array:23 [ "pii" => "S2341192921001426" "issn" => "23411929" "doi" => "10.1016/j.redare.2020.09.010" "estado" => "S300" "fechaPublicacion" => "2021-11-01" "aid" => "1231" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "copyrightAnyo" => "2020" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2021;68:553-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0034935620302383" "issn" => "00349356" "doi" => "10.1016/j.redar.2020.09.008" "estado" => "S300" "fechaPublicacion" => "2021-11-01" "aid" => "1231" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Rev Esp Anestesiol Reanim. 2021;68:553-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Imagen del mes</span>" "titulo" => "Punto hídrico <span class="elsevierStyleItalic">(hydro-Point)</span> en paciente COVID-19 ventilado con hidroneumotórax secundario a barotrauma" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "553" "paginaFinal" => "554" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Hydro-Point in a ventilated COVID-19 patient with hydropneumothorax secondary to barotrauma" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1167 "Ancho" => 1346 "Tamanyo" => 159816 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Variante del signo ecográfico <span class="elsevierStyleItalic">hydro-point</span> durante el ciclo respiratorio obtenida a través de sonda convexa en octavo y noveno espacio intercostal derecho con línea media axilar (plano sagital). A) Final espiración: Se observan diafragma e hígado, así como espacio anecoico entre el diafragma y la pared torácica (derrame pleural). En el espacio intercostal más cefálico se evidencian líneas «A» sin deslizamiento pleural (neumotórax). B) Inicio de inspiración: El patrón «A» observado en el extremo cefálico se empieza a desplazar caudalmente borrando todas las imágenes ecográficas subpleurales. C) Final de inspiración: Se observa solo el patrón «A» sin deslizamiento pleural en todos los espacios intercostales. Interpretamos este signo como fuga de aire del barotrauma desplazándose en sincronía con el ciclo respiratorio <span class="elsevierStyleItalic">(Dynamic Hydro-point)</span> (ver <a class="elsevierStyleCrossRef" href="#sec0020">vídeo suplementario</a>).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.M. Nieves Alonso, R.M. Méndez Hernández, F. Ramasco Rueda, A. Planas Roca" "autores" => array:4 [ 0 => array:2 [ "nombre" => "J.M." "apellidos" => "Nieves Alonso" ] 1 => array:2 [ "nombre" => "R.M." "apellidos" => "Méndez Hernández" ] 2 => array:2 [ "nombre" => "F." "apellidos" => "Ramasco Rueda" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Planas Roca" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2341192921001426" "doi" => "10.1016/j.redare.2020.09.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192921001426?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935620302383?idApp=UINPBA00004N" "url" => "/00349356/0000006800000009/v1_202110240543/S0034935620302383/v1_202110240543/es/main.assets" ] ] "itemAnterior" => array:19 [ "pii" => "S2341192921001402" "issn" => "23411929" "doi" => "10.1016/j.redare.2020.09.009" "estado" => "S300" "fechaPublicacion" => "2021-11-01" "aid" => "1224" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2021;68:552" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image of the month</span>" "titulo" => "Massive bilateral pneumothorax associated with COVID-19 pneumonia" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "552" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hemotórax masivo tras neumonía bilateral por COVID-19" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 488 "Ancho" => 1300 "Tamanyo" => 87896 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Coronal CT of pulmonary arteries showing right pleural effusion (yellow star) causing compressive atelectasis of the underlying lung (red arrow). (B) Video thoracoscopy image (VATS) showing parietal pleural tissue with implants forming clusters (yellow star) and lung (blue star). Colour images are only shown in the online version of the article.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R. López Herrero, E. Álvarez Fuente, B. Sánchez Quirós, P. Román García" "autores" => array:4 [ 0 => array:2 [ "nombre" => "R." "apellidos" => "López Herrero" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Álvarez Fuente" ] 2 => array:2 [ "nombre" => "B." "apellidos" => "Sánchez Quirós" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Román García" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0034935620302310" "doi" => "10.1016/j.redar.2020.09.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935620302310?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192921001402?idApp=UINPBA00004N" "url" => "/23411929/0000006800000009/v1_202111240601/S2341192921001402/v1_202111240601/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image of the month</span>" "titulo" => "Hydro-Point in a ventilated COVID-19 patient with hydropneumothorax secondary to barotrauma" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "553" "paginaFinal" => "554" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J.M. Nieves Alonso, R.M. Méndez Hernández, F. Ramasco Rueda, A. Planas Roca" "autores" => array:4 [ 0 => array:4 [ "nombre" => "J.M." "apellidos" => "Nieves Alonso" "email" => array:1 [ 0 => "jesusmna@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "R.M." "apellidos" => "Méndez Hernández" ] 2 => array:2 [ "nombre" => "F." "apellidos" => "Ramasco Rueda" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Planas Roca" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Anestesiología y Reanimación, Hospital Universitario de La Princesa, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Punto hídrico <span class="elsevierStyleItalic">(hydro-Point)</span> en paciente COVID-19 ventilado con hidroneumotórax secundario a barotrauma" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1167 "Ancho" => 1346 "Tamanyo" => 160867 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Variant of the hydro-point ultrasound sign during the respiratory cycle obtained using a convex transducer placed in the eighth and ninth right intercostal space on the mid-axillary line (sagittal plane). A) End expiration: The diaphragm and liver are seen, together with an anechoic space between the diaphragm and chest wall (pleural effusion). Observe the “A” lines with no lung sliding in the uppermost intercostal space (pneumothorax). B) Start of inspiration: The “A” pattern starts to to shift downwards, erasing all subpleural ultrasound images. C) End inspiration: Only the pattern “A” is visible, with no lung sliding in the intercostal spaces. We interpret this sign as a barotrauma-induced air leak moving in sync with the respiratory cycle (Dynamic Hydro-point) (see Appendix <a class="elsevierStyleCrossRef" href="#sec0015">B</a> supplemental video).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 69-year-old male patient on his thirteenth day of admission to the postsurgical critical care unit for bilateral SARS-CoV-2 pneumonia (26 days from onset of symptoms). His history was only significant for an episode of peritonitis 20 years prior. He was on lung protective mechanical ventilation and had received several cycles of ventilation in the prone position. His PaO<span class="elsevierStyleInf">2</span>/FiO<span class="elsevierStyleInf">2</span> ratio suddenly fell from 140 to 80. A point-of-care pulmonary ultrasound was performed (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> and Appendix <a class="elsevierStyleCrossRef" href="#sec0015">B</a> supplementary table). Pleural drainage was placed on suspicion of pneumothorax secondary to barotrauma. Atelectasis persisted for 24 h, with no improvement in oxygenation and general worsening even after placement of a second pleural drain. In view of the clinical picture, we decided to limit therapeutic effort, and the patient died on day 15 of admission.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0010" class="elsevierStylePara elsevierViewall">The authors declare that they have not received funding for this study.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Nieves Alonso JM, Méndez Hernández RM, Ramasco Rueda F, Planas Roca A. Punto hídrico <span class="elsevierStyleItalic">(hydro-Point)</span> en paciente COVID-19 ventilado con hidroneumotórax secundario a barotrauma. Rev Esp Anestesiol Reanim. 2021;68:553–554.</p>" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0020" class="elsevierStylePara elsevierViewall">The following is Supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0015" ] ] ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1167 "Ancho" => 1346 "Tamanyo" => 160867 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Variant of the hydro-point ultrasound sign during the respiratory cycle obtained using a convex transducer placed in the eighth and ninth right intercostal space on the mid-axillary line (sagittal plane). A) End expiration: The diaphragm and liver are seen, together with an anechoic space between the diaphragm and chest wall (pleural effusion). Observe the “A” lines with no lung sliding in the uppermost intercostal space (pneumothorax). B) Start of inspiration: The “A” pattern starts to to shift downwards, erasing all subpleural ultrasound images. C) End inspiration: Only the pattern “A” is visible, with no lung sliding in the intercostal spaces. We interpret this sign as a barotrauma-induced air leak moving in sync with the respiratory cycle (Dynamic Hydro-point) (see Appendix <a class="elsevierStyleCrossRef" href="#sec0015">B</a> supplemental video).</p>" ] ] 1 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 1109696 "Video" => array:2 [ "mp4" => array:5 [ "fichero" => "mmc1.m4v" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "flv" => array:5 [ "fichero" => "mmc1.flv" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23411929/0000006800000009/v1_202111240601/S2341192921001426/v1_202111240601/en/main.assets" "Apartado" => array:4 [ "identificador" => "70433" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images of the month" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23411929/0000006800000009/v1_202111240601/S2341192921001426/v1_202111240601/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192921001426?idApp=UINPBA00004N" ]
Journal Information
Vol. 68. Issue 9.
Pages 553-554 (November 2021)
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Vol. 68. Issue 9.
Pages 553-554 (November 2021)
Image of the month
Hydro-Point in a ventilated COVID-19 patient with hydropneumothorax secondary to barotrauma
Punto hídrico (hydro-Point) en paciente COVID-19 ventilado con hidroneumotórax secundario a barotrauma
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J.M. Nieves Alonso
, R.M. Méndez Hernández, F. Ramasco Rueda, A. Planas Roca
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Servicio de Anestesiología y Reanimación, Hospital Universitario de La Princesa, Madrid, Spain
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