lubricate with distilled water and avoid using any gels.Bronchoscopy may be done orally or nasally<a class="elsevierStyleCrossRef" href="#bib0275">5</a>; however, the decision to use a nasal approach depends on the associated comorbidities and any potential structural alterations the patient may have. It is critical to identify upper airway hemoptysis to determine the right approach. Several work groups are still debating about the need to administer sedation prior to the procedure.<a class="elsevierStyleCrossRefs" href="#bib0280">6,7</a> The purpose of sedation is to provide patient comfort and to facilitate the job of the bronchoscopist.<a class="elsevierStyleCrossRefs" href="#bib0290">8–10</a> However, a bronchoscopy procedure may be done without sedation.<a class="elsevierStyleCrossRefs" href="#bib0305">11,12</a> However, according to some publications, most bronchoscopies are performed under sedation.<a class="elsevierStyleCrossRefs" href="#bib0315">13–16</a> Indeed, bronchoscopy is a procedure that causes discomfort in most patients.Basic on-going monitoring is recommended for any anesthetic procedure including sedation. There is no ideal formula to sedate a patient and sedation regimes should be tailored to the individual patient, his/her comorbidities and the specific type of procedure. Various pharmacological options or combinations of anesthetic agents have been described. One of them is the combination of a short-acting benzodiazepine such as midazolam with opiates.<a class="elsevierStyleCrossRefs" href="#bib0335">17,18</a>Nerve blocks are seldom performed, unless the anesthesiologist feels it is appropriate. These blocks use local anesthetics such as lidocaine spray, preferably at 2–4% concentrations.<a class="elsevierStyleCrossRefs" href="#bib0345">19,20</a> Atropine or glycopyrrolate may be administered prior to the procedure in order to reduce the amount of secretions and to mitigate vagal hyperactivity.<a class="elsevierStyleCrossRefs" href="#bib0355">21,22</a>Recent advances in various cardiac, thoracic and GI tract surgical techniques have led to the widespread practice of double lumen intubation and the use of the fiber bronchoscope in the OR.<a class="elsevierStyleCrossRefs" href="#bib0365">23–25</a> Regardless of the route it is convenient to always follow the same approach and to return to an identifiable structure to avoid confusion.Airway anatomy and anatomical variationsTwo types of recognizable nomenclatures are used to classify the airway. The most common one being the Jackson–Huber classification that describes and names the divisions in accordance with the anatomic space orientation.<a class="elsevierStyleCrossRef" href="#bib0380">26</a> The other popular classification is Boyden's<a class="elsevierStyleCrossRef" href="#bib0385">27</a> for surgical purposes; this classification numerically divides each zone. Another less popular is the Yamashita Japanese classification.<a class="elsevierStyleCrossRef" href="#bib0390">28</a> The recommendation is to use the Jackson–Huber classification because it is most widely used and less complex (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>Upper airwayA number of general anatomic concepts of the airway are important to remember. The upper airway includes the mouth, the nose, the nasopharynx, the oropharynx, the laryngopharynx and the larynx. All of them are extremely critical in the management of the airway.The mouth is mainly made up of the tongue and the teeth, which are relevant structures o consider for intubation. The surrounding structures of the mouth are the lips (anterior), the hard and soft palate (upper), the floor of the tongue (lower) and the oropharynx (posterior). The tongue is critical for the establishment of a patent airway.The surrounding structures of the nose are the nostrils (anterior), the nasopharynx (posterior) and they are separated from the oral cavity by the palate. The nasal cavity has three turbinates dividing the space into meatus through which air flows to allow for a decrease in turbulent flow, humidifying and warming-up to limit the injury inflicted to the lower airway.<a class="elsevierStyleCrossRefs" href="#bib0395">29–31</a> Such approach is seldom used for intubation and accessory procedures due to internal injuries, skull base fractures or any other pathologic process that hinders the passage through this pathway. The lower turbinate and its corresponding meatus are the most important ones since this space allows for a patent airway. The sphenopalatine branch of the maxillary and facial arteries supplies irrigation both give rise to Kiesselbach's plexus, an area of frequent bleeding.The pharynx is divided into three structures: the nasopharynx, the oropharynx and the laryngopharynx.<a class="elsevierStyleCrossRef" href="#bib0410">32</a> Going through the nasal cavity you find the lower turbinate laterally and the nasal septum medially. When the bronchoscopist examines the nasal cavity the integrity of the mucosa may be assessed, together with potential septal deviations, turbinate hypertrophy or nasal polyposis.When introducing the bronchoscope through the oropharynx, it is critical to identify structures such as the tonsils, the palate and the base of the tongue.<a class="elsevierStyleCrossRefs" href="#bib0415">33–35</a> Further down you find the laryngopharynx with 3 important identifiable structures: the piriform recess, the post-cricoid region and the posterior wall of the pharynx. The space between the base of the tongue and the anterior margin of the epiglottis<a class="elsevierStyleCrossRefs" href="#bib0430">36,37</a> is relevant when trying to locate a foreign body.The larynx is the communicating structure between the upper and lower airway organs.<a class="elsevierStyleCrossRefs" href="#bib0440">38,39</a> The vocal folds should be briefly examined in abduction and adduction (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). La Vocal fold dysfunction may be functional or organic. The upper laryngeal nerve and the recurrent laryngeal nerve innervate the vocal folds. Topical anesthesia helps to pass the instruments through the cavity.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Lower airwayThe trachea is the initial segment of the lower airway and starts at the level of C6.<a class="elsevierStyleCrossRef" href="#bib0450">40</a> It is a cartilaginous tube that extends from the cricoid cartilage to the carina.<a class="elsevierStyleCrossRef" href="#bib0455">41</a> During expiration, the trachea rises up to C4 while in total inspiration it reaches C6. The length of the trachea varies according to age. In neonates it is 3cm, in the pediatric population the range is 7–10cm<a class="elsevierStyleCrossRef" href="#bib0210">42</a> and in adults it is approximately 15cm. The diameter is 6mm, 10mm and 13–22mm respectively. The length of the upper airway does not change with age but the height does. So a 10cm decrease in height represents a 1cm change in the length of the upper airway considering an average height of 1.70m (29cm).<a class="elsevierStyleCrossRef" href="#bib0215">43</a> In adults, the upper airway comprises 16–20 C-shaped cartilages; the anterolateral wall is united by a tracheal membrane with no cartilage and is supported by the tracheal muscle that allows for extension in response large airflows (Ex. Asthma, COPD).<a class="elsevierStyleCrossRefs" href="#bib0220">44–47</a> The above diameters vary in accordance with the gender of the patient, as shown by studies of the average diameter, the coronal diameter and the sagittal diameter. The average in men is 22, 13–25, 13–17mm, respectively, somewhat larger as compared to women: 19, 10–21, 10–23mm.<a class="elsevierStyleCrossRef" href="#bib0240">48</a> The average tracheal wall thickness is 3mm. The trachea is localized in the mid-line, occasionally displaced to the right because of the position of the aortic arch and in elderly patients with morbidities such as COPD that may result in a narrower antero-posterior diameter with subsequent physiological consequences. It is important to examine the integrity of the tracheal mucosa to identify any endotracheal lesions, observe probable deviations caused by masses, the distal trachea at the junction with the carina, since these are potential metastatic areas. In case any lesions are found, both lungs must be examined prior to doing a biopsy. If bleeding is present, the evaluation becomes more difficult because the quality of the fiber-bronchoscopy is compromised, in addition a longer time to complete the procedure.The trachea bifurcates at the level of the carina into the right and left main bronchi; as the trachea advances the lumen decreases progressively. The bifurcation is localized at the level of T5. The right bronchus is more vertically placed at a 90° angle or less with the trachea, while the left bronchus is more horizontal. In children the carina is usually more displaced to the right and with time it becomes more medial and the angulation tends to be more obtuse.2cm and 1.5cm along the length of the right bronchus the right upper bronchus becomes the intermediate bronchus. One out of 300 people have anatomical variants and the upper right lobe emerges on top of the carina (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Some studies report a prevalence of 0.1–2% for the upper right lobe and 0.3–1% for the upper left lobe.<a class="elsevierStyleCrossRef" href="#bib0245">49</a> In some cases you may find a bridge bronchus arising from the left bronchus but ventilates the lower right lobe. A normal variant is any variant that does not obstruct the airflow but this finding is usually incidental. The diameter of this bronchus is 17.5mm in males and 14mm in females. This bronchus divides into apical (B1), anterior (B2) and posterior (B3). The anterior and posterior segments are the most frequent sites for bronchial disease, including carcinomas. The apical is divided into posterior (B1a) and anterior (B1b). The anterior is divided into anterior (B2b) and posterior (B2a), the posterior into anterior (B3b) and posterior (B3a). The above description is based on Boyden's classification but some bronchoscopists use the Japanese Yamashita classification, wherein B2 and B3 are inverted into posterior and anterior, respectively. After generating the right upper lobe bronchus, the right bronchus lobe becomes the intermediate bronchus that extends for approximately 2–2.5cm and then splits into the middle lobe bronchus and the lower lobe bronchus. The middle lobe bronchus emerges anterolateral with a 1–2cm length before it divides into lateral (B4) that is visualized at a long distance and medial (B5), that is visualized more oblique. Both the lateral and the medial divide into anterior and posterior (B4b), (B4a), (B5b) and (B5a). The intermediate bronchus has an oblique shape and runs posterior to the right pulmonary artery and inferior to the right interlobar artery. A cardiac bronchus is a rare congenital anomaly of the intermediate bronchus where the bronchus originates in this segment before giving origin to the lower lobe bronchus that advances into the pericardium. The lower lobe bronchus is divided into upper (B6), medial basal (B7), anterior basal (B8), lateral basal (B9) and posterior (B10).<elsevierMultimedia ident="fig0010"></elsevierMultimedia>With regard to the left lung, it is important to highlight that the division of the bronchi is usually similar if compared to the right lung; however, the left lung may have 8–10 bronchi. The left source bronchus is more horizontal than the right and tends to go more toward posterior and lateral. The left bronchus is divided into the left upper lobe bronchus and the left lower lobe bronchus. The former (first ramification) is at 5 and 4.5cm from the carina in males and females, respectively (the distance from the carina to the bifurcation between the upper and lower left lobe is in average 6–8cm in males and 5–6cm in females).<a class="elsevierStyleCrossRef" href="#bib0250">50</a> The upper left bronchus lobe is divided into the upper division bronchus and the lingular bronchus. The upper division bronchus is divided into apical-posterior (B1/B2) and anterior bronchus (B3) and advances anteriorly accompanied by the anterior segmental artery. The apical–posterior bronchus may be presented in block or divided into the apical and the posterior segment (B1 and B2). The lingular bronchus is slightly inferior–lateral 2–3cm long and divided into upper (B4) and lower (B5). The left bronchus of the lower lobe is divided into upper (B6), anteromedial (B8), lateral basal (B9), and posterior basal (B10). The medial basal segment (B7) may be present in one-third of the population and falls off leaving behind an anterior (B8) and medial (B7) bronchus.ConclusionsThe anatomy of the upper airway is extremely important for a sound bronchoscopy technique (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). There are different anatomical variants you should identify and these are common in a certain proportion of the world population. It is important to know the anatomical variations that result in useful physiological differences in practice. Science is constantly evolving, so physicians are required to adopt a culture of on-going education, in addition to the implementation of policies related to patient safety and quality of care.<elsevierMultimedia ident="fig0015"></elsevierMultimedia>FundingNone.Conflict of interestThe authors declare no conflict of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:2 [ "identificador" => "xres354040" "titulo" => array:5 [ 0 => "Abstract" 1 => "Introduction" 2 => "Objective" 3 => "Methodology" 4 => "Results and conclusions" ] ] 1 => array:2 [ "identificador" => "xpalclavsec335378" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres354039" "titulo" => array:5 [ 0 => "Resumen" 1 => "Introducción" 2 => "Objetivo" 3 => "Metodología" 4 => "Resultados y conclusiones" ] ] 3 => array:2 [ "identificador" => "xpalclavsec335379" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Methodology" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Characteristics of the procedure and anesthesia considerations" ] 7 => array:3 [ "identificador" => "sec0020" "titulo" => "Airway anatomy and anatomical variations" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0025" "titulo" => "Upper airway" ] 1 => array:2 [ "identificador" => "sec0030" "titulo" => "Lower airway" ] ] ] 8 => array:2 [ "identificador" => "sec0035" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0040" "titulo" => "Funding" ] 10 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflict of interest" ] 11 => array:2 [ "identificador" => "xack87366" "titulo" => "Acknowledgements" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-05-03" "fechaAceptado" => "2014-02-02" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec335378" "palabras" => array:5 [ 0 => "Bronchoscopy" 1 => "Anatomy" 2 => "Airway management" 3 => "Anesthesia" 4 => "Pulmonary medicine" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec335379" "palabras" => array:5 [ 0 => "Broncoscopía" 1 => "Anatomía" 2 => "Manejo de la vía aérea" 3 => "Anestesia" 4 => "Neumología" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "IntroductionKnowledge and the development of skills in airway management is one of the core competencies in the training of the anesthesiologist. “Know how” and “Knowing to do well and fast” are decisive under certain critical situations that may arise in the management of anesthesia. Bronchoscopy is a useful diagnostic and therapeutic procedure. Knowledge of the technique and airway anatomy is the cornerstone of bronchoscopy; however, there are anatomical variations and different airway classifications. ObjectiveTo describe the airway anatomy by means of schematic representations, to assess anatomical variations and to learn about the characteristics of the procedure. MethodologyA non-systematic review of databases (PUBMED/MEDLINE, Science Direct, OVID, SciElo) was undertaken using the following. Results and conclusionsBronchoscopy is a useful surgical and diagnostic procedure for different applications. The anatomical variations of the airway are only present in a small percentage of the population. Anatomical classifications are both anatomically and numerically diverse; however, what is really relevant is to develop a spatial relationship. Bronchoscopy is a technique that evolves simultaneously with other technical biomedical breakthroughs and is a procedure that the anesthesiologist must explore further in order to accomplish better outcomes in anesthesia." ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "IntroducciónEl conocimiento y desarrollo de habilidades en el manejo de la vía aérea es una de las competencias importantes en la formación del anestesiólogo; el “saber” y el “saber hacer bien y rápido” son determinantes en algunas situaciones críticas a las que se puede enfrentar durante el manejo anestésico. La broncoscopia es un procedimiento útiltanto diagnóstico como terapéutico. El conocimiento de la técnica y de la anatomía de la vía aérea constituye el pilar de la broncoscopia, encontrando diferentes variaciones anatómicas y clasificaciones de la vía aérea. ObjetivoDescribir la anatomía de la vía aérea a través de esquemas, evaluar variaciones anatómicas y conocer características propias del procedimiento. MetodologíaCon las palabras clave “Bronchoscopy”, “Anatomy”, “Airway” y “Anesthesia” se realizó una revisión no sistemática en bases de datos (PUBMED/MEDLINE, Science Direct, OVID, SciElo). Resultados y conclusionesLa broncoscopia es un procedimiento útil en el plano quirúrgico y diagnóstico, siendo utilizado en distintos procedimientos. Las variaciones anatómicas de la vía aérea se presentan en un porcentaje pequeño de la población. Las clasificaciones anatómicas son diversas tanto anatómica como numéricamente; sin embargo, lo relevante es desarrollar una relación espacial. La broncoscopia es una técnica que va en desarrollo paralelo a otros avances de la tecnología biomédica, es un procedimiento del cual el anestesiólogo debe investigar más con el fin de generar mejores efectos en el campo de la anestesiología." ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: García Araque HF, Valencia Orgaz O, López Vicente R, Gutiérrez Vidal SE. Anatomía de la vía aérea para el broncoscopista. Una aproximación a la anestesia. Rev Colomb Anestesiol. 2014;42:192–198." ] ] "multimedia" => array:5 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Developed by the authors." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 964 "Ancho" => 2332 "Tamanyo" => 208441 ] ] "descripcion" => array:1 [ "en" => "Bronchoscopy Hospital Militar Central." ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Developed by the authors." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1622 "Ancho" => 1562 "Tamanyo" => 112241 ] ] "descripcion" => array:1 [ "en" => "Anatomical variation: tracheal bronchus. The right bronchus emerges superior to the bifurcation of the carina. Congenital anomaly present in 0.33% of the population." ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Developed by the authors." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 2616 "Ancho" => 3167 "Tamanyo" => 489940 ] ] "descripcion" => array:1 [ "en" => "Bronchoscopy – airway anatomy." ] ] 3 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Authors." "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Symptoms investigation \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Hemoptysis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Persistent coughing \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Recurrent infection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Suspicion of neoplasm \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Unexplained vocal folds paralysis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Estridor \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Monophonic wheezing \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Suspicious sputum cytology \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Unexplained pleural effusion \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cancer staging \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Tissue diagnosis (pathology) and staging \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Infection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Identification of microorganisms \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Bronchiectasis/lobar collapse \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Interstitial lung disease \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Bronchoalveolar lavage (cell count difference) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Therapeutic and palliative \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Cleaning of secretions \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Foreign body removal \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Neoplasm treatment \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Endotracheal ablation \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Airway disease treatment \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab528992.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Indications for flexible bronchoscopy." ] ] 4 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Authors." "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Anatomical nomenclature \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Numeric system \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Subsequent division \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Usual variations \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Right lung</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Upper lobe</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Apical \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a and b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">(B1) May be absent of derived from B2 or B3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Posterior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a and b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Anterior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a and b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Middle lobe</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lateral \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a and b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">May have an upper/lower division similar to the lingula \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Medial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a and b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lower lobe</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Upper \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a, b and c \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Basal medial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a and b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">(B7) Occasionally is an additional cardiac accessory branch \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Basal anterior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a and b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">(B8) The basal bronchus is the most frequent variation in the right lung \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Basal lateral \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a and b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Basal posterior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a, b and c \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Left lung</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Upper lobe</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Apical-posterior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B1+2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a, b and c \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">May have a carina separating B1, B2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Anterior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a, b and c \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Superior lingular \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a and b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inferior lingular \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a and b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lower lobe</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Upper \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a, b and c \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">(B8) May have a supernumerary medial bronchus (B7) with a separate anterior bronchus (B8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Basal anteromedial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a and b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">(B10) May trifurcate into a, b and c \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Basal lateral \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a and b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Basal posterior \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a and b \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab528991.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Nomenclature and anatomical variations." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:50 [ 0 => array:3 [ "identificador" => "bib0255" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guía para la intubación con fibrobroncoscopio en un Hospital Universitario" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E. Lema" 1 => "H. Medina" 2 => "C. González" 3 => "C.E. Hoyos" 4 => "L.A. Tafur" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Colomb Anestesiol" "fecha" => "2012" "volumen" => "40" "paginaInicial" => "60" "paginaFinal" => "66" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0260" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Consideraciones anestésicas para procedimientos de neumología intervencionista" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E.E. Barato" 1 => "A. Bernal" 2 => "F.B. Carvajal" 3 => "C. Giraldo" 4 => "F. Echeverri" 5 => "D.A. Martínez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Colomb Anestesiol" "fecha" => "2011" "volumen" => "39" "paginaInicial" => "316" "paginaFinal" => "328" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0265" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Role of fiberoptic bronchoscopy in conjunction with the use of double-lumen tubes for thoracic anesthesia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "U. Klein" 1 => "W. Karzai" 2 => "F. Bloos" 3 => "M. Wohlfarth" 4 => "R. Gottschall" 5 => "H. Fritz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Anesthesiology" "fecha" => "1998" "volumen" => "88" "paginaInicial" => "346" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9477054" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0270" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effects of endobronchial cuff inflation on double-lumen endobronchial tube movement after lateral positioning" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "D.P. Desiderio" 1 => "M. Burt" 2 => "A.C. Kolver" 3 => "M.E. Fischer" 4 => "R. Reinsel" 5 => "R.S. Wilson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Cardiothorac Vasc Anesth" "fecha" => "1997" "volumen" => "11" "paginaInicial" => "595" "paginaFinal" => "598" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9263092" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0275" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Controversies in bronchoscopy nasal versus oral insertion of the flexible bronchoscope: Pronasal insertion" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.C. Mehta" 1 => "R.A. Dweik" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Bronchol" "fecha" => "1996" "volumen" => "3" "paginaInicial" => "224" "paginaFinal" => "248" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0280" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is sedation necessary for bronchoscopy? Con sedation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H.G. Colt" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Bronchol" "fecha" => "1994" "volumen" => "1" "paginaInicial" => "250" "paginaFinal" => "253" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0285" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Should patients undergoing a bronchoscopy be sedated?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R. Gonzalez" 1 => "I. De-la-Rosa-Ramirez" 2 => "A. Maldonado-Hernandez" 3 => "G. Dominguez-Cherit" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Acta Anaesthesiol Scand" "fecha" => "2003" "volumen" => "47" "paginaInicial" => "411" "paginaFinal" => "415" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12694138" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0210480611003925" "estado" => "S300" "issn" => "02104806" ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0290" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Don’t lose the forest for the trees: Satisfaction and success in bronchoscopy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.C. Mehta" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/rccm.200208-895IE" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2002" "volumen" => "166" "paginaInicial" => "1306" "paginaFinal" => "1307" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12421737" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0295" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effect of gender on compensatory neuromuscular response to upper airway obstruction in normal subjects under midazolam general anesthesia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Ayuse" 1 => "Y. Hoshino" 2 => "S. Kurata" 3 => "T. Ayuse" 4 => "H. Schneider" 5 => "J.P. Kirkness" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1213/ane.0b013e3181b0fc70" "Revista" => array:6 [ "tituloSerie" => "Anesth Analg" "fecha" => "2009" "volumen" => "109" "paginaInicial" => "1209" "paginaFinal" => "1218" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19762751" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0300" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Assessment of upper airway anatomy in awake, sedated and anaesthetised patients using magnetic resonance imaging" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G.D. Shorten" 1 => "N.J. Opie" 2 => "P. Graziotti" 3 => "I. Morris" 4 => "M. Khangure" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Anaesth Intensive Care" "fecha" => "1994" "volumen" => "22" "paginaInicial" => "165" "paginaFinal" => "169" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7880227" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0305" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fiberoptic bronchoscopy: Is sedation necessary?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. Pearce" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "BMJ" "fecha" => "1980" "volumen" => "281" "paginaInicial" => "179" "paginaFinal" => "180" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0310" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fiberoptic bronchoscopy without premedication. A retrospective study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H.G. Colt" 1 => "J.F. Morris" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Chest" "fecha" => "1990" "volumen" => "98" "paginaInicial" => "1327" "paginaFinal" => "1330" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2245669" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0022534709031826" "estado" => "S300" "issn" => "00225347" ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0315" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bronchoscopy in North America: The ACCP survey" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "U.B. Prakash" 1 => "K.P. Offord" 2 => "S.E. Stubbs" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "1991" "volumen" => "100" "paginaInicial" => "1668" "paginaFinal" => "1675" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1959412" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0320" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Preparation of the patient for awake flexible bronchoscopy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A. Reed" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "1992" "volumen" => "101" "paginaInicial" => "244" "paginaFinal" => "253" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1729077" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0325" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dexmedetomidina para sedación durante intubación difícil con fibrobroncoscopia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.M. Torres" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Colomb Anestesiol" "fecha" => "2006" "volumen" => "34" "paginaInicial" => "55" "paginaFinal" => "56" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0330" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dexmedetomidine for conscious sedation in difficult awake fiberoptic intubation cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S.D. Bergese" 1 => "B. Khabiri" 2 => "W.D. Roberts" 3 => "M.B. Howie" 4 => "T.D. McSweeney" 5 => "M.A. Gerhardt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jclinane.2006.07.005" "Revista" => array:6 [ "tituloSerie" => "J Clin Anesth" "fecha" => "2007" "volumen" => "19" "paginaInicial" => "141" "paginaFinal" => "144" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17379129" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0335" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cough suppression during flexible bronchoscopy using combined sedation with midazolam and hydrocodone: A randomized, double-blind, placebo-controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "D. Stolz" 1 => "P.N. Chhajed" 2 => "J.D. Leuppi" 3 => "M. Brutsche" 4 => "E. Pflimlin" 5 => "M. Tamm" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/thx.2003.019836" "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "2004" "volumen" => "59" "paginaInicial" => "773" "paginaFinal" => "776" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15333854" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0340" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An update on sedation and analgesia during flexible bronchoscopy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "B.D. Vincent" 1 => "G.A. Silvestri" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Bronchol" "fecha" => "2007" "volumen" => "14" "paginaInicial" => "173" "paginaFinal" => "180" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0345" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Topical nasal anesthesia for fiberoptic bronchoscopy: Patients’ preference for lignocaine gel" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.R. Webb" 1 => "M.A. Woodhead" 2 => "H.R. Dalton" 3 => "J.A. Grigg" 4 => "F.J. Millard" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "1989" "volumen" => "44" "paginaInicial" => "674" "paginaFinal" => "675" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2799746" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0350" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Topical anesthesia of the nasal mucosa for fiberoptic airway endoscopy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "T. Randell" 1 => "A. Yli-Hankala" 2 => "H. Valli" 3 => "L. Lindgren" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Anaesth" "fecha" => "1992" "volumen" => "68" "paginaInicial" => "164" "paginaFinal" => "167" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1540458" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0355" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An audit of bronchoscopy practice in the United Kingdom: A survey of adherence to national guide lines" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D. Honeybourne" 1 => "C. Neuman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "1997" "volumen" => "52" "paginaInicial" => "709" "paginaFinal" => "713" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9337830" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0360" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anticholonergic premedication for fiberoptic bronchoscopy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Roffe" 1 => "M.J. Smith" 2 => "G.S. Basran" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Monaldi Arch Chest Dis" "fecha" => "1994" "volumen" => "49" "paginaInicial" => "101" "paginaFinal" => "106" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8049691" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0365" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Progress in lung separation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.H. Campos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Thorac Surg Clin" "fecha" => "2005" "volumen" => "75" "paginaInicial" => "71" "paginaFinal" => "83" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0370" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Flexible bronchoscopy: A safe method for metal stent implantation in bronchial disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "H. Hautmann" 1 => "M. Bauer" 2 => "K.J. Pfeifer" 3 => "R.M. Huber" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Thorac Surg" "fecha" => "2000" "volumen" => "69" "paginaInicial" => "398" "paginaFinal" => "401" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10735670" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0375" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High frequency jet ventilation in interventional fiberoptic bronchoscopy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "H. Hautmann" 1 => "F. Gamarra" 2 => "M. Henke" 3 => "S. Diehm" 4 => "R.M. Huber" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Anesth Analg" "fecha" => "2000" "volumen" => "90" "paginaInicial" => "1436" "paginaFinal" => "1440" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10825336" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0380" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Committee on anatomical nomenclature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E.A. Boyden" 1 => "S.L. Clark" 2 => "C.H. Danforth" 3 => "W.W. Greulich" 4 => "G.W. Corner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1126/science.96.2483.116" "Revista" => array:5 [ "tituloSerie" => "Science" "fecha" => "1942" "volumen" => "96" "paginaInicial" => "116" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17809984" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0385" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Correlated anatomy of the bronchial tree and lungs with a system of nomenclature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.L. Jackson" 1 => "J.F. Huber" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Dis Chest" "fecha" => "1943" "volumen" => "9" "paginaInicial" => "319" "paginaFinal" => "326" ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0390" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Roentgenologic Anatomy of the Lung" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H. Yamashita" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "edicion" => "1st ed." "fecha" => "1978" "editorial" => "Igaku-Shoin" "editorialLocalizacion" => "Tokyo" ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0395" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anatomy and physiology of the upper airway" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.S. Isaacs" 1 => "J.M. Sykes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Anesthesiol Clin North Am" "fecha" => "2002" "volumen" => "20" "paginaInicial" => "733" "paginaFinal" => "745" ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0400" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparative anatomy, physiology, and function of the upper respiratory tract" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G.K. Reznik" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Environ Health Perspect" "fecha" => "1990" "volumen" => "85" "paginaInicial" => "171" "paginaFinal" => "176" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2384061" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S147020450770284X" "estado" => "S300" "issn" => "14702045" ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0405" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Development, structure and function of the upper airways" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P. Pohunek" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.prrv.2003.09.002" "Revista" => array:6 [ "tituloSerie" => "Paediatr Respir Rev" "fecha" => "2004" "volumen" => "5" "paginaInicial" => "2" "paginaFinal" => "8" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15222948" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0410" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Brimabombe JR. Anatomy. 2nd ed. Philadelphia: Elsevier; 2005. p. 73–104." ] ] ] 32 => array:3 [ "identificador" => "bib0415" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lung defense mechanisms" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G.M. Green" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Med Clin North Am" "fecha" => "1973" "volumen" => "57" "paginaInicial" => "547" "paginaFinal" => "562" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4573460" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0420" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lung defense mechanisms (first of two parts)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Newhouse" 1 => "J. Sanchis" 2 => "J. Bienenstock" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM197610282951805" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "1976" "volumen" => "295" "paginaInicial" => "990" "paginaFinal" => "998" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/787790" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0425" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The unexpected difficult airway and lingual tonsil hyperplasia: A case series and a review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Ovassapian" 1 => "R. Glassenberg" 2 => "G.I. Randel" 3 => "A. Klock" 4 => "P.S. Mesnick" 5 => "J.M. Klafta" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Anesthesiology" "fecha" => "2002" "volumen" => "97" "paginaInicial" => "124" "paginaFinal" => "132" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12131113" "web" => "Medline" ] ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0430" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Functional anatomy of the larynx" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.T. Roberts" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Int Anesthesiol Clin" "fecha" => "1990" "volumen" => "28" "paginaInicial" => "101" "paginaFinal" => "105" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2185987" "web" => "Medline" ] ] ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib0435" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Laryngeal anatomy and physiology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "L.G. Petcu" 1 => "C.T. Sasaki" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Clin Chest Med" "fecha" => "1991" "volumen" => "12" "paginaInicial" => "415" "paginaFinal" => "423" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1934946" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S014067361061389X" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 37 => array:3 [ "identificador" => "bib0440" "etiqueta" => "38" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fundamentals of Tracheal Intubation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J. Roberts" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "1983" "editorial" => "Grune & Stratton" "editorialLocalizacion" => "New York" ] ] ] ] ] ] 38 => array:3 [ "identificador" => "bib0445" "etiqueta" => "39" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An anatomic study of the external laryngeal framework with surgical implications" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L.Z. Meiteles" 1 => "P.T. Lin" 2 => "E.J. Wenk" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Otolaryngol Head Neck Surg" "fecha" => "1992" "volumen" => "106" "paginaInicial" => "235" "paginaFinal" => "240" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1589212" "web" => "Medline" ] ] ] ] ] ] ] ] 39 => array:3 [ "identificador" => "bib0450" "etiqueta" => "40" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anatomy, pathology, and physiology of the tracheobronchial tree: Emphasis on the distal airways" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.M. Hyde" 1 => "Q. Hamid" 2 => "C.G. Irvin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaci.2009.08.048" "Revista" => array:6 [ "tituloSerie" => "J Allergy Clin Immunol" "fecha" => "2009" "volumen" => "124" "paginaInicial" => "S72" "paginaFinal" => "S77" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19962039" "web" => "Medline" ] ] ] ] ] ] ] ] 40 => array:3 [ "identificador" => "bib0455" "etiqueta" => "41" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Imaging of the large airways" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P.M. Boiselle" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Clin Chest Med" "fecha" => "2008" "volumen" => "29" "paginaInicial" => "18" ] ] ] ] ] ] 41 => array:3 [ "identificador" => "bib0210" "etiqueta" => "42" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Elongation of the trachea during neck extension in children: implications of the safety of endotracheal tubes" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Jin-Hee" 1 => "Y.J. Ro" 2 => "M. Seong-Won" 3 => "K. Chong-Soo" 4 => "K. Seong-Deok" 5 => "J.H. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1213/01.ane.0000169330.92707.1e" "Revista" => array:6 [ "tituloSerie" => "Anesth Analg" "fecha" => "2005" "volumen" => "101" "paginaInicial" => "974" "paginaFinal" => "977" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16192505" "web" => "Medline" ] ] ] ] ] ] ] ] 42 => array:3 [ "identificador" => "bib0215" "etiqueta" => "43" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Depth of placement of left double-lumen tubes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.B. Brodsky" 1 => "J.L. Benumof" 2 => "J. Ehrenworth" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Anesth Analg" "fecha" => "1991" "volumen" => "73" "paginaInicial" => "570" "paginaFinal" => "576" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1952136" "web" => "Medline" ] ] ] ] ] ] ] ] 43 => array:3 [ "identificador" => "bib0220" "etiqueta" => "44" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anatomy of the trachea, carina and bronchi" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D.J. Minnich" 1 => "D.J. Mathisen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.thorsurg.2006.12.006" "Revista" => array:6 [ "tituloSerie" => "Thorac Surg Clin" "fecha" => "2007" "volumen" => "17" "paginaInicial" => "571" "paginaFinal" => "585" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18271170" "web" => "Medline" ] ] ] ] ] ] ] ] 44 => array:3 [ "identificador" => "bib0225" "etiqueta" => "45" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "CT virtual endoscopy in the evaluation of large airway disease: review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B.P. Thomas" 1 => "M.K. Strother" 2 => "E.F. Donnelly" 3 => "J.A. Worrell" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2214/AJR.07.7077" "Revista" => array:6 [ "tituloSerie" => "AJR Am J Roentgenol" "fecha" => "2009" "volumen" => "192" "paginaInicial" => "S20" "paginaFinal" => "S30" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19234286" "web" => "Medline" ] ] ] ] ] ] ] ] 45 => array:3 [ "identificador" => "bib0230" "etiqueta" => "46" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Remodeling in asthma and chronic obstructive lung disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P.K. Jeffery" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/ajrccm.164.supplement_2.2106061" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2001" "volumen" => "164" "paginaInicial" => "S28" "paginaFinal" => "S38" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11734464" "web" => "Medline" ] ] ] ] ] ] ] ] 46 => array:3 [ "identificador" => "bib0235" "etiqueta" => "47" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Airway remodeling measured by multidetector CT is increased in severe asthma and correlates with pathology" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.S. Aysola" 1 => "E.A. Hoffman" 2 => "D. Gierada" 3 => "S. Wenzel" 4 => "J. Cook-Granroth" 5 => "J. Tarsi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.07-2779" "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2008" "volumen" => "134" "paginaInicial" => "1183" "paginaFinal" => "1191" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18641116" "web" => "Medline" ] ] ] ] ] ] ] ] 47 => array:3 [ "identificador" => "bib0240" "etiqueta" => "48" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The relationship between the diameters of the adult cricoid ring and main tracheobronchial tree: a cadaver study to investigate the basis for double-lumen tube selection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.H. Seymour" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Cardiothorac Vasc Anesth" "fecha" => "2003" "volumen" => "17" "paginaInicial" => "299" "paginaFinal" => "301" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12827574" "web" => "Medline" ] ] ] ] ] ] ] ] 48 => array:3 [ "identificador" => "bib0245" "etiqueta" => "49" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Major anatomical variations of the tracheobronchial tree: bronchoscopic observation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "U. Gonlugur" 1 => "T. Efeoglu" 2 => "M. Kaptanoglu" 3 => "I. Akkurt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1447-073x.2005.00104.x" "Revista" => array:6 [ "tituloSerie" => "Anat Sci Int" "fecha" => "2005" "volumen" => "80" "paginaInicial" => "111" "paginaFinal" => "115" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15960317" "web" => "Medline" ] ] ] ] ] ] ] ] 49 => array:3 [ "identificador" => "bib0250" "etiqueta" => "50" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Margin of safety in positioning modern double-lumen endotracheal tubes" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J.L. Benumof" 1 => "B.L. Partridge" 2 => "C. Salvatierra" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Anesthesiology" "fecha" => "1985" "volumen" => "67" "paginaInicial" => "729" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3674473" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack87366" "titulo" => "Acknowledgements" "texto" => "Dr. Gloria Gutiérrez, Javier Fabricio Guillen Olaya and Johani Pedraza Torres." "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/22562087/0000004200000003/v2_201407220045/S2256208714000273/v2_201407220045/en/main.assets" "Apartado" => array:4 [ "identificador" => "34050" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Review articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22562087/0000004200000003/v2_201407220045/S2256208714000273/v2_201407220045/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2256208714000273?idApp=UINPBA00004N"]

Statistics

Review

Anatomía de la vía aérea para el broncoscopista. Una aproximación a la anestesia

Hans Fred García Araquea, Oscar Valencia Orgazb, Ramón López Vicentec, Sergio Esteban Gutiérrez Vidald,

Corresponding author

serguvi472@hotmail.com

Corresponding author at: Cra. 57 A Número 128 B 91, Bogotá, Colombia.

a Cardiovascular Anesthesiologist, Anesthesiology and Resuscitation Department, Hospital Militar Central, Bogotá D.C., Colombia

b Anesthesiologist, FEA Anesthesiology and Resuscitation Department Hospital 12 de Octubre, Madrid, Spain

c Anesthesiologist, DESA, FEA Anesthesiology and Resuscitation Department Hospital 12 de Octubre, Madrid, Spain

d Medical Student, Universidad Militar Nueva Granada, Bogotá D.C., Colombia

Read

18044

Times
was read the article

2049

Total PDF

15995

Total HTML

Share statistics

 array:25 [
  "pii" => "S2256208714000273"
  "issn" => "22562087"
  "doi" => "10.1016/j.rcae.2014.02.005"
  "estado" => "S300"
  "fechaPublicacion" => "2014-07-01"
  "aid" => "123"
  "copyright" => "Sociedad Colombiana de Anestesiolog&#237;a y Reanimaci&#243;n"
  "copyrightAnyo" => "2013"
  "documento" => "article"
  "crossmark" => 0
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "ssu"
  "cita" => "Rev Colomb Anestesiol. 2014;42:192-8"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 9718
    "formatos" => array:3 [
      "EPUB" => 102
      "HTML" => 8857
      "PDF" => 759
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:20 [
      "pii" => "S0120334714000252"
      "issn" => "01203347"
      "doi" => "10.1016/j.rca.2014.02.001"
      "estado" => "S300"
      "fechaPublicacion" => "2014-07-01"
      "aid" => "123"
      "copyright" => "Sociedad Colombiana de Anestesiolog&#237;a y Reanimaci&#243;n"
      "documento" => "article"
      "crossmark" => 0
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/3.0/"
      "subdocumento" => "ssu"
      "cita" => "Rev Colomb Anestesiol. 2014;42:192-8"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 11457
        "formatos" => array:3 [
          "EPUB" => 100
          "HTML" => 8178
          "PDF" => 3179
        ]
      ]
      "es" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Revisi&#243;n</span>"
        "titulo" => "Anatom&#237;a de la v&#237;a a&#233;rea para el broncoscopista&#46; Una aproximaci&#243;n a la anestesia"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "192"
            "paginaFinal" => "198"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Airway anatomy for the bronchoscopist&#58; An anesthesia approach"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 964
                "Ancho" => 2332
                "Tamanyo" => 208441
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Broncoscopia en el Hospital Militar Central&#46;</p> <p id="spar0050" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Fuente&#58;</span> Elaboraci&#243;n propia de los autores&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Hans Fred Garc&#237;a Araque, Oscar Valencia Orgaz, Ram&#243;n L&#243;pez Vicente, Sergio Esteban Guti&#233;rrez Vidal"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "Hans Fred"
                "apellidos" => "Garc&#237;a Araque"
              ]
              1 => array:2 [
                "nombre" => "Oscar"
                "apellidos" => "Valencia Orgaz"
              ]
              2 => array:2 [
                "nombre" => "Ram&#243;n"
                "apellidos" => "L&#243;pez Vicente"
              ]
              3 => array:2 [
                "nombre" => "Sergio Esteban"
                "apellidos" => "Guti&#233;rrez Vidal"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2256208714000273"
          "doi" => "10.1016/j.rcae.2014.02.005"
          "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/S2256208714000273?idApp=UINPBA00004N"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0120334714000252?idApp=UINPBA00004N"
      "url" => "/01203347/0000004200000003/v2_201407240025/S0120334714000252/v2_201407240025/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S2256208714000297"
    "issn" => "22562087"
    "doi" => "10.1016/j.rcae.2014.02.007"
    "estado" => "S300"
    "fechaPublicacion" => "2014-07-01"
    "aid" => "126"
    "copyright" => "Sociedad Colombiana de Anestesiolog&#237;a y Reanimaci&#243;n"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "ssu"
    "cita" => "Rev Colomb Anestesiol. 2014;42:199-204"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 2342
      "formatos" => array:3 [
        "EPUB" => 97
        "HTML" => 1595
        "PDF" => 650
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Review</span>"
      "titulo" => "Anaesthesia in craniosynostosis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "199"
          "paginaFinal" => "204"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Anestesia para craneosinostosis"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "V&#237;ctor Hugo Gonz&#225;lez C&#225;rdenas, Mar&#237;a Victoria Vanegas Mart&#237;nez, Mar&#237;a Elvira Rojas Rueda, Nelly Susana Guevara, Jos&#233; Rolando Prada, Pablo Baquero"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "V&#237;ctor Hugo"
              "apellidos" => "Gonz&#225;lez C&#225;rdenas"
            ]
            1 => array:2 [
              "nombre" => "Mar&#237;a Victoria"
              "apellidos" => "Vanegas Mart&#237;nez"
            ]
            2 => array:2 [
              "nombre" => "Mar&#237;a Elvira"
              "apellidos" => "Rojas Rueda"
            ]
            3 => array:2 [
              "nombre" => "Nelly Susana"
              "apellidos" => "Guevara"
            ]
            4 => array:2 [
              "nombre" => "Jos&#233; Rolando"
              "apellidos" => "Prada"
            ]
            5 => array:2 [
              "nombre" => "Pablo"
              "apellidos" => "Baquero"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0120334714000288"
        "doi" => "10.1016/j.rca.2014.02.003"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0120334714000288?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2256208714000297?idApp=UINPBA00004N"
    "url" => "/22562087/0000004200000003/v2_201407220045/S2256208714000297/v2_201407220045/en/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S2256208714000406"
    "issn" => "22562087"
    "doi" => "10.1016/j.rcae.2014.04.002"
    "estado" => "S300"
    "fechaPublicacion" => "2014-07-01"
    "aid" => "129"
    "copyright" => "Sociedad Colombiana de Anestesiolog&#237;a y Reanimaci&#243;n"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Colomb Anestesiol. 2014;42:184-91"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 3069
      "formatos" => array:3 [
        "EPUB" => 81
        "HTML" => 2479
        "PDF" => 509
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific and Technological Research</span>"
      "titulo" => "Sensitivity&#44; specificity and predictive values of the Goldman&#44; Detsky and Lee cardiac indices"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "184"
          "paginaFinal" => "191"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Sensibilidad&#44; especificidad y valores predictivos de los &#237;ndices cardiacos de Goldman&#44; Detsky y Lee"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig3"
          "etiqueta" => "Fig&#46; 3"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "fuente" => "Source&#58; Authors&#46;"
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr3.jpeg"
              "Alto" => 1183
              "Ancho" => 1500
              "Tamanyo" => 65849
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar1070" class="elsevierStyleSimplePara elsevierViewall">Positive and negative probability ratios of cardiac risk indices&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Hern&#225;n Javier Pantoja Mu&#241;oz, Humberto Fern&#225;ndez Ramos, William Leandro Guevara Tovar"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Hern&#225;n Javier Pantoja"
              "apellidos" => "Mu&#241;oz"
            ]
            1 => array:2 [
              "nombre" => "Humberto Fern&#225;ndez"
              "apellidos" => "Ramos"
            ]
            2 => array:2 [
              "nombre" => "William Leandro Guevara"
              "apellidos" => "Tovar"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0120334714000458"
        "doi" => "10.1016/j.rca.2014.02.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0120334714000458?idApp=UINPBA00004N"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2256208714000406?idApp=UINPBA00004N"
    "url" => "/22562087/0000004200000003/v2_201407220045/S2256208714000406/v2_201407220045/en/main.assets"
  ]
  "en" => array:21 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Review</span>"
    "titulo" => "Airway anatomy for the bronchoscopist&#58; An anesthesia approach"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "192"
        "paginaFinal" => "198"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Hans Fred Garc&#237;a Araque, Oscar Valencia Orgaz, Ram&#243;n L&#243;pez Vicente, Sergio Esteban Guti&#233;rrez Vidal"
        "autores" => array:4 [
          0 => array:3 [
            "nombre" => "Hans Fred"
            "apellidos" => "Garc&#237;a Araque"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Oscar"
            "apellidos" => "Valencia Orgaz"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Ram&#243;n"
            "apellidos" => "L&#243;pez Vicente"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:4 [
            "nombre" => "Sergio Esteban"
            "apellidos" => "Guti&#233;rrez Vidal"
            "email" => array:1 [
              0 => "serguvi472&#64;hotmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:4 [
          0 => array:3 [
            "entidad" => "Cardiovascular Anesthesiologist&#44; Anesthesiology and Resuscitation Department&#44; Hospital Militar Central&#44; Bogot&#225; D&#46;C&#46;&#44; Colombia"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Anesthesiologist&#44; FEA Anesthesiology and Resuscitation Department Hospital 12 de Octubre&#44; Madrid&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Anesthesiologist&#44; DESA&#44; FEA Anesthesiology and Resuscitation Department Hospital 12 de Octubre&#44; Madrid&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Medical Student&#44; Universidad Militar Nueva Granada&#44; Bogot&#225; D&#46;C&#46;&#44; Colombia"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author at</span>&#58; Cra&#46; 57 A N&#250;mero 128 B 91&#44; Bogot&#225;&#44; Colombia&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Anatom&#237;a de la v&#237;a a&#233;rea para el broncoscopista&#46; Una aproximaci&#243;n a la anestesia"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig0010"
        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "fuente" => "<span class="elsevierStyleItalic">Source</span>&#58; Developed by the authors&#46;"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1622
            "Ancho" => 1562
            "Tamanyo" => 112241
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Anatomical variation&#58; tracheal bronchus&#46; The right bronchus emerges superior to the bifurcation of the carina&#46; Congenital anomaly present in 0&#46;33&#37; of the population&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Bronchoscopy is a diagnostic and therapeutic procedure to visualize the airway and its pathological alterations&#46; In the last few decades bronchoscopy has enabled complementary procedures such as biopsies that have been adopted into management protocols for specific groups of patients&#46; Advances in this area have been led by pulmonologists&#44; but fortunately this knowledge has been disseminated and is now part of the training of other specialties like anesthesiology and intensive care&#44;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">1&#44;2</span></a> resulting in a valuable contribution to diagnostic and therapeutic procedures&#46; Several training programs for residents have been forced to include bronchoscopy training into their syllabus as a must-have skill&#46; Currently&#44; fibro-bronchoscopy in anesthesia is key for difficult airway management algorithms&#44; as well as for pulmonary support techniques endorsed by different publications&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methodology</span><p id="par0010" class="elsevierStylePara elsevierViewall">Non-systematic literature review both in English and Spanish&#44; with no time restrictions&#44; using PUBMED&#47;MEDLINE&#44; Science Direct&#44; OVID and SciElo databases&#44; complemented with articles referenced in the above search&#46; The following words were used in English&#58; Bronchoscopy&#44; Anatomy&#44; Airway&#44; and Anesthesia&#44; while in Spanish the terms used were&#58; Broncoscopia&#44; anatom&#237;a&#44; v&#237;a a&#233;rea and anestesia&#46; Both the search and the selection of articles were done independently&#44; with no restrictions as to the type of publication&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Characteristics of the procedure and anesthesia considerations</span><p id="par0015" class="elsevierStylePara elsevierViewall">Knowledge of the upper and lower airway structures&#44; including any anatomical alterations&#44; is critical for a sound diagnostic or therapeutic practice&#46; Particularly when pulmonary insulation is required&#44; proper positioning of the device has to be ensured&#59; otherwise&#44; the surgeon may be challenged with hypoxemia&#44; mechanical complications and surgical technique difficulties&#46;<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">3&#44;4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Bronchoscopy is useful as part of the training in these disciplines and is indicated under different situations &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">In order to undertake bronchoscopy procedures&#44; a complete work team and instrumentation are needed&#44; including as a minimum monitoring devices and crash cart with all the pharmacological tools&#46; The bronchoscope must be carefully operated to prevent breakage of the optical fiber&#46; The recommendation is to lubricate with distilled water and avoid using any gels&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Bronchoscopy may be done orally or nasally<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">5</span></a>&#59; however&#44; the decision to use a nasal approach depends on the associated comorbidities and any potential structural alterations the patient may have&#46; It is critical to identify upper airway hemoptysis to determine the right approach&#46; Several work groups are still debating about the need to administer sedation prior to the procedure&#46;<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">6&#44;7</span></a> The purpose of sedation is to provide patient comfort and to facilitate the job of the bronchoscopist&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">8&#8211;10</span></a> However&#44; a bronchoscopy procedure may be done without sedation&#46;<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">11&#44;12</span></a> However&#44; according to some publications&#44; most bronchoscopies are performed under sedation&#46;<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">13&#8211;16</span></a> Indeed&#44; bronchoscopy is a procedure that causes discomfort in most patients&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Basic on-going monitoring is recommended for any anesthetic procedure including sedation&#46; There is no ideal formula to sedate a patient and sedation regimes should be tailored to the individual patient&#44; his&#47;her comorbidities and the specific type of procedure&#46; Various pharmacological options or combinations of anesthetic agents have been described&#46; One of them is the combination of a short-acting benzodiazepine such as midazolam with opiates&#46;<a class="elsevierStyleCrossRefs" href="#bib0335"><span class="elsevierStyleSup">17&#44;18</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Nerve blocks are seldom performed&#44; unless the anesthesiologist feels it is appropriate&#46; These blocks use local anesthetics such as lidocaine spray&#44; preferably at 2&#8211;4&#37; concentrations&#46;<a class="elsevierStyleCrossRefs" href="#bib0345"><span class="elsevierStyleSup">19&#44;20</span></a> Atropine or glycopyrrolate may be administered prior to the procedure in order to reduce the amount of secretions and to mitigate vagal hyperactivity&#46;<a class="elsevierStyleCrossRefs" href="#bib0355"><span class="elsevierStyleSup">21&#44;22</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Recent advances in various cardiac&#44; thoracic and GI tract surgical techniques have led to the widespread practice of double lumen intubation and the use of the fiber bronchoscope in the OR&#46;<a class="elsevierStyleCrossRefs" href="#bib0365"><span class="elsevierStyleSup">23&#8211;25</span></a> Regardless of the route it is convenient to always follow the same approach and to return to an identifiable structure to avoid confusion&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Airway anatomy and anatomical variations</span><p id="par0055" class="elsevierStylePara elsevierViewall">Two types of recognizable nomenclatures are used to classify the airway&#46; The most common one being the Jackson&#8211;Huber classification that describes and names the divisions in accordance with the anatomic space orientation&#46;<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">26</span></a> The other popular classification is Boyden&#39;s<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">27</span></a> for surgical purposes&#59; this classification numerically divides each zone&#46; Another less popular is the Yamashita Japanese classification&#46;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">28</span></a> The recommendation is to use the Jackson&#8211;Huber classification because it is most widely used and less complex &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Upper airway</span><p id="par0065" class="elsevierStylePara elsevierViewall">A number of general anatomic concepts of the airway are important to remember&#46; The upper airway includes the mouth&#44; the nose&#44; the nasopharynx&#44; the oropharynx&#44; the laryngopharynx and the larynx&#46; All of them are extremely critical in the management of the airway&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The mouth is mainly made up of the tongue and the teeth&#44; which are relevant structures o consider for intubation&#46; The surrounding structures of the mouth are the lips &#40;anterior&#41;&#44; the hard and soft palate &#40;upper&#41;&#44; the floor of the tongue &#40;lower&#41; and the oropharynx &#40;posterior&#41;&#46; The tongue is critical for the establishment of a patent airway&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">The surrounding structures of the nose are the nostrils &#40;anterior&#41;&#44; the nasopharynx &#40;posterior&#41; and they are separated from the oral cavity by the palate&#46; The nasal cavity has three turbinates dividing the space into meatus through which air flows to allow for a decrease in turbulent flow&#44; humidifying and warming-up to limit the injury inflicted to the lower airway&#46;<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">29&#8211;31</span></a> Such approach is seldom used for intubation and accessory procedures due to internal injuries&#44; skull base fractures or any other pathologic process that hinders the passage through this pathway&#46; The lower turbinate and its corresponding meatus are the most important ones since this space allows for a patent airway&#46; The sphenopalatine branch of the maxillary and facial arteries supplies irrigation both give rise to Kiesselbach&#39;s plexus&#44; an area of frequent bleeding&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">The pharynx is divided into three structures&#58; the nasopharynx&#44; the oropharynx and the laryngopharynx&#46;<a class="elsevierStyleCrossRef" href="#bib0410"><span class="elsevierStyleSup">32</span></a> Going through the nasal cavity you find the lower turbinate laterally and the nasal septum medially&#46; When the bronchoscopist examines the nasal cavity the integrity of the mucosa may be assessed&#44; together with potential septal deviations&#44; turbinate hypertrophy or nasal polyposis&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">When introducing the bronchoscope through the oropharynx&#44; it is critical to identify structures such as the tonsils&#44; the palate and the base of the tongue&#46;<a class="elsevierStyleCrossRefs" href="#bib0415"><span class="elsevierStyleSup">33&#8211;35</span></a> Further down you find the laryngopharynx with 3 important identifiable structures&#58; the piriform recess&#44; the post-cricoid region and the posterior wall of the pharynx&#46; The space between the base of the tongue and the anterior margin of the epiglottis<a class="elsevierStyleCrossRefs" href="#bib0430"><span class="elsevierStyleSup">36&#44;37</span></a> is relevant when trying to locate a foreign body&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">The larynx is the communicating structure between the upper and lower airway organs&#46;<a class="elsevierStyleCrossRefs" href="#bib0440"><span class="elsevierStyleSup">38&#44;39</span></a> The vocal folds should be briefly examined in abduction and adduction &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; La Vocal fold dysfunction may be functional or organic&#46; The upper laryngeal nerve and the recurrent laryngeal nerve innervate the vocal folds&#46; Topical anesthesia helps to pass the instruments through the cavity&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Lower airway</span><p id="par0100" class="elsevierStylePara elsevierViewall">The trachea is the initial segment of the lower airway and starts at the level of C6&#46;<a class="elsevierStyleCrossRef" href="#bib0450"><span class="elsevierStyleSup">40</span></a> It is a cartilaginous tube that extends from the cricoid cartilage to the carina&#46;<a class="elsevierStyleCrossRef" href="#bib0455"><span class="elsevierStyleSup">41</span></a> During expiration&#44; the trachea rises up to C4 while in total inspiration it reaches C6&#46; The length of the trachea varies according to age&#46; In neonates it is 3<span class="elsevierStyleHsp" style=""></span>cm&#44; in the pediatric population the range is 7&#8211;10<span class="elsevierStyleHsp" style=""></span>cm<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">42</span></a> and in adults it is approximately 15<span class="elsevierStyleHsp" style=""></span>cm&#46; The diameter is 6<span class="elsevierStyleHsp" style=""></span>mm&#44; 10<span class="elsevierStyleHsp" style=""></span>mm and 13&#8211;22<span class="elsevierStyleHsp" style=""></span>mm respectively&#46; The length of the upper airway does not change with age but the height does&#46; So a 10<span class="elsevierStyleHsp" style=""></span>cm decrease in height represents a 1<span class="elsevierStyleHsp" style=""></span>cm change in the length of the upper airway considering an average height of 1&#46;70<span class="elsevierStyleHsp" style=""></span>m &#40;29<span class="elsevierStyleHsp" style=""></span>cm&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">43</span></a> In adults&#44; the upper airway comprises 16&#8211;20 C-shaped cartilages&#59; the anterolateral wall is united by a tracheal membrane with no cartilage and is supported by the tracheal muscle that allows for extension in response large airflows &#40;Ex&#46; Asthma&#44; COPD&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0220"><span class="elsevierStyleSup">44&#8211;47</span></a> The above diameters vary in accordance with the gender of the patient&#44; as shown by studies of the average diameter&#44; the coronal diameter and the sagittal diameter&#46; The average in men is 22&#44; 13&#8211;25&#44; 13&#8211;17<span class="elsevierStyleHsp" style=""></span>mm&#44; respectively&#44; somewhat larger as compared to women&#58; 19&#44; 10&#8211;21&#44; 10&#8211;23<span class="elsevierStyleHsp" style=""></span>mm&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">48</span></a> The average tracheal wall thickness is 3<span class="elsevierStyleHsp" style=""></span>mm&#46; The trachea is localized in the mid-line&#44; occasionally displaced to the right because of the position of the aortic arch and in elderly patients with morbidities such as COPD that may result in a narrower antero-posterior diameter with subsequent physiological consequences&#46; It is important to examine the integrity of the tracheal mucosa to identify any endotracheal lesions&#44; observe probable deviations caused by masses&#44; the distal trachea at the junction with the carina&#44; since these are potential metastatic areas&#46; In case any lesions are found&#44; both lungs must be examined prior to doing a biopsy&#46; If bleeding is present&#44; the evaluation becomes more difficult because the quality of the fiber-bronchoscopy is compromised&#44; in addition a longer time to complete the procedure&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The trachea bifurcates at the level of the carina into the right and left main bronchi&#59; as the trachea advances the lumen decreases progressively&#46; The bifurcation is localized at the level of T5&#46; The right bronchus is more vertically placed at a 90&#176; angle or less with the trachea&#44; while the left bronchus is more horizontal&#46; In children the carina is usually more displaced to the right and with time it becomes more medial and the angulation tends to be more obtuse&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">2<span class="elsevierStyleHsp" style=""></span>cm and 1&#46;5<span class="elsevierStyleHsp" style=""></span>cm along the length of the right bronchus the right upper bronchus becomes the intermediate bronchus&#46; One out of 300 people have anatomical variants and the upper right lobe emerges on top of the carina &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; Some studies report a prevalence of 0&#46;1&#8211;2&#37; for the upper right lobe and 0&#46;3&#8211;1&#37; for the upper left lobe&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">49</span></a> In some cases you may find a bridge bronchus arising from the left bronchus but ventilates the lower right lobe&#46; A normal variant is any variant that does not obstruct the airflow but this finding is usually incidental&#46; The diameter of this bronchus is 17&#46;5<span class="elsevierStyleHsp" style=""></span>mm in males and 14<span class="elsevierStyleHsp" style=""></span>mm in females&#46; This bronchus divides into apical &#40;B1&#41;&#44; anterior &#40;B2&#41; and posterior &#40;B3&#41;&#46; The anterior and posterior segments are the most frequent sites for bronchial disease&#44; including carcinomas&#46; The apical is divided into posterior &#40;B1a&#41; and anterior &#40;B1b&#41;&#46; The anterior is divided into anterior &#40;B2b&#41; and posterior &#40;B2a&#41;&#44; the posterior into anterior &#40;B3b&#41; and posterior &#40;B3a&#41;&#46; The above description is based on Boyden&#39;s classification but some bronchoscopists use the Japanese Yamashita classification&#44; wherein B2 and B3 are inverted into posterior and anterior&#44; respectively&#46; After generating the right upper lobe bronchus&#44; the right bronchus lobe becomes the intermediate bronchus that extends for approximately 2&#8211;2&#46;5<span class="elsevierStyleHsp" style=""></span>cm and then splits into the middle lobe bronchus and the lower lobe bronchus&#46; The middle lobe bronchus emerges anterolateral with a 1&#8211;2<span class="elsevierStyleHsp" style=""></span>cm length before it divides into lateral &#40;B4&#41; that is visualized at a long distance and medial &#40;B5&#41;&#44; that is visualized more oblique&#46; Both the lateral and the medial divide into anterior and posterior &#40;B4b&#41;&#44; &#40;B4a&#41;&#44; &#40;B5b&#41; and &#40;B5a&#41;&#46; The intermediate bronchus has an oblique shape and runs posterior to the right pulmonary artery and inferior to the right interlobar artery&#46; A cardiac bronchus is a rare congenital anomaly of the intermediate bronchus where the bronchus originates in this segment before giving origin to the lower lobe bronchus that advances into the pericardium&#46; The lower lobe bronchus is divided into upper &#40;B6&#41;&#44; medial basal &#40;B7&#41;&#44; anterior basal &#40;B8&#41;&#44; lateral basal &#40;B9&#41; and posterior &#40;B10&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">With regard to the left lung&#44; it is important to highlight that the division of the bronchi is usually similar if compared to the right lung&#59; however&#44; the left lung may have 8&#8211;10 bronchi&#46; The left source bronchus is more horizontal than the right and tends to go more toward posterior and lateral&#46; The left bronchus is divided into the left upper lobe bronchus and the left lower lobe bronchus&#46; The former &#40;first ramification&#41; is at 5 and 4&#46;5<span class="elsevierStyleHsp" style=""></span>cm from the carina in males and females&#44; respectively &#40;the distance from the carina to the bifurcation between the upper and lower left lobe is in average 6&#8211;8<span class="elsevierStyleHsp" style=""></span>cm in males and 5&#8211;6<span class="elsevierStyleHsp" style=""></span>cm in females&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">50</span></a> The upper left bronchus lobe is divided into the upper division bronchus and the lingular bronchus&#46; The upper division bronchus is divided into apical-posterior &#40;B1&#47;B2&#41; and anterior bronchus &#40;B3&#41; and advances anteriorly accompanied by the anterior segmental artery&#46; The apical&#8211;posterior bronchus may be presented in block or divided into the apical and the posterior segment &#40;B1 and B2&#41;&#46; The lingular bronchus is slightly inferior&#8211;lateral 2&#8211;3<span class="elsevierStyleHsp" style=""></span>cm long and divided into upper &#40;B4&#41; and lower &#40;B5&#41;&#46; The left bronchus of the lower lobe is divided into upper &#40;B6&#41;&#44; anteromedial &#40;B8&#41;&#44; lateral basal &#40;B9&#41;&#44; and posterior basal &#40;B10&#41;&#46; The medial basal segment &#40;B7&#41; may be present in one-third of the population and falls off leaving behind an anterior &#40;B8&#41; and medial &#40;B7&#41; bronchus&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conclusions</span><p id="par0120" class="elsevierStylePara elsevierViewall">The anatomy of the upper airway is extremely important for a sound bronchoscopy technique &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; There are different anatomical variants you should identify and these are common in a certain proportion of the world population&#46; It is important to know the anatomical variations that result in useful physiological differences in practice&#46; Science is constantly evolving&#44; so physicians are required to adopt a culture of on-going education&#44; in addition to the implementation of policies related to patient safety and quality of care&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Funding</span><p id="par0125" class="elsevierStylePara elsevierViewall">None&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflict of interest</span><p id="par0130" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:13 [
        0 => array:2 [
          "identificador" => "xres354040"
          "titulo" => array:5 [
            0 => "Abstract"
            1 => "Introduction"
            2 => "Objective"
            3 => "Methodology"
            4 => "Results and conclusions"
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec335378"
          "titulo" => "Keywords"
        ]
        2 => array:2 [
          "identificador" => "xres354039"
          "titulo" => array:5 [
            0 => "Resumen"
            1 => "Introducci&#243;n"
            2 => "Objetivo"
            3 => "Metodolog&#237;a"
            4 => "Resultados y conclusiones"
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec335379"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Methodology"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Characteristics of the procedure and anesthesia considerations"
        ]
        7 => array:3 [
          "identificador" => "sec0020"
          "titulo" => "Airway anatomy and anatomical variations"
          "secciones" => array:2 [
            0 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Upper airway"
            ]
            1 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Lower airway"
            ]
          ]
        ]
        8 => array:2 [
          "identificador" => "sec0035"
          "titulo" => "Conclusions"
        ]
        9 => array:2 [
          "identificador" => "sec0040"
          "titulo" => "Funding"
        ]
        10 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "Conflict of interest"
        ]
        11 => array:2 [
          "identificador" => "xack87366"
          "titulo" => "Acknowledgements"
        ]
        12 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2013-05-03"
    "fechaAceptado" => "2014-02-02"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec335378"
          "palabras" => array:5 [
            0 => "Bronchoscopy"
            1 => "Anatomy"
            2 => "Airway management"
            3 => "Anesthesia"
            4 => "Pulmonary medicine"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec335379"
          "palabras" => array:5 [
            0 => "Broncoscop&#237;a"
            1 => "Anatom&#237;a"
            2 => "Manejo de la v&#237;a a&#233;rea"
            3 => "Anestesia"
            4 => "Neumolog&#237;a"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Knowledge and the development of skills in airway management is one of the core competencies in the training of the anesthesiologist&#46; &#8220;Know how&#8221; and &#8220;Knowing to do well and fast&#8221; are decisive under certain critical situations that may arise in the management of anesthesia&#46; Bronchoscopy is a useful diagnostic and therapeutic procedure&#46; Knowledge of the technique and airway anatomy is the cornerstone of bronchoscopy&#59; however&#44; there are anatomical variations and different airway classifications&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To describe the airway anatomy by means of schematic representations&#44; to assess anatomical variations and to learn about the characteristics of the procedure&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0020">Methodology</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A non-systematic review of databases &#40;PUBMED&#47;MEDLINE&#44; Science Direct&#44; OVID&#44; SciElo&#41; was undertaken using the following&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0025">Results and conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Bronchoscopy is a useful surgical and diagnostic procedure for different applications&#46; The anatomical variations of the airway are only present in a small percentage of the population&#46; Anatomical classifications are both anatomically and numerically diverse&#59; however&#44; what is really relevant is to develop a spatial relationship&#46; Bronchoscopy is a technique that evolves simultaneously with other technical biomedical breakthroughs and is a procedure that the anesthesiologist must explore further in order to accomplish better outcomes in anesthesia&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El conocimiento y desarrollo de habilidades en el manejo de la v&#237;a a&#233;rea es una de las competencias importantes en la formaci&#243;n del anestesi&#243;logo&#59; el &#8220;saber&#8221; y el &#8220;saber hacer bien y r&#225;pido&#8221; son determinantes en algunas situaciones cr&#237;ticas a las que se puede enfrentar durante el manejo anest&#233;sico&#46; La broncoscopia es un procedimiento &#250;tiltanto diagn&#243;stico como terap&#233;utico&#46; El conocimiento de la t&#233;cnica y de la anatom&#237;a de la v&#237;a a&#233;rea constituye el pilar de la broncoscopia&#44; encontrando diferentes variaciones anat&#243;micas y clasificaciones de la v&#237;a a&#233;rea&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0040">Objetivo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Describir la anatom&#237;a de la v&#237;a a&#233;rea a trav&#233;s de esquemas&#44; evaluar variaciones anat&#243;micas y conocer caracter&#237;sticas propias del procedimiento&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0045">Metodolog&#237;a</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Con las palabras clave &#8220;Bronchoscopy&#8221;&#44; &#8220;Anatomy&#8221;&#44; &#8220;Airway&#8221; y &#8220;Anesthesia&#8221; se realiz&#243; una revisi&#243;n no sistem&#225;tica en bases de datos &#40;PUBMED&#47;MEDLINE&#44; Science Direct&#44; OVID&#44; SciElo&#41;&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0050">Resultados y conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La broncoscopia es un procedimiento &#250;til en el plano quir&#250;rgico y diagn&#243;stico&#44; siendo utilizado en distintos procedimientos&#46; Las variaciones anat&#243;micas de la v&#237;a a&#233;rea se presentan en un porcentaje peque&#241;o de la poblaci&#243;n&#46; Las clasificaciones anat&#243;micas son diversas tanto anat&#243;mica como num&#233;ricamente&#59; sin embargo&#44; lo relevante es desarrollar una relaci&#243;n espacial&#46; La broncoscopia es una t&#233;cnica que va en desarrollo paralelo a otros avances de la tecnolog&#237;a biom&#233;dica&#44; es un procedimiento del cual el anestesi&#243;logo debe investigar m&#225;s con el fin de generar mejores efectos en el campo de la anestesiolog&#237;a&#46;</p>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Garc&#237;a Araque HF&#44; Valencia Orgaz O&#44; L&#243;pez Vicente R&#44; Guti&#233;rrez Vidal SE&#46; Anatom&#237;a de la v&#237;a a&#233;rea para el broncoscopista&#46; Una aproximaci&#243;n a la anestesia&#46; Rev Colomb Anestesiol&#46; 2014&#59;42&#58;192&#8211;198&#46;</p>"
      ]
    ]
    "multimedia" => array:5 [
      0 => array:8 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "fuente" => "<span class="elsevierStyleItalic">Source</span>&#58; Developed by the authors&#46;"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 964
            "Ancho" => 2332
            "Tamanyo" => 208441
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Bronchoscopy Hospital Militar Central&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "fig0010"
        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "fuente" => "<span class="elsevierStyleItalic">Source</span>&#58; Developed by the authors&#46;"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1622
            "Ancho" => 1562
            "Tamanyo" => 112241
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Anatomical variation&#58; tracheal bronchus&#46; The right bronchus emerges superior to the bifurcation of the carina&#46; Congenital anomaly present in 0&#46;33&#37; of the population&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "fig0015"
        "etiqueta" => "Fig&#46; 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "fuente" => "<span class="elsevierStyleItalic">Source</span>&#58; Developed by the authors&#46;"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 2616
            "Ancho" => 3167
            "Tamanyo" => 489940
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Bronchoscopy &#8211; airway anatomy&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "fuente" => "<span class="elsevierStyleItalic">Source</span>&#58; Authors&#46;"
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Symptoms investigation</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8226; Hemoptysis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8226; Persistent coughing&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8226; Recurrent infection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Suspicion of neoplasm</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8226; Unexplained vocal folds paralysis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8226; Estridor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8226; Monophonic wheezing&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8226; Suspicious sputum cytology&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8226; Unexplained pleural effusion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Cancer staging</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8226; Tissue diagnosis &#40;pathology&#41; and staging&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Infection</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8226; Identification of microorganisms&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8226; Bronchiectasis&#47;lobar collapse&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Interstitial lung disease</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8226; Bronchoalveolar lavage &#40;cell count difference&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Therapeutic and palliative</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8226; Cleaning of secretions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8226; Foreign body removal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8226; Neoplasm treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8226; Endotracheal ablation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8226; Airway disease treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab528992.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Indications for flexible bronchoscopy&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "fuente" => "<span class="elsevierStyleItalic">Source</span>&#58; Authors&#46;"
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Anatomical nomenclature&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Numeric system&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Subsequent division&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Usual variations&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Right lung</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Upper lobe</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Apical&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">a and b&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;B1&#41; May be absent of derived from B2 or B3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Posterior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">a and b&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Anterior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">a and b&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Middle lobe</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Lateral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">a and b&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">May have an upper&#47;lower division similar to the lingula&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Medial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">a and b&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Lower lobe</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Upper&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">a&#44; b and c&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Basal medial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">a and b&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;B7&#41; Occasionally is an additional cardiac accessory branch&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Basal anterior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">a and b&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;B8&#41; The basal bronchus is the most frequent variation in the right lung&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Basal lateral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">a and b&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Basal posterior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">a&#44; b and c&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">Left lung</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Upper lobe</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Apical-posterior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B1<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">a&#44; b and c&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">May have a carina separating B1&#44; B2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Anterior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">a&#44; b and c&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Superior lingular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">a and b&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Inferior lingular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">a and b&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Lower lobe</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Upper&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">a&#44; b and c&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;B8&#41; May have a supernumerary medial bronchus &#40;B7&#41; with a separate anterior bronchus &#40;B8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Basal anteromedial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">a and b&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;B10&#41; May trifurcate into a&#44; b and c&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Basal lateral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">a and b&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Basal posterior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">a and b&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab528991.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Nomenclature and anatomical variations&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:50 [
            0 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Gu&#237;a para la intubaci&#243;n con fibrobroncoscopio en un Hospital Universitario"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46; Lema"
                            1 => "H&#46; Medina"
                            2 => "C&#46; Gonz&#225;lez"
                            3 => "C&#46;E&#46; Hoyos"
                            4 => "L&#46;A&#46; Tafur"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Colomb Anestesiol"
                        "fecha" => "2012"
                        "volumen" => "40"
                        "paginaInicial" => "60"
                        "paginaFinal" => "66"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Consideraciones anest&#233;sicas para procedimientos de neumolog&#237;a intervencionista"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46;E&#46; Barato"
                            1 => "A&#46; Bernal"
                            2 => "F&#46;B&#46; Carvajal"
                            3 => "C&#46; Giraldo"
                            4 => "F&#46; Echeverri"
                            5 => "D&#46;A&#46; Mart&#237;nez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Colomb Anestesiol"
                        "fecha" => "2011"
                        "volumen" => "39"
                        "paginaInicial" => "316"
                        "paginaFinal" => "328"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Role of fiberoptic bronchoscopy in conjunction with the use of double-lumen tubes for thoracic anesthesia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "U&#46; Klein"
                            1 => "W&#46; Karzai"
                            2 => "F&#46; Bloos"
                            3 => "M&#46; Wohlfarth"
                            4 => "R&#46; Gottschall"
                            5 => "H&#46; Fritz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Anesthesiology"
                        "fecha" => "1998"
                        "volumen" => "88"
                        "paginaInicial" => "346"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9477054"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effects of endobronchial cuff inflation on double-lumen endobronchial tube movement after lateral positioning"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "D&#46;P&#46; Desiderio"
                            1 => "M&#46; Burt"
                            2 => "A&#46;C&#46; Kolver"
                            3 => "M&#46;E&#46; Fischer"
                            4 => "R&#46; Reinsel"
                            5 => "R&#46;S&#46; Wilson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Cardiothorac Vasc Anesth"
                        "fecha" => "1997"
                        "volumen" => "11"
                        "paginaInicial" => "595"
                        "paginaFinal" => "598"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9263092"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Controversies in bronchoscopy nasal versus oral insertion of the flexible bronchoscope&#58; Pronasal insertion"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46;C&#46; Mehta"
                            1 => "R&#46;A&#46; Dweik"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Bronchol"
                        "fecha" => "1996"
                        "volumen" => "3"
                        "paginaInicial" => "224"
                        "paginaFinal" => "248"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is sedation necessary for bronchoscopy&#63; Con sedation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "H&#46;G&#46; Colt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Bronchol"
                        "fecha" => "1994"
                        "volumen" => "1"
                        "paginaInicial" => "250"
                        "paginaFinal" => "253"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Should patients undergoing a bronchoscopy be sedated&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Gonzalez"
                            1 => "I&#46; De-la-Rosa-Ramirez"
                            2 => "A&#46; Maldonado-Hernandez"
                            3 => "G&#46; Dominguez-Cherit"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Acta Anaesthesiol Scand"
                        "fecha" => "2003"
                        "volumen" => "47"
                        "paginaInicial" => "411"
                        "paginaFinal" => "415"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12694138"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0210480611003925"
                          "estado" => "S300"
                          "issn" => "02104806"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Don&#8217;t lose the forest for the trees&#58; Satisfaction and success in bronchoscopy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46;C&#46; Mehta"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/rccm.200208-895IE"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2002"
                        "volumen" => "166"
                        "paginaInicial" => "1306"
                        "paginaFinal" => "1307"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12421737"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effect of gender on compensatory neuromuscular response to upper airway obstruction in normal subjects under midazolam general anesthesia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Ayuse"
                            1 => "Y&#46; Hoshino"
                            2 => "S&#46; Kurata"
                            3 => "T&#46; Ayuse"
                            4 => "H&#46; Schneider"
                            5 => "J&#46;P&#46; Kirkness"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1213/ane.0b013e3181b0fc70"
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesth Analg"
                        "fecha" => "2009"
                        "volumen" => "109"
                        "paginaInicial" => "1209"
                        "paginaFinal" => "1218"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19762751"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Assessment of upper airway anatomy in awake&#44; sedated and anaesthetised patients using magnetic resonance imaging"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46;D&#46; Shorten"
                            1 => "N&#46;J&#46; Opie"
                            2 => "P&#46; Graziotti"
                            3 => "I&#46; Morris"
                            4 => "M&#46; Khangure"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Anaesth Intensive Care"
                        "fecha" => "1994"
                        "volumen" => "22"
                        "paginaInicial" => "165"
                        "paginaFinal" => "169"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7880227"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fiberoptic bronchoscopy&#58; Is sedation necessary&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46; Pearce"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "1980"
                        "volumen" => "281"
                        "paginaInicial" => "179"
                        "paginaFinal" => "180"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fiberoptic bronchoscopy without premedication&#46; A retrospective study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H&#46;G&#46; Colt"
                            1 => "J&#46;F&#46; Morris"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1990"
                        "volumen" => "98"
                        "paginaInicial" => "1327"
                        "paginaFinal" => "1330"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2245669"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0022534709031826"
                          "estado" => "S300"
                          "issn" => "00225347"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0315"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bronchoscopy in North America&#58; The ACCP survey"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "U&#46;B&#46; Prakash"
                            1 => "K&#46;P&#46; Offord"
                            2 => "S&#46;E&#46; Stubbs"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1991"
                        "volumen" => "100"
                        "paginaInicial" => "1668"
                        "paginaFinal" => "1675"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1959412"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0320"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Preparation of the patient for awake flexible bronchoscopy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46; Reed"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1992"
                        "volumen" => "101"
                        "paginaInicial" => "244"
                        "paginaFinal" => "253"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1729077"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0325"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dexmedetomidina para sedaci&#243;n durante intubaci&#243;n dif&#237;cil con fibrobroncoscopia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46;M&#46; Torres"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Colomb Anestesiol"
                        "fecha" => "2006"
                        "volumen" => "34"
                        "paginaInicial" => "55"
                        "paginaFinal" => "56"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0330"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dexmedetomidine for conscious sedation in difficult awake fiberoptic intubation cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "S&#46;D&#46; Bergese"
                            1 => "B&#46; Khabiri"
                            2 => "W&#46;D&#46; Roberts"
                            3 => "M&#46;B&#46; Howie"
                            4 => "T&#46;D&#46; McSweeney"
                            5 => "M&#46;A&#46; Gerhardt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jclinane.2006.07.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Anesth"
                        "fecha" => "2007"
                        "volumen" => "19"
                        "paginaInicial" => "141"
                        "paginaFinal" => "144"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17379129"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0335"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cough suppression during flexible bronchoscopy using combined sedation with midazolam and hydrocodone&#58; A randomized&#44; double-blind&#44; placebo-controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "D&#46; Stolz"
                            1 => "P&#46;N&#46; Chhajed"
                            2 => "J&#46;D&#46; Leuppi"
                            3 => "M&#46; Brutsche"
                            4 => "E&#46; Pflimlin"
                            5 => "M&#46; Tamm"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/thx.2003.019836"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2004"
                        "volumen" => "59"
                        "paginaInicial" => "773"
                        "paginaFinal" => "776"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15333854"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0340"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An update on sedation and analgesia during flexible bronchoscopy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "B&#46;D&#46; Vincent"
                            1 => "G&#46;A&#46; Silvestri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Bronchol"
                        "fecha" => "2007"
                        "volumen" => "14"
                        "paginaInicial" => "173"
                        "paginaFinal" => "180"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0345"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Topical nasal anesthesia for fiberoptic bronchoscopy&#58; Patients&#8217; preference for lignocaine gel"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46;R&#46; Webb"
                            1 => "M&#46;A&#46; Woodhead"
                            2 => "H&#46;R&#46; Dalton"
                            3 => "J&#46;A&#46; Grigg"
                            4 => "F&#46;J&#46; Millard"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "1989"
                        "volumen" => "44"
                        "paginaInicial" => "674"
                        "paginaFinal" => "675"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2799746"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0350"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Topical anesthesia of the nasal mucosa for fiberoptic airway endoscopy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46; Randell"
                            1 => "A&#46; Yli-Hankala"
                            2 => "H&#46; Valli"
                            3 => "L&#46; Lindgren"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Anaesth"
                        "fecha" => "1992"
                        "volumen" => "68"
                        "paginaInicial" => "164"
                        "paginaFinal" => "167"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1540458"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0355"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An audit of bronchoscopy practice in the United Kingdom&#58; A survey of adherence to national guide lines"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46; Honeybourne"
                            1 => "C&#46; Neuman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "1997"
                        "volumen" => "52"
                        "paginaInicial" => "709"
                        "paginaFinal" => "713"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9337830"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0360"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anticholonergic premedication for fiberoptic bronchoscopy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Roffe"
                            1 => "M&#46;J&#46; Smith"
                            2 => "G&#46;S&#46; Basran"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Monaldi Arch Chest Dis"
                        "fecha" => "1994"
                        "volumen" => "49"
                        "paginaInicial" => "101"
                        "paginaFinal" => "106"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8049691"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0365"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Progress in lung separation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;H&#46; Campos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Thorac Surg Clin"
                        "fecha" => "2005"
                        "volumen" => "75"
                        "paginaInicial" => "71"
                        "paginaFinal" => "83"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0370"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Flexible bronchoscopy&#58; A safe method for metal stent implantation in bronchial disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46; Hautmann"
                            1 => "M&#46; Bauer"
                            2 => "K&#46;J&#46; Pfeifer"
                            3 => "R&#46;M&#46; Huber"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Thorac Surg"
                        "fecha" => "2000"
                        "volumen" => "69"
                        "paginaInicial" => "398"
                        "paginaFinal" => "401"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10735670"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0375"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "High frequency jet ventilation in interventional fiberoptic bronchoscopy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46; Hautmann"
                            1 => "F&#46; Gamarra"
                            2 => "M&#46; Henke"
                            3 => "S&#46; Diehm"
                            4 => "R&#46;M&#46; Huber"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesth Analg"
                        "fecha" => "2000"
                        "volumen" => "90"
                        "paginaInicial" => "1436"
                        "paginaFinal" => "1440"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10825336"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0380"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Committee on anatomical nomenclature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46;A&#46; Boyden"
                            1 => "S&#46;L&#46; Clark"
                            2 => "C&#46;H&#46; Danforth"
                            3 => "W&#46;W&#46; Greulich"
                            4 => "G&#46;W&#46; Corner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1126/science.96.2483.116"
                      "Revista" => array:5 [
                        "tituloSerie" => "Science"
                        "fecha" => "1942"
                        "volumen" => "96"
                        "paginaInicial" => "116"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17809984"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0385"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Correlated anatomy of the bronchial tree and lungs with a system of nomenclature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;L&#46; Jackson"
                            1 => "J&#46;F&#46; Huber"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Dis Chest"
                        "fecha" => "1943"
                        "volumen" => "9"
                        "paginaInicial" => "319"
                        "paginaFinal" => "326"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0390"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Roentgenologic Anatomy of the Lung"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "H&#46; Yamashita"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "edicion" => "1st ed&#46;"
                        "fecha" => "1978"
                        "editorial" => "Igaku-Shoin"
                        "editorialLocalizacion" => "Tokyo"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0395"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anatomy and physiology of the upper airway"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;S&#46; Isaacs"
                            1 => "J&#46;M&#46; Sykes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Anesthesiol Clin North Am"
                        "fecha" => "2002"
                        "volumen" => "20"
                        "paginaInicial" => "733"
                        "paginaFinal" => "745"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0400"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparative anatomy&#44; physiology&#44; and function of the upper respiratory tract"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "G&#46;K&#46; Reznik"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Environ Health Perspect"
                        "fecha" => "1990"
                        "volumen" => "85"
                        "paginaInicial" => "171"
                        "paginaFinal" => "176"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2384061"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S147020450770284X"
                          "estado" => "S300"
                          "issn" => "14702045"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0405"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Development&#44; structure and function of the upper airways"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46; Pohunek"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.prrv.2003.09.002"
                      "Revista" => array:6 [
                        "tituloSerie" => "Paediatr Respir Rev"
                        "fecha" => "2004"
                        "volumen" => "5"
                        "paginaInicial" => "2"
                        "paginaFinal" => "8"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15222948"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0410"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Brimabombe JR&#46; Anatomy&#46; 2nd ed&#46; Philadelphia&#58; Elsevier&#59; 2005&#46; p&#46; 73&#8211;104&#46;"
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0415"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lung defense mechanisms"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "G&#46;M&#46; Green"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Med Clin North Am"
                        "fecha" => "1973"
                        "volumen" => "57"
                        "paginaInicial" => "547"
                        "paginaFinal" => "562"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4573460"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0420"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lung defense mechanisms &#40;first of two parts&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Newhouse"
                            1 => "J&#46; Sanchis"
                            2 => "J&#46; Bienenstock"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM197610282951805"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1976"
                        "volumen" => "295"
                        "paginaInicial" => "990"
                        "paginaFinal" => "998"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/787790"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0425"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The unexpected difficult airway and lingual tonsil hyperplasia&#58; A case series and a review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Ovassapian"
                            1 => "R&#46; Glassenberg"
                            2 => "G&#46;I&#46; Randel"
                            3 => "A&#46; Klock"
                            4 => "P&#46;S&#46; Mesnick"
                            5 => "J&#46;M&#46; Klafta"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesthesiology"
                        "fecha" => "2002"
                        "volumen" => "97"
                        "paginaInicial" => "124"
                        "paginaFinal" => "132"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12131113"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0430"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Functional anatomy of the larynx"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;T&#46; Roberts"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Int Anesthesiol Clin"
                        "fecha" => "1990"
                        "volumen" => "28"
                        "paginaInicial" => "101"
                        "paginaFinal" => "105"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2185987"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0435"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Laryngeal anatomy and physiology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "L&#46;G&#46; Petcu"
                            1 => "C&#46;T&#46; Sasaki"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Clin Chest Med"
                        "fecha" => "1991"
                        "volumen" => "12"
                        "paginaInicial" => "415"
                        "paginaFinal" => "423"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1934946"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S014067361061389X"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0440"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Fundamentals of Tracheal Intubation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Roberts"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "1983"
                        "editorial" => "Grune &#38; Stratton"
                        "editorialLocalizacion" => "New York"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0445"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An anatomic study of the external laryngeal framework with surgical implications"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46;Z&#46; Meiteles"
                            1 => "P&#46;T&#46; Lin"
                            2 => "E&#46;J&#46; Wenk"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Otolaryngol Head Neck Surg"
                        "fecha" => "1992"
                        "volumen" => "106"
                        "paginaInicial" => "235"
                        "paginaFinal" => "240"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1589212"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib0450"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anatomy&#44; pathology&#44; and physiology of the tracheobronchial tree&#58; Emphasis on the distal airways"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46;M&#46; Hyde"
                            1 => "Q&#46; Hamid"
                            2 => "C&#46;G&#46; Irvin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaci.2009.08.048"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "2009"
                        "volumen" => "124"
                        "paginaInicial" => "S72"
                        "paginaFinal" => "S77"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19962039"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib0455"
              "etiqueta" => "41"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Imaging of the large airways"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46;M&#46; Boiselle"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Clin Chest Med"
                        "fecha" => "2008"
                        "volumen" => "29"
                        "paginaInicial" => "18"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "42"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Elongation of the trachea during neck extension in children&#58; implications of the safety of endotracheal tubes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Jin-Hee"
                            1 => "Y&#46;J&#46; Ro"
                            2 => "M&#46; Seong-Won"
                            3 => "K&#46; Chong-Soo"
                            4 => "K&#46; Seong-Deok"
                            5 => "J&#46;H&#46; Lee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1213/01.ane.0000169330.92707.1e"
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesth Analg"
                        "fecha" => "2005"
                        "volumen" => "101"
                        "paginaInicial" => "974"
                        "paginaFinal" => "977"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16192505"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            42 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "43"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Depth of placement of left double-lumen tubes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;B&#46; Brodsky"
                            1 => "J&#46;L&#46; Benumof"
                            2 => "J&#46; Ehrenworth"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesth Analg"
                        "fecha" => "1991"
                        "volumen" => "73"
                        "paginaInicial" => "570"
                        "paginaFinal" => "576"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1952136"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            43 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "44"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anatomy of the trachea&#44; carina and bronchi"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46;J&#46; Minnich"
                            1 => "D&#46;J&#46; Mathisen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.thorsurg.2006.12.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorac Surg Clin"
                        "fecha" => "2007"
                        "volumen" => "17"
                        "paginaInicial" => "571"
                        "paginaFinal" => "585"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18271170"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            44 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "45"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "CT virtual endoscopy in the evaluation of large airway disease&#58; review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "B&#46;P&#46; Thomas"
                            1 => "M&#46;K&#46; Strother"
                            2 => "E&#46;F&#46; Donnelly"
                            3 => "J&#46;A&#46; Worrell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2214/AJR.07.7077"
                      "Revista" => array:6 [
                        "tituloSerie" => "AJR Am J Roentgenol"
                        "fecha" => "2009"
                        "volumen" => "192"
                        "paginaInicial" => "S20"
                        "paginaFinal" => "S30"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19234286"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            45 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "46"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Remodeling in asthma and chronic obstructive lung disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46;K&#46; Jeffery"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm.164.supplement_2.2106061"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Respir Crit Care Med"
                        "fecha" => "2001"
                        "volumen" => "164"
                        "paginaInicial" => "S28"
                        "paginaFinal" => "S38"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11734464"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            46 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "47"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Airway remodeling measured by multidetector CT is increased in severe asthma and correlates with pathology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;S&#46; Aysola"
                            1 => "E&#46;A&#46; Hoffman"
                            2 => "D&#46; Gierada"
                            3 => "S&#46; Wenzel"
                            4 => "J&#46; Cook-Granroth"
                            5 => "J&#46; Tarsi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.07-2779"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2008"
                        "volumen" => "134"
                        "paginaInicial" => "1183"
                        "paginaFinal" => "1191"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18641116"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            47 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "48"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The relationship between the diameters of the adult cricoid ring and main tracheobronchial tree&#58; a cadaver study to investigate the basis for double-lumen tube selection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46;H&#46; Seymour"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Cardiothorac Vasc Anesth"
                        "fecha" => "2003"
                        "volumen" => "17"
                        "paginaInicial" => "299"
                        "paginaFinal" => "301"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12827574"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            48 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "49"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Major anatomical variations of the tracheobronchial tree&#58; bronchoscopic observation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "U&#46; Gonlugur"
                            1 => "T&#46; Efeoglu"
                            2 => "M&#46; Kaptanoglu"
                            3 => "I&#46; Akkurt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1447-073x.2005.00104.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Anat Sci Int"
                        "fecha" => "2005"
                        "volumen" => "80"
                        "paginaInicial" => "111"
                        "paginaFinal" => "115"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15960317"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            49 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "50"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Margin of safety in positioning modern double-lumen endotracheal tubes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;L&#46; Benumof"
                            1 => "B&#46;L&#46; Partridge"
                            2 => "C&#46; Salvatierra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Anesthesiology"
                        "fecha" => "1985"
                        "volumen" => "67"
                        "paginaInicial" => "729"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3674473"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack87366"
        "titulo" => "Acknowledgements"
        "texto" => "<p id="par0140" class="elsevierStylePara elsevierViewall">Dr&#46; Gloria Guti&#233;rrez&#44; Javier Fabricio Guillen Olaya and Johani Pedraza Torres&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/22562087/0000004200000003/v2_201407220045/S2256208714000273/v2_201407220045/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "34050"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Review articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/22562087/0000004200000003/v2_201407220045/S2256208714000273/v2_201407220045/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2256208714000273?idApp=UINPBA00004N"
]

Article information

ISSN: 22562087
Original language: English

DOI:10.1016/j.rcae.2014.02.005

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	42	2	44
2024 October	240	18	258
2024 September	328	16	344
2024 August	235	26	261
2024 July	233	24	257
2024 June	114	11	125
2024 May	111	18	129
2024 April	143	45	188
2024 March	172	24	196
2024 February	198	23	221
2024 January	229	31	260
2023 December	202	22	224
2023 November	276	42	318
2023 October	310	31	341
2023 September	211	39	250
2023 August	163	19	182
2023 July	127	14	141
2023 June	127	12	139
2023 May	152	21	173
2023 April	122	7	129
2023 March	77	12	89
2023 February	69	11	80
2023 January	69	10	79
2022 December	69	16	85
2022 November	69	11	80
2022 October	86	18	104
2022 September	97	23	120
2022 August	131	18	149
2022 July	102	22	124
2022 June	93	20	113
2022 May	91	29	120
2022 April	107	26	133
2022 March	124	27	151
2022 February	101	10	111
2022 January	89	18	107
2021 December	110	22	132
2021 November	90	11	101
2021 October	146	26	172
2021 September	88	21	109
2021 August	100	24	124
2021 July	58	15	73
2021 June	83	19	102
2021 May	131	16	147
2021 April	175	50	225
2021 March	164	62	226
2021 February	100	33	133
2021 January	120	36	156
2020 December	75	32	107
2020 November	95	21	116
2020 October	71	27	98
2020 September	81	33	114
2020 August	75	20	95
2020 July	63	30	93
2020 June	34	13	47
2020 May	42	23	65
2020 April	36	12	48
2020 March	58	20	78
2020 February	72	12	84
2020 January	64	14	78
2019 December	53	5	58
2019 November	29	9	38
2019 October	30	11	41
2019 September	10	1	11
2019 August	3	2	5
2019 July	2	9	11
2019 June	2	4	6
2019 May	0	10	10
2019 April	1	0	1
2018 September	1	0	1
2018 July	1	0	1
2018 June	40	0	40
2018 May	267	10	277
2018 April	342	10	352
2018 March	302	15	317
2018 February	205	16	221
2018 January	138	15	153
2017 December	154	7	161
2017 November	165	7	172
2017 October	227	11	238
2017 September	199	6	205
2017 August	238	8	246
2017 July	219	4	223
2017 June	212	24	236
2017 May	209	13	222
2017 April	187	10	197
2017 March	211	10	221
2017 February	204	6	210
2017 January	231	10	241
2016 December	274	13	287
2016 November	378	10	388
2016 October	412	21	433
2016 September	414	20	434
2016 August	382	25	407
2016 July	179	12	191
2016 June	0	29	29
2016 May	4	23	27
2016 April	6	20	26
2016 March	11	33	44
2016 February	3	0	3
2016 January	1	18	19
2015 December	69	15	84
2015 November	208	18	226
2015 October	235	20	255
2015 September	179	21	200
2015 August	212	9	221
2015 July	318	22	340
2015 June	194	11	205
2015 May	115	11	126
2015 April	136	10	146
2015 March	152	19	171
2015 February	159	9	168
2015 January	109	7	116
2014 December	107	18	125
2014 November	115	10	125
2014 October	124	14	138
2014 September	93	19	112
2014 August	102	19	121
2014 July	182	32	214

Show all

Indexed in:

Follow us:

Statistics

Indexed in:

Follow us:

Statistics

Subscribe to our newsletter