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Máscara laríngea I-Gel® versus bolsa-válvula-mascarilla en la reanimación cardiopulmonar instrumental bajo monitorización capnográfica: ensayo clínico piloto aleatorizado por grupos
I-Gel® laryngeal mask versus bag-valve-mask in instrumental cardiopulmonary resuscitation under capnographic monitoring: Cluster-randomized pilot clinical trial
Francisco José Cereceda-Sáncheza,
Autor para correspondencia
frajocesa@gmail.com

Autor para correspondencia.
, Juan Clar-Terradasa, Rut Moros-Alberta, Andreu Mascaró-Galmésa, Miguel Navarro-Miróa, Jesús Molina-Mulab
a Gerencia SAMU 061 Baleares, Palma de Mallorca, Islas Baleares, España
b Universidad de las Islas Baleares
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como la m&#225;scara lar&#237;ngea &#40;ML&#41;&#44; han visto aumentada su utilizaci&#243;n durante la RCP&#44; su inserci&#243;n r&#225;pida a ciegas y una curva de aprendizaje m&#225;s corta que la intubaci&#243;n orotraqueal &#40;IOT&#41;&#44; los hace adecuados para ser utilizados por manos inexpertas en IOT<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">3</span></a>&#46; Dentro de la amplia gama de ML disponibles en el mercado encontramos la I-Gel&#174; &#40;Intersurgical Ltd&#44; Workingham&#44; Berkshire&#44; Reino Unido&#41;&#44; esta ML ha demostrado su utilidad en el campo de la anestesia y las emergencias<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">4&#44;5</span></a>&#44; con tasas de &#233;xito de inserci&#243;n al primer intento superiores al 90&#37; y una baja incidencia de complicaciones frente otras ML de segunda generaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">4&#44;6&#44;7</span></a>&#46; El European Resuscitation Council &#40;ERC&#41; en 2015&#44; ya suger&#237;a la utilizaci&#243;n de la monitorizaci&#243;n capnogr&#225;fica durante la ventilaci&#243;n de los pacientes por medio de DEG y&#47;o BVM en la RCP<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">8</span></a>&#46; El International Liaison Committee on Resuscitation en 2015 indicaba que los profesionales entrenados deben utilizar DEG o IOT como v&#237;a a&#233;rea avanzada inicial &#40;Class IIb&#41;&#44; remarcando que el uso de la capnograf&#237;a durante la RCP con dispositivos diferentes a la IOT requiere m&#225;s estudios<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">2</span></a>&#46; El objetivo general era comparar la v&#237;a a&#233;rea b&#225;sica frente a la v&#237;a a&#233;rea avanzada con la I-Gel&#174;&#44; por medio de la capnograf&#237;a&#46; Los objetivos secundarios fueron&#58; a&#41; comparar los valores capnogr&#225;ficos a trav&#233;s de BVM frente a la I-Gel&#174;&#46; b&#41; Correlacionar los valores capnogr&#225;ficos obtenidos con la recuperaci&#243;n de la circulaci&#243;n espont&#225;nea &#40;ROSC&#41; durante la RCP&#46; c&#41; Analizar los tiempos y eficacia del uso de la I-Gel&#174; por parte de los t&#233;cnicos en emergencias sanitarias &#40;TES&#41;&#46; d&#41; Determinar la efectividad de una formaci&#243;n de 5<span class="elsevierStyleHsp" style=""></span>h&#44; duraci&#243;n en el adiestramiento y utilizaci&#243;n de la I-Gel&#174; bajo monitorizaci&#243;n capnogr&#225;fica por TES&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Material y m&#233;todos</span><p id="par0010" class="elsevierStylePara elsevierViewall">Estudio experimental aleatorizado por grupos y cruzado en 4 Unidades de Soporte vital B&#225;sico &#40;SVB&#41; del SAMU 061 Baleares de la isla de Mallorca&#44; con mayor casu&#237;stica de asistencia a PCR en 2017&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Tras obtener autorizaci&#243;n del Comit&#233; de &#201;tica de la Investigaci&#243;n de la Islas Baleares &#40;IB 3607&#47;18 PI&#41;&#44; participaron voluntariamente TES que efectuaban guardias en alguna de las SVB diana&#44; siendo las unidades de SVB los conglomerados&#46; Se facilit&#243; una formaci&#243;n reglada de 5<span class="elsevierStyleHsp" style=""></span>h&#44; que fue reconocida por la Comisi&#243;n de Formaci&#243;n Continuada de las Islas Baleares&#59; en total se formaron 62 TES&#46; Se utiliz&#243; un cuaderno de recogida de datos y los valores capnom&#233;tricos se registraron por medio del monitor-desfibrilador Heartstart MRx &#40;Philips&#44; EE&#46; UU&#46;&#41;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Los pacientes eran candidatos para participar en el estudio al ser atendidos por alguno de los TES formados en las unidades de SVB seleccionadas y cumplir con los siguientes criterios de inclusi&#243;n&#58; pacientes en PCR de origen no traum&#225;tico &#40;incluy&#233;ndose ahogados&#41; con edad<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleUnderline">&#62;</span>18 a&#241;os&#44; PCR asistidas por las unidades de SVB en primera instancia&#44; o recibiendo SVB sin manejo avanzado de la v&#237;a a&#233;rea&#46; Se analizaron aquellos pacientes que dispusieran de 4 min de registro capnogr&#225;fico&#46; Los criterios de exclusi&#243;n fueron&#58; pacientes con un peso estimado &#60;<span class="elsevierStyleHsp" style=""></span>50<span class="elsevierStyleHsp" style=""></span>kg&#59; apertura de la cavidad oral &#60;<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>cm o con trismus&#59; pacientes que ya estuvieran siendo atendidos por personal facultativo o sanitario con t&#233;cnicas de SVA&#59; PCR por obstrucci&#243;n de la v&#237;a a&#233;rea por cuerpo extra&#241;o&#44; pacientes con ROSC a la llegada del equipo de SVB&#59; presencia de regurgitaci&#243;n al inicio de la RCP los exclu&#237;a de la rama de ML y situaciones evidentes de muerte como rigidez&#44; descomposici&#243;n&#44; voluntades anticipadas o pacientes paliativos terminales&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Las ramas del estudio fueron&#58; a&#41; Grupo control&#44; pacientes con manejo b&#225;sico de la v&#237;a a&#233;rea por medio de BVM&#46; b&#41; Grupo experimental&#58; pacientes con manejo inicial avanzado de la v&#237;a a&#233;rea mediante DSG &#40;I-Gel&#174;&#41;&#46; En esta rama se exig&#237;a obtener unos valores capnom&#233;tricos<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleUnderline">&#62;</span>5<span class="elsevierStyleHsp" style=""></span>mmHg&#44; para mantener la ventilaci&#243;n con el dispositivo como se hab&#237;a descrito previamente<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">9</span></a>&#46; En ambas ramas se segu&#237;an las recomendaciones 2015 del ERC priorizando la desfibrilaci&#243;n y compresiones tor&#225;cicas &#40;CT&#41; antes de realizar el manejo de la v&#237;a a&#233;rea&#46; La relaci&#243;n CT-ventilaciones durante la RCP era sincronizada con cadencia 30&#58;2 en ambas ramas&#44; hasta la llegada de los equipos de SVA y que el facultativo que hiciera cargo de la v&#237;a a&#233;rea&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Las variables dependientes del estudio correspond&#237;an a&#58; niveles capnom&#233;tricos obtenidos &#40;entre 1 y 9 min registro&#41; seg&#250;n el dispositivo empleado en el manejo de la v&#237;a a&#233;rea&#46; N&#250;mero de inserciones una o dos de la I-Gel&#174;&#44; n&#250;mero de casos sin conseguir una correcta inserci&#243;n&#47;ventilaci&#243;n por ramas&#44; consecuci&#243;n de ROSC en la RCP y n&#250;mero de ingresos vivos hospitalarios&#46; Las variables independientes fueron&#58; sociodemogr&#225;ficas&#44; a&#241;os experiencia TES&#44; manejo b&#225;sico o avanzado de v&#237;a a&#233;rea seg&#250;n rama&#44; ventilaci&#243;n boca-boca testigo&#44; ventilaci&#243;n instrumentalizada por primeros intervinientes&#44; duraci&#243;n RCP b&#225;sica testigos y primeros intervinientes&#44; n&#250;mero desfibrilaciones en la RCP&#44; facilidad inserci&#243;n I-Gel&#174;&#44; fugas audibles durante la ventilaci&#243;n con I-Gel&#174; y v&#243;mitos durante la RCP&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Inicialmente se realiz&#243; una asignaci&#243;n aleatoria simple&#44; de las unidades de SVB participantes en el estudio&#44; a una de las dos ramas A &#91;BVM&#93; o B &#91;ML&#93;&#46; Dicho sistema de aleatorizaci&#243;n cruzado consisti&#243; en una asignaci&#243;n de 2 unidades de SVB durante 4 meses al grupo A y las otras 2 unidades al grupo B&#46; Pasados estos 4 meses&#44; las del grupo A pasaron al B y viceversa&#44; durante otros 4 meses&#59; los pacientes se recogieron de manera consecutiva&#46; Esta aleatorizaci&#243;n se basa en estudios previos<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">10&#44;11</span></a>&#44; donde se retiraban las ML al grupo B con la finalidad de reducir un sesgo de selecci&#243;n del dispositivo&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Se solicit&#243; el consentimiento informado del paciente o familiares&#44; en el momento que recibi&#243; el alta de la Unidad de Cuidados Intensivos&#44; puesto se ha sugerido como momento m&#225;s adecuado<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">12</span></a>&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Para el an&#225;lisis de datos se utilizaron&#58; la prueba de Kolmogorov-Smirnov&#44; t de Student&#44; la U de Mann-Whitney&#44; ANOVA&#44; el coeficiente de correlaci&#243;n de Pearson &#40;r&#41; o Spearman &#40;rho&#41; y el test de Wilcoxon&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Se aplic&#243; un modelo de regresi&#243;n lineal binaria con aquellas variables que alcanzaron una significaci&#243;n &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;2 en las comparaciones univariantes&#44; obteniendo una estimaci&#243;n de riesgo &#40;OR&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">La probabilidad de supervivencia se calcul&#243; con un modelo de riesgos proporcionales de Kaplan-Meier&#46; La comparaci&#243;n de las probabilidades de las diferentes curvas de supervivencia se realiz&#243; con la prueba de comparaci&#243;n de curvas de supervivencia del Log-Rank&#46; La probabilidad de supervivencia se calcul&#243; para cada momento de ocurrencia de los diferentes eventos en base al tiempo en min de la primera ventilaci&#243;n efectiva&#46; Finalmente se incluy&#243; el an&#225;lisis de Regresi&#243;n de Cox para la obtenci&#243;n de la hazzard ratio &#40;HR&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Los an&#225;lisis se realizaron con un nivel de significaci&#243;n estad&#237;stica del 95&#37; &#40;p&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; y con el programa estad&#237;stico SPSS versi&#243;n 23 para Windows&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Resultados</span><p id="par0065" class="elsevierStylePara elsevierViewall">Cincuenta pacientes fueron asistidos por las unidades participantes durante el periodo de estudio &#40;julio-2018 a enero-2020&#41;&#44; no se registraron eventos adversos ni reclamaciones por parte de los pacientes o sus familiares&#46; Se obtuvieron registros capnogr&#225;ficos de m&#237;nimos necesarios en 23 pacientes&#44; formando la muestra analizada&#46; Sus caracter&#237;sticas sociodemogr&#225;ficas est&#225;n en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; La distribuci&#243;n de los grupos fue de 9 pacientes al grupo control &#40;asistidos con BVM&#41; y 14 en el grupo intervenci&#243;n &#40;I-Gel&#174;&#41;&#46; En la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a> se describe el reclutamiento de los sujetos a estudio&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Se analizaron los valores capnom&#233;tricos hasta el minuto 9 de los pacientes que dispon&#237;an de registro &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46; La media de a&#241;os de experiencia de los TES participantes fue de 15&#44;7 a&#241;os &#40;&#177;7&#44;71&#41;&#46; En el grupo intervenci&#243;n&#44; la tasa de &#233;xito de inserci&#243;n de la ML al primer intento fue de 92&#44;9&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>13&#41;&#59; el 14&#44;2&#37;&#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41; del grupo intervenci&#243;n presentaron como complicaci&#243;n v&#243;mitos tras la inserci&#243;n del dispositivo&#46; Solo se registr&#243; un caso &#40;5&#37;&#41; en el que no se pudo insertar y&#47;o ventilar en el grupo intervenci&#243;n&#44; mientras que en el grupo control ning&#250;n paciente present&#243; v&#243;mitos tras iniciar las maniobras&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> se representan las variables relacionadas con el manejo de la v&#237;a a&#233;rea&#44; la presencia de fugas de aire e inserci&#243;n en la rama I-Gel&#174; y complicaciones en ambas ramas&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Los valores capnom&#233;tricos medios de los 9 min fueron de 16&#44;3 &#40;&#177;7&#44;1&#41; mmHg en el grupo control y de 27&#44;4 &#40;&#177;15&#44;5&#41; mmHg en el grupo intervenci&#243;n&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a> est&#225;n representados los valores medios agrupados por rama y minuto&#44; presentando un valor significativamente m&#225;s elevado en m&#225;s min en el grupo intervenci&#243;n que en el control&#46; Los valores capnom&#233;tricos categorizados seg&#250;n el umbral de<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleHsp" style=""></span>mmHg y por rama de estudio&#44; correlacionados con la consecuci&#243;n de ROSC en alg&#250;n momento de la RCP &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a>&#41; y con la variable ingreso vivo&#44; no aportan significaci&#243;n estad&#237;stica &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;65 y p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;96 respectivamente&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">Las pruebas no param&#233;tricas entre valores capnom&#233;tricos&#44; consecuci&#243;n de ROSC o ingreso vivo en el hospital se pueden consultar en la <a class="elsevierStyleCrossRef" href="#tbl0030">tabla 6</a>&#46; Por otro lado&#44; los valores obtenidos en los an&#225;lisis de regresi&#243;n log&#237;stica binaria &#40;<a class="elsevierStyleCrossRef" href="#tbl0035">tabla 7</a>&#41;&#44; comparando los valores capnom&#233;tricos categorizados &#40;&#177;10<span class="elsevierStyleHsp" style=""></span>mmHg&#41; intergrupo con ROSC&#44; se obtuvo una OR de 0&#44;571 &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;654&#41; y&#44; con ingreso vivo de 0&#44;933 &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleMonospace">0</span>&#44;957&#41;&#46; Los pacientes que recibieron ventilaci&#243;n boca-boca por testigos y los que se les efectu&#243; RCP instrumentalizada por primeros intervinientes&#44; presentaban 1&#44;87 veces m&#225;s de probabilidad de ROSC en ambos casos&#44; mientras que se incrementaba la probabilidad de ingresar vivo en el hospital en 2&#44;83 veces a la ventilaci&#243;n boca-boca y 4&#44;44 veces si la RCP del primer interviniente hab&#237;a sido instrumentalizada &#40;p&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46;</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><elsevierMultimedia ident="tbl0035"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0040">tabla 8</a> se pueden consultar los resultados de la correlaci&#243;n Rho-Spearman entre valores capnom&#233;tricos por minuto&#44; a&#241;os de experiencia de los TES y la edad del paciente&#46; De todos los pacientes el 34&#44;8&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#41; alcanz&#243; ROSC en alg&#250;n momento y el 26&#44;1&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#41; ingresaron vivos en el hospital&#46; El an&#225;lisis de supervivencia comparando el transcurso de tiempo de llegada a la escena y el primer minuto de ventilaci&#243;n efectiva registrado&#44; junto a la variable ingreso vivo&#44; ha arrojado una significaci&#243;n de p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;066&#59; con una estimaci&#243;n de 6&#44;0<span class="elsevierStyleHsp" style=""></span>min en el grupo BVM &#40;IC&#58;4&#44;381-9&#44;619&#41; y en el grupo I-Gel&#174; 9&#44;6<span class="elsevierStyleHsp" style=""></span>min &#40;IC&#58;3&#44;828-12&#44;172&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0040"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Discusi&#243;n</span><p id="par0090" class="elsevierStylePara elsevierViewall">Este es el primer ensayo cl&#237;nico que refleja los valores capnom&#233;tricos obtenidos por minuto para evaluar la calidad de la ventilaci&#243;n entre un DSG y BVM durante la RCP&#44; as&#237; como corroborar en nuestro medio&#44; la posibilidad de utilizar un DSG por parte de personal sanitario que no est&#225; habituado a manejarlo con una formaci&#243;n breve&#46; La tasa de &#233;xito de inserci&#243;n del I-Gel&#174; fue similar a datos publicados en experiencias previas con DSG<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">12</span></a>&#46; Adem&#225;s&#44; el uso de la monitorizaci&#243;n capnogr&#225;fica junto estos dispositivos&#44; nos brinda un instrumento centinela sobre la adecuada inserci&#243;n y ventilaci&#243;n del paciente como ya indicaba en las &#250;ltimas recomendaciones de RCP<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">8</span></a>&#46; Llevamos m&#225;s de dos d&#233;cadas correlacionando los valores capnom&#233;tricos como pron&#243;sticos del resultado de la RCP<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">13</span></a>&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Mientras que los valores capnom&#233;tricos obtenidos por rama del estudio sin correlacionar con ninguna otra variable&#44; presentan cierta superioridad en la ventilaci&#243;n por medio de la ML sobre BVM con significaci&#243;n estad&#237;stica &#40;p&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#44; las otras pruebas de contraste y correlaci&#243;n con variables de resultado de la reanimaci&#243;n analizadas no sugieren superioridad de una estrategia sobre la otra&#46; Este resultado podemos contrastarlo con un ECA reciente<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">14</span></a> que no encontr&#243; superioridad de supervivencia entre la asistencia con BVM versus v&#237;a a&#233;rea avanzada con IOT convencional&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">En nuestro estudio apreciamos una tendencia m&#225;s elevada en la OR entre los pacientes con valores<span class="elsevierStyleHsp" style=""></span>&#62; 10<span class="elsevierStyleHsp" style=""></span>mmHg al ROSC y a ingresar vivo en el hospital&#44; que concuerda con las indicaciones de las &#250;ltimas recomendaciones de RCP<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">8</span></a>&#46; El an&#225;lisis de supervivencia de Kaplan-Meier no permitir&#237;a rechazar la hip&#243;tesis nula sobre unos mejores resultados de la reanimaci&#243;n en cuanto a mayor supervivencia inicial &#40;ingreso vivo en hospital&#41;&#44; de los pacientes asistidos con I-Gel&#174; aunque con un valor muy pr&#243;ximo a la significaci&#243;n&#44; indica una tendencia de inter&#233;s &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Existen otras publicaciones en la literatura que indican haber utilizado la capnograf&#237;a para corroborar la adecuada ventilaci&#243;n del paciente por medio de DEG&#44; pero solo el estudio publicado hace 21 a&#241;os de Nakatani et al&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">15</span></a> realiz&#243; una comparaci&#243;n parecida&#59; efectuando la medici&#243;n en un momento determinado&#44; con un capn&#243;metro colorim&#233;trico &#40;semicuantitativo&#41; y con el riesgo de sesgo de selecci&#243;n del dispositivo para el manejo de la v&#237;a a&#233;rea por parte de los TES&#44; puesto que pod&#237;an elegir el dispositivo seg&#250;n criterio personal&#46; El sistema de aleatorizaci&#243;n cruzada por grupos utilizado&#44; retirando la I-Gel&#174; al grupo que pasaba a ser control&#44; probablemente ha colaborado a reducir un sesgo de selecci&#243;n del dispositivo asignado y subsecuentemente de la rama del estudio&#59; factor ya anunciado con anterioridad al inicio del estudio<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">16</span></a>&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">El tiempo medio de llegada hasta la primera ventilaci&#243;n efectiva registrada presenta una cadencia mayor en el grupo de intervenci&#243;n&#46; Debemos tener en cuenta que el manejo de la v&#237;a a&#233;rea es el &#250;ltimo paso que efect&#250;an los TES priorizando CT y desfibrilaci&#243;n&#46; La realizaci&#243;n de las maniobras de manera sincr&#243;nica entre CT y ventilaciones de 30&#58;2 en las dos ramas&#44; puede haber reducido un sesgo de realizaci&#243;n en comparaci&#243;n con ejecuci&#243;n de las CT ininterrumpidas en el grupo intervenci&#243;n&#44; aboliendo este factor de confusi&#243;n potencial&#44; el cual no aparenta mermar la calidad de las ventilaciones suministradas en el grupo intervenci&#243;n&#46; Los valores capnom&#233;tricos significativamente m&#225;s elevados en la rama intervenci&#243;n&#44; aporta cierta evidencia a las recomendaciones emitidas por el ERC<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">17</span></a> del uso de DSG ante la situaci&#243;n de pandemia que vivimos en la actualidad&#46; Por otro lado&#44; debemos reconocer un potencial sesgo de notificaci&#243;n al haber seleccionado los valores de hasta el minuto 9&#44; disponi&#233;ndose hasta ese momento de registros capnom&#233;tricos un tanto desiguales siendo mayor n&#250;mero los del grupo intervenci&#243;n &#40;9 vs&#46; 5 registros en el grupo control&#44; &#91;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#93;&#41;&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">La monitorizaci&#243;n capnogr&#225;fica presenta algunas limitaciones&#46; Uno de los factores que pueden alterar los valores capnogr&#225;ficos es la calidad de las CT&#44; como se analiz&#243; en un estudio<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">18</span></a> que correlacion&#243; la profundidad de las CT con un incremento medio de 1&#44;4<span class="elsevierStyleHsp" style=""></span>mmHg por cada 10<span class="elsevierStyleHsp" style=""></span>mm de profundidad &#40;p&#60;<span class="elsevierStyleHsp" style=""></span>&#44;001&#41;&#46; Otras variables que pueden interferir en los valores capnom&#233;tricos pueden ser la hipoperfusi&#243;n pulmonar secundaria a un tromboembolismo pulmonar&#44; alteraciones metab&#243;licas&#44; hipovolemia severa&#44; PCR de origen asf&#237;xico o en pacientes retenedores de CO<span class="elsevierStyleInf">2</span>&#44; etc&#46; La realizaci&#243;n de un contraste de los valores obtenidos con la causa real de la PCR podr&#237;a ayudar a controlar estos factores que se alejan del objetivo de nuestro estudio piloto&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Otra limitaci&#243;n remarcable en nuestro estudio es la peque&#241;a muestra obtenida dada la casu&#237;stica de la PCR extrahospitalaria&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Teniendo en cuenta el tama&#241;o muestral y sus limitaciones&#44; se podr&#237;a concluir que el uso de la I-Gel&#174; aparentemente mejorar&#237;a la ventilaci&#243;n de los pacientes en PCR&#44; facilit&#225;ndose la confirmaci&#243;n de la adecuada inserci&#243;n y ventilaci&#243;n del paciente por medio de la capnograf&#237;a&#46; Una formaci&#243;n breve aparenta ser suficiente para adiestrar a personal sanitario inexperto en IOT con unas tasas de &#233;xito elevadas y cuantificables&#46; Se precisa realizar ECA con muestras mayores para obtener un poder estad&#237;stico significativo&#46;<elsevierMultimedia ident="tb0005"></elsevierMultimedia></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflicto de intereses</span><p id="par0145" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Comparar la v&#237;a a&#233;rea b&#225;sica y la v&#237;a a&#233;rea avanzada con el dispositivo supragl&#243;tico I-Gel&#174;&#44; por medio de la capnograf&#237;a durante la RCP intermedia&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Dise&#241;o</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio piloto experimental aleatorizado por grupos&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Emplazamiento</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Asistencia extrahospitalaria en unidades de soporte vital b&#225;sico en la isla de Mallorca&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Participantes</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Adultos atendidos tras parada cardiorrespiratoria de origen no traum&#225;tico&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Intervenciones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Manejo de la v&#237;a a&#233;rea avanzado durante la RCP instrumental con I-Gel&#174; o b&#225;sica con bolsa-v&#225;lvula-mascarilla&#44; bajo monitorizaci&#243;n capnogr&#225;fica&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Mediciones principales</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Niveles capnom&#233;tricos obtenidos seg&#250;n dispositivo empleado&#44; n&#250;mero de inserciones de la I-Gel&#174;&#44; casos sin conseguir una correcta inserci&#243;n&#47;ventilaci&#243;n por ramas&#44; consecuci&#243;n de ROSC en la RCP y n&#250;mero de ingresos vivos hospitalarios&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se reclutaron 23 casos para su an&#225;lisis&#46; La tasa de &#233;xito de inserci&#243;n de la I-Gel&#174; fue 92&#44;9&#37; al primer intento&#44; los valores capnom&#233;tricos medios fueron de 16&#44;3<span class="elsevierStyleHsp" style=""></span>mmHg en grupo control y de 27&#44;4&#37; en el grupo intervenci&#243;n&#46; El 34&#44;8&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#41; de los pacientes alcanz&#243; recuperaci&#243;n&#44; circulaci&#243;n espont&#225;nea en alg&#250;n momento y el 26&#44;1&#37; &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#41; ingresaron vivos en el hospital&#46; El an&#225;lisis de supervivencia&#44; atendiendo a la llegada de la unidad y el primer minuto de ventilaciones registrados junto a la variable ingreso vivo hospitalario sugiere una cierta tendencia hacia una mayor supervivencia en la rama intervenci&#243;n &#40;P<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;066&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El uso de la I-Gel&#174; suscita una mejora en la ventilaci&#243;n de los pacientes en PCR&#44; evidenciado por los valores capnom&#233;tricos medios en el grupo intervenci&#243;n&#44; no encontr&#225;ndose correlaci&#243;n con variables de resultado de la RCP&#46;</p></span>"
        "secciones" => array:8 [
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            "titulo" => "Objetivo"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Dise&#241;o"
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          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Emplazamiento"
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          3 => array:2 [
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            "titulo" => "Participantes"
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          4 => array:2 [
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            "titulo" => "Intervenciones"
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          5 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Mediciones principales"
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          6 => array:2 [
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            "titulo" => "Resultados"
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            "titulo" => "Conclusiones"
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Objective</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">To compare the basic airway and the advanced airway with the supraglottic device I-Gel&#174;&#44; by means of capnography during intermediate CPR&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Design</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Randomized experimental pilot study by groups&#46;</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Setting</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Out-hospital care basic life support units on the Island of Mallorca&#46;</p></span> <span id="abst0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Participants</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Adults attended after cardiorespiratory arrest of non-traumatic origin&#46;</p></span> <span id="abst0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Interventions</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Advanced airway management during instrumental CPR with I-Gel&#174; or basic CPR with bag-valve-mask&#44; under capnographic monitoring&#46;</p></span> <span id="abst0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Main measurements</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Capnometric levels obtained according to the device used&#44; number of insertions of the I-Gel&#174;&#44; cases without achieving correct insertion&#47;ventilation by branches&#44; achievement of ROSC in CPR and number of hospital live admissions&#46;</p></span> <span id="abst0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Twenty-three cases were recruited for analysis&#46; The insertion success rate of the I-Gel&#174; was 92&#46;9&#37; at the first attempt&#44; the mean capnometric values were 16&#46;3<span class="elsevierStyleHsp" style=""></span>mmHg in the control group and 27&#46;4&#37; in the intervention group&#46; 34&#46;8&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#41; of the patients achieved spontaneous circulation recovery at some point and 26&#46;1&#37; &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#41; were admitted to hospital alive&#46; The survival analysis&#44; taking into account the arrival of the unit and the first minute of ventilations recorded together with the variable hospital admission&#44; suggests a certain trend of greater survival in the intervention branch &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;066&#41;&#46;</p></span> <span id="abst0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusions</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">The use of I-Gel&#174; raises an improvement in the ventilation of the patients in PCR&#44; evidenced by the mean capnometric values in the intervention group&#44; finding no correlation with CPR outcome variables&#46;</p></span>"
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            "titulo" => "Design"
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            "identificador" => "abst0055"
            "titulo" => "Setting"
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            "titulo" => "Participants"
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            "identificador" => "abst0065"
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          5 => array:2 [
            "identificador" => "abst0070"
            "titulo" => "Main measurements"
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            "identificador" => "abst0075"
            "titulo" => "Results"
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            "identificador" => "abst0080"
            "titulo" => "Conclusions"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Muestra&#47;porcentaje&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hombre&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">18 &#40;78&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mujer&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#40;21&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Edad media&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">61&#44;52 &#40;&#177;14&#44;44&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>25-50 a&#241;os&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3 &#40;13&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>51-65 a&#241;os&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">8 &#40;39&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>66-100 a&#241;os&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">9 &#40;47&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Card&#237;aca&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;17&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Respiratoria&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1 &#40;4&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diabetes&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2 &#40;8&#44;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Digestiva&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1 &#40;4&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Renal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1 &#40;4&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tabaquismo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1 &#40;4&#44;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ninguna&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;17&#44;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Desconocidas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;13&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Otras&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;26&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">RCP testigo</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;60&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;39&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Ventilaci&#243;n boca-boca</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;26&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;73&#44;9&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;39&#44;1&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;60&#44;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Alguna descarga con DESA primer interviniente</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;13&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;87&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables inserci&#243;n I-GEL&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#60;<span class="elsevierStyleHsp" style=""></span>15 a&#241;os experiencia TES&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleHsp" style=""></span>&#62;15 a&#241;os experiencia TES&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">U Mann-WhitneyValor p<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Facilidad inserci&#243;n</span> I-G<span class="elsevierStyleItalic">el&#174;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;656&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>F&#225;cil&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35&#44;7&#37; &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#44;9&#37; &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Media&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#44;3&#37; &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#37; &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dif&#237;cil&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#37; &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;1&#37; &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Fugas audibles</span> I-<span class="elsevierStyleItalic">Gel&#174;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sin fugas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#44;8&#37; &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#44;5&#37; &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;656&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pocas fugas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#37; &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#44;2&#37; &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Abundantes fugas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;1&#37; &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#37; &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;3&#37; &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;3&#37; &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Imposible ventilar&#47;insertar</span> I<span class="elsevierStyleItalic">-Gel&#174; intergrupo</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;118&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">V&#243;mitos durante manejo v&#237;a a&#233;rea intergrupo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BVM&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">34&#44;93<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>21&#44;41&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">28&#44;14<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#44;06&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;101&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;133&nbsp;\t\t\t\t\t\t\n
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                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2729602.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis valores capnom&#233;tricos registrados por minuto seg&#250;n umbral 10<span class="elsevierStyleHsp" style=""></span>mmHg EtCO<span class="elsevierStyleInf">2</span> y regresi&#243;n binaria seg&#250;n consecuci&#243;n de ROSC</p>"
        ]
      ]
      7 => array:8 [
        "identificador" => "tbl0030"
        "etiqueta" => "Tabla 6"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at6"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Minuto EtCO2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ROSC <a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Grados libertad&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P valor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Ingreso vivo <a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Grados libertad&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p valor&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">49&#44;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;171&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">48&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;552&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;956&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;280&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;185&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;280&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">55&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sexo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Patolog&#237;a base&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>RCP testigo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Vent boca-boca testigo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>RCP instrumental 1&#46;<span class="elsevierStyleSup">er</span> interviniente&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>EtCO<span class="elsevierStyleInf">2-</span>1&#8217;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>EtCO<span class="elsevierStyleInf">2-</span>2&#8217;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#44;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>EtCO<span class="elsevierStyleInf">2-</span>3&#8217;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#44;833&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;028&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>EtCO<span class="elsevierStyleInf">2-</span>5&#8217;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>EtCO<span class="elsevierStyleInf">2-</span>6&#8217;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11&#44;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">16&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>EtCO<span class="elsevierStyleInf">2-</span>7&#8217;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>EtCO<span class="elsevierStyleInf">2-</span>8&#8217;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#44;999&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8&#44;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>A&#241;os experiencia<span class="elsevierStyleHsp" style=""></span>TES&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Rama estudio&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Patolog&#237;a base&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;028&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Vent boca-boca testigo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Facilidad inserci&#243;n I-Gel&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>ROSC durante RCP&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">53&#44;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">77&#44;8&nbsp;\t\t\t\t\t\t\n
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                  """
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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Información del artículo
ISSN: 02126567
Idioma original: Español
DOI:10.1016/j.aprim.2021.102062
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¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos