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Pneumothorax: Immediate ultrasound diagnosis in the critical patient
Neumotórax: diagnóstico ecográfico inmediato en el paciente crítico
M.I. Espigares López
, E. Meléndez Leal, A. Pernia Romero, L.M. Torres Morera
Corresponding author
Unidad de Gestión Clínica de Anestesiología y Reanimación, Hospital Universitario Puerta del Mar, Cádiz, Spain
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Espigares López, E. Meléndez Leal, A. Pernia Romero, L.M. Torres Morera" "autores" => array:4 [ 0 => array:4 [ "nombre" => "M.I." "apellidos" => "Espigares López" "email" => array:1 [ 0 => "mabelespigares@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Meléndez Leal" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Pernia Romero" ] 3 => array:2 [ "nombre" => "L.M." "apellidos" => "Torres Morera" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Unidad de Gestión Clínica de Anestesiología y Reanimación, Hospital Universitario Puerta del Mar, Cádiz, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Neumotórax: diagnóstico ecográfico inmediato en el paciente crítico" ] ] "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" => 1031 "Ancho" => 2500 "Tamanyo" => 398019 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a) M-mode ultrasound image of pneumothorax in the left lung; 1: ‘stratosphere sign’ or ‘bar code’, represented by horizontal hyperechoic parallel lines; 3: reverberation artefacts, or A-lines; (b) M-mode ultrasound image of the right lung; 2: “Sea shore sign”; 3: A-lines.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We describe pneumothorax in a patient in the postanaesthesia care unit with acute respiratory distress after placement of a resynchronisation device associated with a defibrillator. Diagnostic ultrasound gives highly sensitive real-time results, although it can also give false positives. Our patient was in the supine position and breathing spontaneously. We used a convex transducer (2–5<span class="elsevierStyleHsp" style=""></span>MHz) to evaluate underlying pleural line artefacts in M mode in the upper and lower fields. <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> (left pneumothorax) shows hyperechoic horizontal artifacts called “stratosphere sign” or “bar code”. This sign, which is not pathognomonic, only indicates lung immobility. It can appear in selective intubation, apnoea, severe bronchospasm, pleurodesis, hypoventilation, etc. <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>b (healthy right lung) shows 2 areas that make up the “sea-shore sign”: the upper area, with horizontal lines (the sea) and the lower one, well aerated parenchyma, which has a granulated appearance (sand). As the “lung point sign” was not present, we requested an urgent chest radiograph.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Espigares López MI, Meléndez Leal E, Pernia Romero A, Torres Morera LM. Neumotórax: diagnóstico ecográfico inmediato en el paciente crítico. Rev Esp Anestesiol Reanim. 2018;65:541–542.</p>" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0015" class="elsevierStylePara elsevierViewall">The following are the supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0010" ] ] ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1031 "Ancho" => 2500 "Tamanyo" => 398019 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(a) M-mode ultrasound image of pneumothorax in the left lung; 1: ‘stratosphere sign’ or ‘bar code’, represented by horizontal hyperechoic parallel lines; 3: reverberation artefacts, or A-lines; (b) M-mode ultrasound image of the right lung; 2: “Sea shore sign”; 3: A-lines.</p>" ] ] 1 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:2 [ "fichero" => "mmc1.pdf" "ficheroTamanyo" => 382716 ] ] ] ] "idiomaDefecto" => "en" "url" => "/23411929/0000006500000009/v1_201811070606/S2341192918301525/v1_201811070606/en/main.assets" "Apartado" => array:4 [ "identificador" => "66475" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Image of the month" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23411929/0000006500000009/v1_201811070606/S2341192918301525/v1_201811070606/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192918301525?idApp=UINPBA00004N" ]
