Corresponding author at: Cll 119 # 7-75 Departamento de Anestesiología, Fundación Santa Fe de Bogotá, Bogotá, DC, Colombia.
was read the article
array:24 [ "pii" => "S2256208714001126" "issn" => "22562087" "doi" => "10.1016/j.rcae.2014.10.001" "estado" => "S300" "fechaPublicacion" => "2015-01-01" "aid" => "171" "copyright" => "Sociedad Colombiana de Anestesiología y Reanimación" "copyrightAnyo" => "2012" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Rev Colomb Anestesiol. 2015;43:76-86" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3600 "formatos" => array:3 [ "EPUB" => 91 "HTML" => 2995 "PDF" => 514 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0120334714001300" "issn" => "01203347" "doi" => "10.1016/j.rca.2014.09.005" "estado" => "S300" "fechaPublicacion" => "2015-01-01" "aid" => "171" "copyright" => "Sociedad Colombiana de Anestesiología y Reanimación" "documento" => "article" "licencia" => "http://creativecommons.org/licenses/by-nc-nd/3.0/" "subdocumento" => "fla" "cita" => "Rev Colomb Anestesiol. 2015;43:76-86" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 9520 "formatos" => array:3 [ "EPUB" => 98 "HTML" => 4813 "PDF" => 4609 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Investigación científica y tecnológica</span>" "titulo" => "Canalización venosa yugular interna: ¿qué tanta seguridad podemos llegar a ofrecer?" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "76" "paginaFinal" => "86" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Internal jugular vein cannulation: How much safety can we offer?" ] ] "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" => "fig0040" "etiqueta" => "Figura 8" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr8.jpeg" "Alto" => 1003 "Ancho" => 2500 "Tamanyo" => 174062 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">Valoración ecográfica doppler pulsado. A)<span class="elsevierStyleHsp" style=""></span>Vaso arterial; la masa globular se acerca al transductor generando un espectro positivo de alta velocidad (en este caso 30<span class="elsevierStyleHsp" style=""></span>cm/s). B)<span class="elsevierStyleHsp" style=""></span>Vaso venoso; se visualiza un espectro negativo de baja velocidad (en este caso −10<span class="elsevierStyleHsp" style=""></span>cm/s) correspondiente al flujo de masa globular que se aleja del transductor.</p> <p id="spar0130" class="elsevierStyleSimplePara elsevierViewall">Fuente: autores.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "William F. Amaya Zuñiga, Fernando Raffán Sanabria, Claudia Niño de Mejía, Eduardo Hermida, Jorge Alvarado Sánchez, María Conchita Solórzano, Raphael Hernando Parrado Rodriguez, Leonardo José León Nuñez" "autores" => array:8 [ 0 => array:2 [ "nombre" => "William F." "apellidos" => "Amaya Zuñiga" ] 1 => array:2 [ "nombre" => "Fernando" "apellidos" => "Raffán Sanabria" ] 2 => array:2 [ "nombre" => "Claudia" "apellidos" => "Niño de Mejía" ] 3 => array:2 [ "nombre" => "Eduardo" "apellidos" => "Hermida" ] 4 => array:2 [ "nombre" => "Jorge" "apellidos" => "Alvarado Sánchez" ] 5 => array:2 [ "nombre" => "María Conchita" "apellidos" => "Solórzano" ] 6 => array:2 [ "nombre" => "Raphael Hernando" "apellidos" => "Parrado Rodriguez" ] 7 => array:2 [ "nombre" => "Leonardo José" "apellidos" => "León Nuñez" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2256208714001126" "doi" => "10.1016/j.rcae.2014.10.001" "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/S2256208714001126?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0120334714001300?idApp=UINPBA00004N" "url" => "/01203347/0000004300000001/v2_201706012200/S0120334714001300/v2_201706012200/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2256208714000741" "issn" => "22562087" "doi" => "10.1016/j.rcae.2014.06.004" "estado" => "S300" "fechaPublicacion" => "2015-01-01" "aid" => "149" "copyright" => "Sociedad Colombiana de Anestesiología y Reanimación" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Rev Colomb Anestesiol. 2015;43:87-94" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2362 "formatos" => array:3 [ "EPUB" => 89 "HTML" => 1729 "PDF" => 544 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific and Technological Research</span>" "titulo" => "Cost/effectiveness evaluation of three fixed combinations of acetaminophen and opioids in the management of acute pain in Colombia" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "87" "paginaFinal" => "94" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Evaluación de costo/efectividad de tres combinaciones fijas de acetaminofén y opiáceos para el manejo del dolor agudo en Colombia" ] ] "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" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Authors" "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2170 "Ancho" => 1625 "Tamanyo" => 214300 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">A) Codeine/Acet vs. hydrocodone/Acet. B) Codeine/Acet vs. tramadol/Acet.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Rafael Alfonso Cristancho, Andres I. Vecino, Juan Diego Misas" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Rafael Alfonso" "apellidos" => "Cristancho" ] 1 => array:2 [ "nombre" => "Andres I." "apellidos" => "Vecino" ] 2 => array:2 [ "nombre" => "Juan Diego" "apellidos" => "Misas" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S012033471400080X" "doi" => "10.1016/j.rca.2014.05.006" "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/S012033471400080X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2256208714000741?idApp=UINPBA00004N" "url" => "/22562087/0000004300000001/v1_201501210932/S2256208714000741/v1_201501210932/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2256208714001138" "issn" => "22562087" "doi" => "10.1016/j.rcae.2014.10.002" "estado" => "S300" "fechaPublicacion" => "2015-01-01" "aid" => "172" "copyright" => "Sociedad Colombiana de Anestesiología y Reanimación" "documento" => "article" "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "fla" "cita" => "Rev Colomb Anestesiol. 2015;43:68-75" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1985 "formatos" => array:3 [ "EPUB" => 86 "HTML" => 1549 "PDF" => 350 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific and Technological Research</span>" "titulo" => "Effectiveness of a program for improving teamwork in Operanting Rooms" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "68" "paginaFinal" => "75" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Efectividad de un programa para mejorar el trabajo en equipo en salas de cirugía" ] ] "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" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Authors." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1450 "Ancho" => 2427 "Tamanyo" => 261294 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">General structure of the intervention program for improving teamwork in the OR and the obstetric suite.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ana Carolina Amaya-Arias, Douglas Idarraga, Vanessa Giraldo, Luz María Gómez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Ana Carolina" "apellidos" => "Amaya-Arias" ] 1 => array:2 [ "nombre" => "Douglas" "apellidos" => "Idarraga" ] 2 => array:2 [ "nombre" => "Vanessa" "apellidos" => "Giraldo" ] 3 => array:2 [ "nombre" => "Luz María" "apellidos" => "Gómez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0120334714001312" "doi" => "10.1016/j.rca.2014.09.006" "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/S0120334714001312?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2256208714001138?idApp=UINPBA00004N" "url" => "/22562087/0000004300000001/v1_201501210932/S2256208714001138/v1_201501210932/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Scientific and Technological Research</span>" "titulo" => "Internal jugular vein cannulation: How much safety can we offer?" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "76" "paginaFinal" => "86" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "William F. Amaya Zuñiga, Fernando Raffán Sanabria, Claudia Niño de Mejía, Eduardo Hermida, Jorge Alvarado Sánchez, María Conchita Solórzano, Raphael Hernando Parrado Rodriguez, Leonardo José León Nuñez" "autores" => array:8 [ 0 => array:5 [ "preGrado" => "MD" "nombre" => "William F. Amaya" "apellidos" => "Zuñiga" "email" => array:1 [ 0 => "Williamf.amayaz@yahoo.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:4 [ "preGrado" => "MD" "nombre" => "Fernando Raffán" "apellidos" => "Sanabria" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:4 [ "preGrado" => "MD" "nombre" => "Claudia Niño" "apellidos" => "de Mejía" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:4 [ "preGrado" => "MD" "nombre" => "Eduardo" "apellidos" => "Hermida" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 4 => array:4 [ "preGrado" => "MD" "nombre" => "Jorge Alvarado" "apellidos" => "Sánchez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] 5 => array:3 [ "nombre" => "María Conchita" "apellidos" => "Solórzano" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff0030" ] ] ] 6 => array:3 [ "nombre" => "Raphael Hernando Parrado" "apellidos" => "Rodriguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">g</span>" "identificador" => "aff0035" ] ] ] 7 => array:3 [ "nombre" => "Leonardo José León" "apellidos" => "Nuñez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">h</span>" "identificador" => "aff0040" ] ] ] ] "afiliaciones" => array:8 [ 0 => array:3 [ "entidad" => "Cardiovascular and Transplant Anesthesiologist, Departament of Anesthesiology, Hospital Universitario Fundación Santa Fe de Bogotá; Clinical Professor, Universidad de los Andes, Bogotá, Colombia" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Intensive and Transplant Anesthesiologist, Department of Anesthesiology, Hospital Universitario Fundación Santa Fe de Bogotá; Clinical Professor, Universidad de los Andes, Universidad el Bosque; Coordinator of the Transplant and Transfusion Committee of the Colombian Society of Anesthesiology, Bogotá, Colombia" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Section Chief of Neuroanesthesiology, Neuroanesthesiologist, Department of Anesthesiology, Hospital Universitario Fundación Santa Fe de Bogotá; Clinical Professor, Universidad de los Andes, Universidad el Bosque, Bogotá, Colombia" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Pediatric Anesthesiologist, Department of Anesthesiology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Resident in the Anesthesia and Resuscitation Program, Hospital Universitario Fundación Santa Fe de Bogotá, Universidad el Bosque, Bogotá, Colombia" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Special Intern in Anesthesiology, Universidad de los Andes, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia" "etiqueta" => "f" "identificador" => "aff0030" ] 6 => array:3 [ "entidad" => "Anesthesiology Intern, Universidad de los Andes, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia" "etiqueta" => "g" "identificador" => "aff0035" ] 7 => array:3 [ "entidad" => "Clinical Epidemiologist, Bogotá, Colombia" "etiqueta" => "h" "identificador" => "aff0040" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author at</span>: Cll 119 # 7-75 Departamento de Anestesiología, Fundación Santa Fe de Bogotá, Bogotá, DC, Colombia." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Canalización venosa yugular interna: que tanta seguridad podemos llegar a ofrecer?" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0050" "etiqueta" => "Fig. 10" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Authors." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr10.jpeg" "Alto" => 1023 "Ancho" => 1659 "Tamanyo" => 45499 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Change in needle direction (black arrow). The goal is to avoid the lateral arterial wall in order to lower the probability of vascular injury.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Based on the technique designed by Seldinger<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> and the description by English of percutaneous internal jugular vein catheterization,<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> various strategies have been developed and implemented with the aim of achieving adequate endovascular positioning and confirmation, thus reducing the incidence of complications that often result in increase morbidity, even death.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The classical landmark technique, based on the presumed location of the vessels of the neck from the identification of the external anatomical structures, is considered a blind technique. Although it is widely used and is inherent to our medical practice, mechanical complication rates ranging between 5% and 19% were reported in the United States in 2003. These have been found to be related to operator experience, population group (children and elderly patients), anatomical considerations (obese patients, anatomical variants, thrombosis), comorbidities (coagulopathies, emphysema), number of attempts by operator, prior neck surgery, and a history of failed punctures.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3–11</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">With the introduction of ultrasound in clinical practice for the placement of central venous catheters, the incidence of complications has dropped, optimizing placement time and the number of attempts. Despite increased safety and ease, this technique is not free from adverse events.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4,10</span></a> This has led to the development of management guidelines and protocols, in an attempt at standardizing increasingly accurate procedures with the least number of associated complications.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4,12,13</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Organizations such as the Agency for Healthcare Research and Quality and the National Institute for Clinical Excellence have recommended the use of ultrasound for the placement of central venous catheters as one of the practices designed to improve patient safety and care.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14,15</span></a> Some authors have even encouraged the broad use of ultrasound, not limiting it only to the field of radiology, in order to bring significant benefits to other specialties.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8,16</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">At the Department of Anaesthesia of the Fundación Santa Fe de Bogotá University Hospital, skill training has been optimized, strengthening the operational development of this technique. The objective of this study was to evaluate the clinical application of a guiding algorithm for vascular cannulation developed at this institution, based on the evidence that shows the best results and the lowest complications rate.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Methods</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Prospective descriptive case series study</span><p id="par0030" class="elsevierStylePara elsevierViewall">The protocol was submitted to the institutional ethics committee and the HUFSFB Anaesthesia Department for approval. The subjects were patients undergoing elective or emergency surgical procedures requiring invasive central venous pressure monitoring.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The inclusion criteria were patients over 18 years of age with informed consent appropiately filled. The exclusion criteria were patients with masses, anatomical abnormalities, puncture site infections, or coagulation disorders (INR<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>2.0 and platelet count ≤50.000).</p><p id="par0040" class="elsevierStylePara elsevierViewall">A consensus of experts in invasive procedures and ultrasound from the Department of Anaesthesia was brought together to develop an algorithm for central venous cannulation under ultrasound guidance (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Adjustments and validation of this procedure were based on the HUFSFB safety recommendations and management guidelines.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">The data collection process was performed using a form designed for that purpose. The SPSS 19<span class="elsevierStyleSup">®</span> software was used for the univariate analysis, describing proportions and central trend measurements.</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">“Successful ultrasound-guided internal jugular vein catheter insertion” algorithm</span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">1. Patient positioning and catheter laterality</span><p id="par0055" class="elsevierStylePara elsevierViewall">Trendelemburg positioning is recommended, with the head in neutral position or with the least contralateral rotation possible;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17,18</span></a> the operator stands at the head of the patient with the ultrasound equipment on the ipsilateral side of the puncture area. Prior studies have shown increased vascular overlap associated with contralateral cephalad rotation.<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19–22</span></a> (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) Wang et al. reported important loss of up to 72% of the safety margin with increased vascular overlap when 90° rotation is used. These data have contributed to explain arterial vascular injury during puncture.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">The notch in the probe helps orient laterality on the patient image and its corresponding display on the ultrasound screen. When the notch is identified (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>A), the image is found on the ultrasound screen (the green dot in our case) in order to serve as a guide to the imaged side and its schematic representation on the screen (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>B).</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Correct probe placement allows identification of anatomical structures for adequate assessment of the tracheal rings and vascular structures (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>), lowering the probability of puncture error.</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">2. Two-dimensional (2D) ultrasound scan</span><p id="par0080" class="elsevierStylePara elsevierViewall">Initial vascular differentiation is done using the 2D mode to establish the distinct characteristics of the venous and arterial vessels. It is recommended to assess the short axis, the long axis and the oblique axis views (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>) in order to identify anatomical relationships between the structures and assess for the presence of thrombi or masses that may interfere with the cannulation.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">3. Colour Doppler and Pulsed Doppler assessment</span><p id="par0090" class="elsevierStylePara elsevierViewall">Before conducting these assessments, it is important to become familiar with the settings of the equipment. In our case, for Colour Doppler we set the colour that will identify the flow that moves towards the transducer and the flow that moves away from the transducer (<a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>).</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">For Pulsed Doppler assessment, an incidence angle of 30–60° was considered. Angles of less than 60° must be the goal in order to avoid velocity estimation errors.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">With the determination of blood cell mass flow velocity and direction using Colour Doppler and Pulsed Doppler assessment, venous and arterial identification is significantly enhanced. The Colour Doppler assessment is performed at an angle of 30–60° in a caudal direction. On the image, the flow moving towards the transducer is flow coming from the heart and is displayed in red. The flow that appears in blue is blood moving away from the transducer, in this case flow coming from the brain and ending in the heart (<a class="elsevierStyleCrossRef" href="#fig0030">Fig. 6</a>).</p><elsevierMultimedia ident="fig0030"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">At that same point, if the assessment angle is switched to a cephalad direction (120–150°), the flow appears red, depicting blood coming from the brain, while blue flow corresponds to arterial blood coming from the heart and ending in the brain (<a class="elsevierStyleCrossRef" href="#fig0035">Fig. 7</a>).</p><elsevierMultimedia ident="fig0035"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">As soon as flow direction is determined, it is important to measure velocity. When used to assess the arterial vessel in a caudal direction, Pulsed Doppler records a positive high-velocity (<a class="elsevierStyleCrossRef" href="#fig0040">Fig. 8</a>A). If the venous flow is assessed for comparison, a lower velocity negative wave is obtained (<a class="elsevierStyleCrossRef" href="#fig0040">Fig. 8</a>B). When assessment direction is changed to cephalad, the viewing direction of the waves is inverted and the negative wave represents the arterial vessel while the positive wave represents the venous vessel, and velocities are maintained.</p><elsevierMultimedia ident="fig0040"></elsevierMultimedia></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">4. Margin of safety identification</span><p id="par0120" class="elsevierStylePara elsevierViewall">A margin of safety has been described in the short axis view, defined as the distance from the mid point of the internal jugular vein and the lateral border of the carotid artery, identifying the overlap of the jugular vein in relation to the carotid artery.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> This margin must be taken into consideration to lower the possibility of injuring the artery<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> (<a class="elsevierStyleCrossRef" href="#fig0045">Fig. 9</a>).</p><elsevierMultimedia ident="fig0045"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">If the margin of safety is small or absent, the incidence angle must be changed during puncture (<a class="elsevierStyleCrossRef" href="#fig0050">Fig. 10</a>). If it is technically difficult to change the angle, the operator must determine the need to change catheter laterality. The internal jugular vein is a readily compressible low-pressure vessel, which means that there is a possibility of transecting the posterior wall during needle advancement.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> This manoeuvre ensures that the patient will not be subjected to multiple attempts with a potential risk of arterial vascular injury.</p><elsevierMultimedia ident="fig0050"></elsevierMultimedia></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">5. Real-time puncture visualization</span><p id="par0135" class="elsevierStylePara elsevierViewall">When external compression is applied with the needle cap, the operator analyses the course and potential direction of the puncture needle. The depth at which venous return will be obtained is determined on the screen, avoiding deep punctures and potential tissue injuries or even pneumothorax.</p><p id="par0140" class="elsevierStylePara elsevierViewall">Cannulation strategies have consisted of puncturing under continuous ultrasound visualization (real-time), in the short axis view, at a 60° angle.<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">26,27</span></a> When done in real time, it is possible to visualize the tip of the needle, direction and depth at all times, avoiding puncture of the posterior wall of the vessel or even loss of the right course; it also helps identify errors early on in order to take prompt action.<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">28,29</span></a> Added to this, the needle is also visualized on the long-axis view, providing greater margin of safety for the patient.</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">6. Catheter advancement</span><p id="par0150" class="elsevierStylePara elsevierViewall">As soon as intravascular needle placement is observed and adequate venous return is obtained, the introducer catheter and the guidewire are allowed to slide in. The catheter-over-the-needle technique is advocated. Guidewire advancement should be smooth and unobstructed, and the maximum depth of introduction must be 15<span class="elsevierStyleHsp" style=""></span>cm. In the oblique view, considering the position of the notch, the linear displacement of the guidewire towards the rib cage must be determined, ruling out the presence of intraluminal dissection, false courses or kinks that might interfere with catheter advancement.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> The assessment is complemented using the short axis and long axis views (<a class="elsevierStyleCrossRef" href="#fig0055">Fig. 11</a>).</p><elsevierMultimedia ident="fig0055"></elsevierMultimedia><p id="par0155" class="elsevierStylePara elsevierViewall">In the event the attempt is unsuccessful, the process must be reassessed and a new attempt must be made. If the new attempt at cannulation fails, the assistance of another operator must be requested. If adequate venous return is obtained but guidewire advancement is inadequate, the possibility of changing laterality of the puncture area must be considered, because of the potential presence of venous thrombi.</p><p id="par0160" class="elsevierStylePara elsevierViewall">It is important to avoid arrhythmias as the guidewire is advanced because induced ectopic beats have been associated with morbidity in some cases.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a> There is not enough evidence regarding the efficacy of intravascular placement using continuous electrocardiogram, but there is well known the relationship between narrow complex ectopic beats and the presence of the intravascular guidewire.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,32,33</span></a></p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">7. Catheter placement confirmation</span><p id="par0170" class="elsevierStylePara elsevierViewall">Central venous catheter advancement is done using the Seldinger technique, followed by confirmation of adequate placement (<a class="elsevierStyleCrossRef" href="#fig0060">Fig. 12</a>). In the event of an unsuccessful attempt, the process is reassessed and step 6 is performed.</p><elsevierMultimedia ident="fig0060"></elsevierMultimedia></span></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Results</span><p id="par0175" class="elsevierStylePara elsevierViewall">This case series included 38 patients with a mean age of 61 years (range between 24 and 88), of whom 81.6% were males. The right side was preferred for the puncture area in 89.5% of the cases, because of the usual operator position for placing central catheters in the operating room. A single puncture attempt was required in 97.4% of the cases. In the patient who required two attempts, cephalad advancement of the guidewire was observed and it was decided to repeat the puncture (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0180" class="elsevierStylePara elsevierViewall">In 2 cases (5.2%) there was evidence of posterior vessel wall puncture unrelated with haematoma or infection. There were no complications like pneumothorax, air embolism, nerve injury, haematoma or infection. The assisted operator modality was applied in 100% of the cases, meaning tutor supervision of the resident or intern performing the procedure.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Discussion</span><p id="par0185" class="elsevierStylePara elsevierViewall">Despite the significant advantages reported in the world literature, in 2005 Girard et al.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a> studied the use of ultrasound for guiding vascular cannulation in a level III university hospital. As part of the results, they observed that only 15% of the practitioners used ultrasound guidance in more than 60% of their attempts at central vascular cannulation, showing a relatively infrequent use despite the favourable evidence.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">35</span></a></p><p id="par0190" class="elsevierStylePara elsevierViewall">Excellent results published worlwide on ultrasound guided central venous cannulation, as well as the study by Raffan et al., prompted us to develop several strategies aimed at improving success and patient safety.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">35</span></a></p><p id="par0195" class="elsevierStylePara elsevierViewall">Successful cannulation on the first attempt was achieved in 97.4% of the cases, similar to the 98% result found by Chittoodan in 2011<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> with short-axis view puncture. In this case series we chose to use and view the different approach planes, with a resulting increase in success rates and reduced complications such as carotid punctures reported with the use of the long-axis view.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a></p><p id="par0200" class="elsevierStylePara elsevierViewall">The central venous cannulation algorithm was shown to be a useful tool for performing this procedure in a systematic way, and for preventing the complications described by other authors. Despite the occurrence of posterior wall punctures in two patients (5.2%), the ability to use an adequate incidence angle reduces the possibility of puncturing the carotid artery; moreover, real time visualization prevents a too deep advancement of the needle, thus lowering the possibility of a pneumothorax.</p><p id="par0205" class="elsevierStylePara elsevierViewall">Laterality confirmation in the displacement of the metal guidewire allows for early identification of inadequate catheter advancement or misplacement, leading to fast repositioning.</p><p id="par0210" class="elsevierStylePara elsevierViewall">As far as the routine use of ultrasound guidance for subclavian catheter insertion is concerned, there is not enough support in the literature showing benefit or lower complications to the patient.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3–5,10</span></a> Recently, Fragou et al. published a study that favoured the use of real-time ultrasonography.<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">36</span></a> In view of the absence of conclusive studies, this procedure was not included in the algorithm. It is worth highlighting that dynamic or real-time procedures performed recently have shown better results than the use of the technique of identifying ultrasonographic landmarks or static technique.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Conclusions</span><p id="par0215" class="elsevierStylePara elsevierViewall">The use of the algorithm for the “Successful ultrasound-guided jugular vein catheter insertion” may be an effective way to prevent potential complications, considering that it allows for real-time adjustments, improves operational standards and provides better quality of care for patients.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Considerations</span><p id="par0220" class="elsevierStylePara elsevierViewall">Interesting proposals are found in the literature regarding approaches and puncture techniques. The most convenient ones are under review in our clinical practice on the basis of the best reports, as we seek to adopt the most appropriate for our institution.<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">36,37</span></a>.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Conflict of interest</span><p id="par0225" class="elsevierStylePara elsevierViewall">We have no conflict of interest to report.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:13 [ 0 => array:2 [ "identificador" => "xres412686" "titulo" => array:6 [ 0 => "Abstract" 1 => "Introduction" 2 => "Objective" 3 => "Methods" 4 => "Results" 5 => "Conclusions" ] ] 1 => array:2 [ "identificador" => "xpalclavsec388411" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres412685" "titulo" => array:6 [ 0 => "Resumen" 1 => "Introducción" 2 => "Objetivo" 3 => "Metodología" 4 => "Resultados" 5 => "Conclusiones" ] ] 3 => array:2 [ "identificador" => "xpalclavsec388410" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Methods" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0045" "titulo" => "Prospective descriptive case series study" ] ] ] 6 => array:3 [ "identificador" => "sec0050" "titulo" => "“Successful ultrasound-guided internal jugular vein catheter insertion” algorithm" "secciones" => array:7 [ 0 => array:2 [ "identificador" => "sec0055" "titulo" => "1. Patient positioning and catheter laterality" ] 1 => array:2 [ "identificador" => "sec0060" "titulo" => "2. Two-dimensional (2D) ultrasound scan" ] 2 => array:2 [ "identificador" => "sec0065" "titulo" => "3. Colour Doppler and Pulsed Doppler assessment" ] 3 => array:2 [ "identificador" => "sec0070" "titulo" => "4. Margin of safety identification" ] 4 => array:2 [ "identificador" => "sec0075" "titulo" => "5. Real-time puncture visualization" ] 5 => array:2 [ "identificador" => "sec0080" "titulo" => "6. Catheter advancement" ] 6 => array:2 [ "identificador" => "sec0085" "titulo" => "7. Catheter placement confirmation" ] ] ] 7 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 8 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 9 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusions" ] 10 => array:2 [ "identificador" => "sec0030" "titulo" => "Considerations" ] 11 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflict of interest" ] 12 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2012-12-17" "fechaAceptado" => "2014-09-29" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec388411" "palabras" => array:5 [ 0 => "Ultrasonography" 1 => "Catheters" 2 => "Patient safety" 3 => "Catheterization, Central venous" 4 => "Anesthesia" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec388410" "palabras" => array:5 [ 0 => "Ultrasonografìa" 1 => "Catèteres" 2 => "Seguridad del Paciente" 3 => "Cateterìsmo Venoso Central" 4 => "Anestesia" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Central venous catheterization, performed by the anatomical landmark technique, has a mechanical complication rate between 5% and 19%. This technique has been modified and new approaches have been implemented aiming to improve patient safety. With the introduction of ultrasonography in the clinical practice, and recently in central venous catheter insertion, the rate of complications has dropped over time.</p> <span class="elsevierStyleSectionTitle" id="sect0015">Objective</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">To measure the clinical application of the algorithm “Successful ultrasound-guided internal jugular vein cannulation”.</p> <span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A descriptive, prospective, case series study. Patients over 18 years of age were selected, and the informed consent documentation was filled out appropriately. Patients with masses, anatomical abnormalities, insertion site infections and coagulopathy (International Normalized Ratio [INR]<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>2.0, platelet count ≤50.000) were excluded. Central venous cannulation was performed under ultrasound guidance in accordance with safety recommendations from the Anaesthesia Department of the Fundación Santa Fe de Bogotá University Hospital (HUFSFB). Adjustment and validation of the algorithm was done according to an expert consensus in our department. A descriptive univariate analysis was conducted, and efficacy was determined on the basis of the number of attempts to achieve successful venous cannulation, and the incidence of complications.</p> <span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">This series included 38 patients with a mean age of 62 years. In 97.4% of the cases, successful venous cannulation was achieved on the first attempt. Guidewire displacement was observed in one case, requiring a second attempt. The posterior jugular vein wall was punctured in two patients (5.2%), with no associated arterial vascular injury or pneumothorax.</p> <span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">This algorithm resulted in a high rate of successful first attempts and the prevention of potential complications, improving operational standards and healthcare quality for the patients.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0040">Introducción</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">La canulación venosa central por técnica de reparos anatómicos presenta complicaciones mecánicas entre 5–19%, por tal motivo se han modificado e implementado técnicas buscando disminuir los riesgos para el paciente. La introducción de la ultrasonografía en la práctica clínica y más recientemente en la colocación de catéteres venosos centrales, ha disminuido la incidencia de complicaciones.</p> <span class="elsevierStyleSectionTitle" id="sect0045">Objetivo</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Evaluar la aplicación clínica del algoritmo “Adecuada inserción de catéteres venosos yugulares internos guiados por ultrasonografía”.</p> <span class="elsevierStyleSectionTitle" id="sect0050">Metodología</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Estudio descriptivo prospectivo de serie de casos. Se seleccionaron pacientes mayores de 18 años de edad, con el consentimiento informado completamente diligenciado. Los criterios de exclusión fueron pacientes con masas, alteraciones anatómicas o infecciones en el sitio de punción, trastornos de coagulación (Índice Normalizado Internacional INR<span class="elsevierStyleHsp" style=""></span>≥<span class="elsevierStyleHsp" style=""></span>2,0 y conteo plaquetario ≤50.000). La canulación venosa central fue realizada con técnica ultrasonofigura considerando las recomendaciones de seguridad que se tienen en el departamento de anestesia del Hospital Universitario Fundación Santa Fe de Bogotá (HUFSFB), los ajustes y validación del algoritmo guía se realizaron según el consenso de expertos en procedimientos invasivos y ultrasonografía. Se realizó análisis descriptivo univariado y la eficacia fue determinada por el número de punciones necesarias para una adecuada canulación vascular y la incidencia de complicaciones.</p> <span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">La serie de casos fue de 38 pacientes con una edad promedio de 62 años. En el 97,4% de los casos el paso fue realizado en el primer intento. En un paciente se evidenció desplazamiento inadecuado de la guía por lo que fue necesario repetir la punción. En 2 pacientes (5,2%) se presentó punción de la pared posterior del vaso sin que esto se hubiese correlacionado con presencia de lesión vascular arterial o neumotórax.</p> <span class="elsevierStyleSectionTitle" id="sect0060">Conclusiones</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">La implementación del algoritmo guía, permitió una alta tasa de éxito en el primer intento y la prevención de complicaciones potenciales, mejorando los estándares operacionales, brindando una mayor calidad en el cuidado y atención de los pacientes.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Zuñiga WFA, Sanabria FR, de Mejía CN, Hermida E, Sánchez JA, Solórzano MC, et al. Canalización venosa yugular interna: que tanta seguridad podemos llegar a ofrecer?. Rev Colomb Anestesiol. 2015;43:76–86.</p>" ] ] "multimedia" => array:14 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Authors." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 3898 "Ancho" => 3078 "Tamanyo" => 606584 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Venous cannulation algorithm.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Authors." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1032 "Ancho" => 2167 "Tamanyo" => 205018 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Effect of cephalad rotation on vascular overlap.</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Authors." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1337 "Ancho" => 2167 "Tamanyo" => 102938 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">(A) External identification of the transducer notch. (B) Schematic representation of the notch in the ultrasound machine. See the notch in the left upper part of the screen (green dot).</p>" ] ] 3 => array:8 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Authors." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 834 "Ancho" => 3251 "Tamanyo" => 184250 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Ultrasound assessment of vascular structures. See the trachea (yellow arrow), followed by the common carotid artery (red arrow) and then the internal jugular vein (blue arrow). Left side. The transducer is positioned with the notch oriented laterally. Right side. The transducer is positioned with the notch oriented medially.</p>" ] ] 4 => array:8 [ "identificador" => "fig0025" "etiqueta" => "Fig. 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Authors." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1244 "Ancho" => 1659 "Tamanyo" => 115715 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Colour Doppler mode settings. Red (point A) is flow moving towards the transducer. Blue (point B) is flow moving away from the transducer.</p>" ] ] 5 => array:8 [ "identificador" => "fig0030" "etiqueta" => "Fig. 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Authors." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 713 "Ancho" => 2499 "Tamanyo" => 130002 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Caudal-orientation Colour Doppler ultrasound assessment. (A) See the 30–60° angle of incidence between the axis of the transducer and the vessels of the neck. (B) Flow moving towards the transducer is arterial and is shown in red; flow in blue is blood going to the heart, i.e. venous flow.</p>" ] ] 6 => array:8 [ "identificador" => "fig0035" "etiqueta" => "Fig. 7" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Authors." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr7.jpeg" "Alto" => 742 "Ancho" => 2523 "Tamanyo" => 132707 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Cephalad-oriented Colour Doppler ultrasound assessment. (A) The angle of incidence changes to 120–150° between the axis of the transducer and the vessels of the neck. (B) In this case, flow moving towards the transducer is cerebral venous return, and is shown in red; flow in blue is blood going to the brain, i.e. arterial flow.</p>" ] ] 7 => array:8 [ "identificador" => "fig0040" "etiqueta" => "Fig. 8" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Authors." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr8.jpeg" "Alto" => 1003 "Ancho" => 2500 "Tamanyo" => 141410 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Pulsed Doppler ultrasound assessment. (A) Arterial vessel; the blood cell mass moves towards the transducer, creating a high velocity positive spectrum (30<span class="elsevierStyleHsp" style=""></span>cm/s in this case). (B) Venous vessel; a low-velocity negative spectrum is observed (10<span class="elsevierStyleHsp" style=""></span>cm/s in this case), corresponding to the flow of blood cell mass away from the transducer.</p>" ] ] 8 => array:8 [ "identificador" => "fig0045" "etiqueta" => "Fig. 9" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Authors." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr9.jpeg" "Alto" => 658 "Ancho" => 1570 "Tamanyo" => 44460 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Safety margin. (A) Venous and arterial vascular overlap; there is no possibility for a safety margin. (B) Small safety margin. (C) Wide safety margin.</p>" ] ] 9 => array:8 [ "identificador" => "fig0050" "etiqueta" => "Fig. 10" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Authors." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr10.jpeg" "Alto" => 1023 "Ancho" => 1659 "Tamanyo" => 45499 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Change in needle direction (black arrow). The goal is to avoid the lateral arterial wall in order to lower the probability of vascular injury.</p>" ] ] 10 => array:8 [ "identificador" => "fig0055" "etiqueta" => "Fig. 11" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Authors." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr11.jpeg" "Alto" => 854 "Ancho" => 3249 "Tamanyo" => 148963 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Confirmation of adequate intravascular positioning of the guidewire (arrow). (A) Short axis; (B) Long axis; (C) Oblique axis.</p>" ] ] 11 => array:8 [ "identificador" => "fig0060" "etiqueta" => "Fig. 12" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Authors." "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr12.jpeg" "Alto" => 965 "Ancho" => 2499 "Tamanyo" => 128679 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Confirmation of adequate catheter positioning. (A) Short axis; (B) Long axis; (C) Oblique axis.</p>" ] ] 12 => 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=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Characteristic \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Arterial vessel \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Venous vessel \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic"><span class="elsevierStyleBold">Shape</span></span>Short axis view \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Spherical, small calibre vessel \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Elliptical, large calibre vessel \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleInlineFigure"><elsevierMultimedia class="elsevierStyleLink" ident="fx1"></elsevierMultimedia></span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleInlineFigure"><elsevierMultimedia class="elsevierStyleLink" ident="fx2"></elsevierMultimedia></span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic"><span class="elsevierStyleBold">Wall thickness</span></span>Short axis view \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Thick walls; calcium and atheroma plaques may be identified according to patient age \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Thin walls \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic"><span class="elsevierStyleBold">Compression/collapse</span></span>Short and long axis views \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Not very compressible \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Easily compressible \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleInlineFigure"><elsevierMultimedia class="elsevierStyleLink" ident="fx3"></elsevierMultimedia></span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleInlineFigure"><elsevierMultimedia class="elsevierStyleLink" ident="fx4"></elsevierMultimedia></span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic"><span class="elsevierStyleBold">Change with Valsalva manoeuvre</span></span>Short and long axis views \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No significant changes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Vessel size increases and there is less compressibility \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab642079.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Different characteristics of venous and arterial vessels.</p>" ] ] 13 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Source: Authors." "tabla" => array:2 [ "leyenda" => "<p id="spar0125" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Note</span>: Proportions are shown for categorical variables and means plus standard deviations (SD) are shown for continuous variables.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Patients</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">Age</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">61.8 (13.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Gender</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">81.6% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">18.4% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Catheter insertion laterality</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Right \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">89.5% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Left \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.5% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Number of attempts</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Single puncture \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">97.4% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Two punctures \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.6% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Complications</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pneumothorax \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Nerve injury \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Haematoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Infection \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Transfixing puncture \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab642080.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Characterization of assessment variables (demographic and clinical).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:37 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Catheter replacement of the needle in percutaneous arteriography: a new technique" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S.I. Seldinger" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Radiol [Old Series]" "fecha" => "1953" "volumen" => "39" "paginaInicial" => "368" "paginaFinal" => "376" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Percutaneous cannulation of the internal jugular vein" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "I.C.W. English" 1 => "R.M. Frew" 2 => "J.F.G. Pigott" 3 => "M. Zaky" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "1969" "volumen" => "24" "paginaInicial" => "496" "paginaFinal" => "497" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5795652" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidelines for performing ultrasound guided vascular cannulation: recommendations of the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.A. Troianos" 1 => "G.S. Hartman" 2 => "K.E. Glas" 3 => "N.J. Skubas" 4 => "R.T. Eberhardt" 5 => "J.D. Walker" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.echo.2011.09.021" "Revista" => array:6 [ "tituloSerie" => "J Am Soc Echocardiogr" "fecha" => "2011" "volumen" => "24" "paginaInicial" => "1291" "paginaFinal" => "1318" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22115322" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Practice guidelines for central venous access: a report by the American Society of Anesthesiologists Task Force on Central Venous Access. American Society of Anesthesiologists Task Force on Central Venous Access" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.M. Rupp" 1 => "J.L. Apfelbaum" 2 => "C. Blitt" 3 => "R.A. Caplan" 4 => "R.T. Connis" 5 => "K.B. Domino" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/ALN.0b013e31823c9569" "Revista" => array:6 [ "tituloSerie" => "Anesthesiology" "fecha" => "2012" "volumen" => "116" "paginaInicial" => "539" "paginaFinal" => "573" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22307320" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ultrasonic locating devices for central venous cannulation: meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Hind" 1 => "N. Calvert" 2 => "R. McWilliams" 3 => "A. Davidson" 4 => "S. Paisley" 5 => "C. Beverly" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bmj.327.7411.361" "Revista" => array:5 [ "tituloSerie" => "BMJ" "fecha" => "2003" "volumen" => "327" "paginaInicial" => "361" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12919984" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of ultrasound to place central lines" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S.P. Keenan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Crit Care" "fecha" => "2002" "volumen" => "17" "paginaInicial" => "126" "paginaFinal" => "137" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12096376" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ultrasound guidance for placement of central venous catheters: a meta-analysis of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.G. Randolph" 1 => "D.J. Cook" 2 => "C.A. Gonzales" 3 => "C.G. Pribble" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Crit Care Med" "fecha" => "1996" "volumen" => "24" "paginaInicial" => "2053" "paginaFinal" => "2058" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8968276" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ultrasound-guided internal jugular access: a proposed standardized approach and implications for training and practice" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D. Feller-Kopman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.06-2711" "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "2007" "volumen" => "132" "paginaInicial" => "302" "paginaFinal" => "309" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17625091" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Preventing complications of central venous catheterization" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D.C. McGee" 1 => "M.K. Gould" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMra011883" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2003" "volumen" => "348" "paginaInicial" => "1123" "paginaFinal" => "1133" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12646670" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Complications and failures of subclavian-vein catheterization" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P.F. Mansfield" 1 => "D.C. Hohn" 2 => "B.D. Fornage" 3 => "M.A. Gregurich" 4 => "D.M. Ota" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM199412293312602" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "1994" "volumen" => "331" "paginaInicial" => "1735" "paginaFinal" => "1738" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7984193" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Complications of central venous catheterization" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.E. Kusminsky" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jamcollsurg.2007.01.039" "Revista" => array:6 [ "tituloSerie" => "J Am Coll Surg" "fecha" => "2007" "volumen" => "204" "paginaInicial" => "681" "paginaFinal" => "696" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17382229" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Videos in clinical medicine. Ultrasound-guided internal jugular vein cannulation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R. Ortega" 1 => "M. Song" 2 => "C.J. Hansen" 3 => "P. Barash" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMvcm0810156" "Revista" => array:5 [ "tituloSerie" => "N Engl J Med" "fecha" => "2010" "volumen" => "362" "paginaInicial" => "e57" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20410510" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Algoritmo de práctica clínica basado en la evidencia para el uso de ultrasonido en la colocación de cateteres venosos centrales" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "F. Raffán" 1 => "M.T. Garcia" 2 => "E. Celis" 3 => "A. Chaves" 4 => "F. Ramirez" 5 => "J. Diaz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Colomb Anestesiol" "fecha" => "2005" "volumen" => "33" "paginaInicial" => "51" "paginaFinal" => "58" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evidence report/technology assessment number 43: making health care. Safer: a critical analysis of patient safety practices" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.M. Rothschild" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:2 [ "fecha" => "2001" "editorial" => "US Department of Health and Human Services Publication 01-E058" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "National Institute for Clinical Excellence: Guidance on the Use of Ultrasound Locating Devices for Central Venous Catheters (NICE technology appraisal, No. 49)" ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2002" "editorial" => "NICE" "editorialLocalizacion" => "London" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Simulation-based mastery learning reduces complications during central venous catheter insertion in a medical intensive care unit" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.H. Barsuk" 1 => "W.C. McGaghie" 2 => "E.R. Cohen" 3 => "K.J. O’Leary" 4 => "D. Wayne" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Crit Care Med" "fecha" => "2009" "volumen" => "37" "paginaInicial" => "2697" "paginaFinal" => "2701" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19885989" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Real-time ultrasound-guided subclavian vein cannulation versus the landmark method in critical care patients: a prospective randomized study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Fragou" 1 => "A. Gravvanis" 2 => "V. Dimitriou" 3 => "A. Papalois" 4 => "G. Kouraklis" 5 => "T. Saranteas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/CCM.0b013e318218a1ae" "Revista" => array:6 [ "tituloSerie" => "Crit Care Med" "fecha" => "2011" "volumen" => "39" "paginaInicial" => "1607" "paginaFinal" => "1612" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21494105" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ultrasound-guided cannulation of the internal jugular vein. A prospective, randomized study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C.A. Troianos" 1 => "D.R. Jobes" 2 => "N. Ellison" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Anesth Analg" "fecha" => "1991" "volumen" => "72" "paginaInicial" => "823" "paginaFinal" => "826" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2035868" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trendelenburg position, head elevation and a midline position optimize right internal jugular vein diameter" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G. Parry" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/BF03018243" "Revista" => array:6 [ "tituloSerie" => "Can J Anaesth" "fecha" => "2004" "volumen" => "51" "paginaInicial" => "379" "paginaFinal" => "381" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15064268" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Internal jugular vein and carotid artery anatomic relation as determined by ultrasonography" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C.A. Troianos" 1 => "R.J. Kuwik" 2 => "J.R. Pasqual" 3 => "A.J. Lim" 4 => "D.P. Odasso" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Anesthesiology" "fecha" => "1996" "volumen" => "85" "paginaInicial" => "43" "paginaFinal" => "48" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8694381" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Head rotation during internal jugular vein cannulation and the risk of carotid artery puncture" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C.A. Sulek" 1 => "N. Gravenstein" 2 => "R. Blackshear" 3 => "L. Weiss" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Anesth Analg" "fecha" => "1996" "volumen" => "82" "paginaInicial" => "125" "paginaFinal" => "128" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8712386" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Optimal head rotation for internal jugular vein cannulation when relying on external landmarks" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.A. Lieberman" 1 => "K.A. Williams" 2 => "A.L. Rosenberg" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1213/01.ANE.0000132908.77111.CA" "Revista" => array:6 [ "tituloSerie" => "Anesth Analg" "fecha" => "2004" "volumen" => "99" "paginaInicial" => "982" "paginaFinal" => "988" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15385337" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of head rotation on vascular anatomy of the neck: an ultrasound study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R. Wang" 1 => "E.R. Snoey" 2 => "R.C. Clements" 3 => "H.G. Hern" 4 => "D. Price" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jemermed.2005.12.026" "Revista" => array:6 [ "tituloSerie" => "J Emerg Med" "fecha" => "2006" "volumen" => "31" "paginaInicial" => "283" "paginaFinal" => "286" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16982362" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ultrasonography in Vascular Diagnosis. Chap. 1. Fundamental Principles" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "W. Schäberle" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2011" "paginaInicial" => "1" "paginaFinal" => "27" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0125" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anatomic relationship of the internal jugular vein and the common carotid artery applied to percutaneous transjugular procedures" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "U.C. Turba" 1 => "R. Uflacker" 2 => "C. Hannegan" 3 => "J.B. Selby" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Cardiovasc Interv Radiol" "fecha" => "2005" "volumen" => "28" "paginaInicial" => "303" "paginaFinal" => "306" ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0130" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An unseen danger: frequency of posterior vessel wall penetration by needles during attempts to place internal jugular vein central catheters using ultrasound guidance" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Blaivas" 1 => "S. Adhikari" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/CCM.0b013e3181a067d4" "Revista" => array:6 [ "tituloSerie" => "Crit Care Med" "fecha" => "2009" "volumen" => "37" "paginaInicial" => "2345" "paginaFinal" => "2349" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19531950" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0135" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long versus short axis ultrasound guided approach for internal jugular vein cannulation: a prospective randomised controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Chittoodan" 1 => "D. Breen" 2 => "B. O’Donnell" 3 => "G. Iohom" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Med Ultrason" "fecha" => "2011" "volumen" => "13" "paginaInicial" => "21" "paginaFinal" => "25" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21390339" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0140" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Short-axis versus long-axis approaches for teaching ultrasound-guided vascular access on a new inanimate model" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Blaivas" 1 => "L. Brannam" 2 => "E. Fernandez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acad Emerg Med" "fecha" => "2003" "volumen" => "10" "paginaInicial" => "1307" "paginaFinal" => "1311" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14644780" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0145" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A randomized controlled clinical trial of real-time needle-guided ultrasound for internal jugular venous cannulation in a large university anesthesia department" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.G. Augoustides" 1 => "J. Horak" 2 => "A.E. Ochroch" 3 => "W.J. Vernick" 4 => "A.J. Gambone" 5 => "J. Weiner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Cardiothorac Vasc Anesth" "fecha" => "2005" "volumen" => "19" "paginaInicial" => "310" "paginaFinal" => "315" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16130056" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0150" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of real-time ultrasound guidance for the placement of hemodialysis catheters: a systematic review and meta-analysis of randomized controlled trials" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "K.S. Rabindranath" 1 => "E. Kumar" 2 => "K.S. Rabindranath" 3 => "E. Kumar" 4 => "R. Shail" 5 => "E. Vaux" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/j.ajkd.2011.07.025" "Revista" => array:6 [ "tituloSerie" => "Am J Kidney Dis" "fecha" => "2011" "volumen" => "58" "paginaInicial" => "964" "paginaFinal" => "970" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22099570" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0155" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ultrasound confirmation of guidewire position may eliminate accidental arterial dilatation during central venous cannulation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L.M. Gillman" 1 => "M. Blaivas" 2 => "J. Lord" 3 => "A. Al-Kadi" 4 => "A.W. Kirkpatrick" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1757-7241-18-39" "Revista" => array:5 [ "tituloSerie" => "Scand J Trauma Resusc Emerg Med" "fecha" => "2010" "volumen" => "18" "paginaInicial" => "39" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20626896" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0160" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation and management of central venous access complications" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.T. Bhutta" 1 => "W.C. Culp" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/j.tvir.2011.05.003" "Revista" => array:6 [ "tituloSerie" => "Tech Vasc Interv Radiol" "fecha" => "2011" "volumen" => "14" "paginaInicial" => "217" "paginaFinal" => "224" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22099014" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0165" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of the bedside central venous catheter placement techniques: landmark vs electrocardiogram guidance" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.H. Lee" 1 => "J.H. Bahk" 2 => "H.G. Ryu" 3 => "C.W. Jung" 4 => "Y. Jeon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/bja/aep046" "Revista" => array:6 [ "tituloSerie" => "Br J Anaesth" "fecha" => "2009" "volumen" => "102" "paginaInicial" => "662" "paginaFinal" => "666" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19329467" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0170" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Transesophageal echocardiographic evaluation of ECG-guided central venous catheter placement" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Y. Jeon" 1 => "H.G. Ryu" 2 => "S.Z. Yoon" 3 => "J.H. Kim" 4 => "J.H. Bahk" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/BF03022525" "Revista" => array:6 [ "tituloSerie" => "Can J Anaesth" "fecha" => "2006" "volumen" => "53" "paginaInicial" => "978" "paginaFinal" => "983" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16987851" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0175" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ultrasound guidance during central venous catheterization: a survey of use by house staff physicians" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "T.D. Girard" 1 => "J.M. Schectman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jcrc.2005.06.005" "Revista" => array:6 [ "tituloSerie" => "J Crit Care" "fecha" => "2005" "volumen" => "20" "paginaInicial" => "224" "paginaFinal" => "229" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16253790" "web" => "Medline" ] ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0180" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "La canalización de la vena yugular interna guiada por ultrasonografía en pacientes sometidos a trasplante hepático" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F. Raffán" 1 => "C. Guerrero" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Colomb Anestesiol" "fecha" => "2001" "volumen" => "29" "paginaInicial" => "295" "paginaFinal" => "300" ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib0185" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The “medial-oblique” approach to ultrasound-guided central venous cannulation-maximize the view, minimize the risk" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Dilisio" 1 => "A.J. Mittnacht" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1053/j.jvca.2012.04.013" "Revista" => array:6 [ "tituloSerie" => "J Cardiothorac Vasc Anesth" "fecha" => "2012" "volumen" => "26" "paginaInicial" => "982" "paginaFinal" => "984" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22683157" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22562087/0000004300000001/v1_201501210932/S2256208714001126/v1_201501210932/en/main.assets" "Apartado" => array:4 [ "identificador" => "951" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific and Technological Research" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22562087/0000004300000001/v1_201501210932/S2256208714001126/v1_201501210932/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2256208714001126?idApp=UINPBA00004N" ]
Year/Month | Html | Total | |
---|---|---|---|
2024 November | 8 | 0 | 8 |
2024 October | 82 | 6 | 88 |
2024 September | 104 | 1 | 105 |
2024 August | 82 | 6 | 88 |
2024 July | 113 | 5 | 118 |
2024 June | 75 | 3 | 78 |
2024 May | 73 | 2 | 75 |
2024 April | 59 | 5 | 64 |
2024 March | 83 | 11 | 94 |
2024 February | 93 | 15 | 108 |
2024 January | 122 | 9 | 131 |
2023 December | 126 | 24 | 150 |
2023 November | 129 | 13 | 142 |
2023 October | 202 | 22 | 224 |
2023 September | 114 | 9 | 123 |
2023 August | 109 | 6 | 115 |
2023 July | 105 | 18 | 123 |
2023 June | 116 | 12 | 128 |
2023 May | 139 | 6 | 145 |
2023 April | 111 | 6 | 117 |
2023 March | 107 | 5 | 112 |
2023 February | 82 | 6 | 88 |
2023 January | 79 | 3 | 82 |
2022 December | 92 | 6 | 98 |
2022 November | 116 | 15 | 131 |
2022 October | 97 | 11 | 108 |
2022 September | 95 | 5 | 100 |
2022 August | 122 | 23 | 145 |
2022 July | 71 | 7 | 78 |
2022 June | 56 | 13 | 69 |
2022 May | 53 | 10 | 63 |
2022 April | 75 | 11 | 86 |
2022 March | 98 | 13 | 111 |
2022 February | 76 | 6 | 82 |
2022 January | 151 | 16 | 167 |
2021 December | 79 | 8 | 87 |
2021 November | 68 | 18 | 86 |
2021 October | 72 | 9 | 81 |
2021 September | 79 | 15 | 94 |
2021 August | 108 | 8 | 116 |
2021 July | 48 | 8 | 56 |
2021 June | 51 | 7 | 58 |
2021 May | 67 | 8 | 75 |
2021 April | 237 | 20 | 257 |
2021 March | 172 | 18 | 190 |
2021 February | 95 | 8 | 103 |
2021 January | 99 | 13 | 112 |
2020 December | 85 | 6 | 91 |
2020 November | 84 | 12 | 96 |
2020 October | 53 | 11 | 64 |
2020 September | 90 | 14 | 104 |
2020 August | 69 | 11 | 80 |
2020 July | 39 | 17 | 56 |
2020 June | 38 | 2 | 40 |
2020 May | 39 | 3 | 42 |
2020 April | 26 | 4 | 30 |
2020 March | 41 | 2 | 43 |
2020 February | 37 | 2 | 39 |
2020 January | 17 | 6 | 23 |
2019 December | 10 | 7 | 17 |
2019 November | 8 | 1 | 9 |
2019 October | 5 | 0 | 5 |
2019 September | 4 | 2 | 6 |
2019 August | 2 | 2 | 4 |
2019 July | 3 | 3 | 6 |
2019 June | 2 | 1 | 3 |
2019 May | 1 | 9 | 10 |
2019 April | 1 | 0 | 1 |
2018 December | 0 | 1 | 1 |
2018 September | 1 | 1 | 2 |
2018 August | 0 | 1 | 1 |
2018 July | 0 | 1 | 1 |
2018 June | 7 | 6 | 13 |
2018 May | 58 | 12 | 70 |
2018 April | 66 | 6 | 72 |
2018 March | 53 | 9 | 62 |
2018 February | 27 | 8 | 35 |
2018 January | 74 | 8 | 82 |
2017 December | 52 | 5 | 57 |
2017 November | 78 | 5 | 83 |
2017 October | 57 | 10 | 67 |
2017 September | 58 | 8 | 66 |
2017 August | 72 | 6 | 78 |
2017 July | 77 | 9 | 86 |
2017 June | 68 | 7 | 75 |
2017 May | 87 | 5 | 92 |
2017 April | 78 | 10 | 88 |
2017 March | 74 | 14 | 88 |
2017 February | 53 | 2 | 55 |
2017 January | 46 | 1 | 47 |
2016 December | 79 | 11 | 90 |
2016 November | 98 | 8 | 106 |
2016 October | 120 | 13 | 133 |
2016 September | 222 | 13 | 235 |
2016 August | 190 | 11 | 201 |
2016 July | 43 | 10 | 53 |
2016 June | 3 | 17 | 20 |
2016 May | 2 | 17 | 19 |
2016 April | 0 | 28 | 28 |
2016 March | 8 | 23 | 31 |
2016 February | 3 | 26 | 29 |
2016 January | 2 | 14 | 16 |
2015 December | 38 | 15 | 53 |
2015 November | 92 | 17 | 109 |
2015 October | 115 | 24 | 139 |
2015 September | 94 | 12 | 106 |
2015 August | 89 | 6 | 95 |
2015 July | 149 | 12 | 161 |
2015 June | 94 | 7 | 101 |
2015 May | 86 | 11 | 97 |
2015 April | 83 | 9 | 92 |
2015 March | 112 | 17 | 129 |
2015 February | 80 | 16 | 96 |
2015 January | 33 | 9 | 42 |