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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">El uso de ventilaci&#243;n mec&#225;nica no invasiva &#40;VNI&#41; en el tratamiento de pacientes cr&#237;ticos ha aumentado claramente desde finales del siglo XX<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">1</span></a>&#46; La VNI forma parte de las normas asistenciales de los pacientes con exacerbaci&#243;n de su EPOC&#44; especialmente cuando es de tipo hiperc&#225;pnico<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">2&#8211;4</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">De forma similar&#44; se han descrito efectos favorables de la VNI en pacientes con EPOC y neumon&#237;a<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">5&#8211;8</span></a>&#44; pero su utilidad en pacientes sin EPOC con neumon&#237;a grave sigue siendo motivo de controversia&#44; debido al elevado porcentaje de fracasos de la VNI<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">6&#44;9</span></a>&#46; En este sentido&#44; existe una cierta preocupaci&#243;n por los efectos de la VNI en la evoluci&#243;n de estos pacientes&#44; ya que se ha descrito que no aporta efectos beneficiosos e incluso que empeora la evoluci&#243;n&#44; especialmente cuando fracasa<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">1&#44;6&#44;10&#8211;16</span></a> y&#44; en particular&#44; cuando retrasa la intubaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">8</span></a>&#46; Se han propuesto varias explicaciones que podr&#237;an justificar la mala evoluci&#243;n observada en pacientes que precisan intubaci&#243;n tras el fracaso de la VNI&#44; tales como el retraso en la intubaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">8</span></a>&#44; el eventual elevado volumen corriente espirado durante la VNI<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">17</span></a> o complicaciones de la propia intubaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">18</span></a>&#46; Asimismo&#44; pacientes con neumon&#237;a grave suelen presentar comorbilidades&#44; como EPOC&#44; insuficiencia card&#237;aca o inmunosupresi&#243;n<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">19&#44;20</span></a> que pueden confundir en la evaluaci&#243;n de la eficacia de la VNI&#46; A pesar de esto&#44; la VNI se usa con frecuencia en servicios de urgencias y unidades de cuidados intensivos &#40;UCI&#41; para tratar la neumon&#237;a y con el objetivo de evitar la intubaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">21&#44;22</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El objetivo principal de este estudio fue evaluar los efectos de la VNI&#44; en comparaci&#243;n con la VM invasiva como tratamiento ventilatorio inicial&#44; sobre la mortalidad hospitalaria en la pr&#225;ctica cl&#237;nica real&#44; en pacientes sin EPOC con neumon&#237;a que precisaban soporte ventilatorio&#46; Los objetivos secundarios fueron evaluar los efectos de la VNI sobre la duraci&#243;n de la estancia e identificar factores capaces de predecir el fracaso de la VNI&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Entorno y poblaci&#243;n del estudio</span><p id="par0020" class="elsevierStylePara elsevierViewall">En el estudio se incluyeron pacientes con diagn&#243;stico principal de neumon&#237;a que hab&#237;an sido ingresados consecutivamente en nuestra UCI desde marzo de 2002 hasta octubre de 2012&#46; Los pacientes se identificaron a trav&#233;s de la base de datos de informes de la UCI&#46; El equipo m&#233;dico revis&#243; los episodios seleccionados y confirm&#243; que el diagn&#243;stico de neumon&#237;a hab&#237;a sido el motivo del ingreso en UCI&#46; La neumon&#237;a se defini&#243; por la presencia de infiltrados pulmonares en la radiograf&#237;a de t&#243;rax en el momento del ingreso en la UCI y de s&#237;ntomas &#40;tos&#44; esputo purulento&#44; disnea o fiebre&#41; y signos &#40;crepitantes o recuento leucocitario superior a 12&#44;0<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">9</span>&#47;l o inferior a 4&#44;0<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">9</span>&#47;l&#41; de infecci&#243;n de v&#237;as respiratorias<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">23</span></a>&#46; El diagn&#243;stico cl&#237;nico de EPOC se determin&#243; por la constataci&#243;n de un cociente FEV<span class="elsevierStyleInf">1</span>&#47;FVC posbroncodilataci&#243;n inferior a 0&#44;70 o&#44; alternativamente&#44; por antecedentes de disnea&#44; tos cr&#243;nica y&#47;o expectoraci&#243;n&#44; y exposici&#243;n a los factores de riesgo de la enfermedad del paciente<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">24</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Los datos se recabaron consultando las historias cl&#237;nicas electr&#243;nicas de los pacientes en las que el uso de dispositivos m&#233;dicos y de perfusiones intravenosas se registra de manera autom&#225;tica &#40;Optum Clinical Solutions<span class="elsevierStyleSup">&#174;</span>&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">En el an&#225;lisis no se incluy&#243; a los pacientes con neumon&#237;a que no hab&#237;an precisado asistencia respiratoria&#46; A continuaci&#243;n&#44; los pacientes incluidos se clasificaron en dos grupos&#44; en funci&#243;n del primer tipo de asistencia aplicada&#58; VM invasiva o VNI&#46; Consideramos que la VNI hab&#237;a fracasado si el paciente hab&#237;a precisado intubaci&#243;n por la neumon&#237;a en alg&#250;n momento&#46; Se defini&#243; como fracaso precoz de la VNI la necesidad de intubaci&#243;n en las 48<span class="elsevierStyleHsp" style=""></span>h siguientes a su inicio<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">25</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Todos los pacientes recibieron tratamiento habitual seg&#250;n las normas asistenciales de nuestra unidad&#46; Los m&#233;dicos intensivistas del equipo decidieron la necesidad de asistencia respiratoria y el tipo de soporte a aplicar &#40;invasivo o no invasivo&#41; de forma no protocolizada&#46; La interfaz utilizada en todos los episodios de ventilaci&#243;n no invasiva fue una m&#225;scara oronasal&#44; y en todos los pacientes intubados se siguieron los protocolos de sedaci&#243;n-analgesia y de retirada del soporte ventilatorio&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Recogida de datos</span><p id="par0040" class="elsevierStylePara elsevierViewall">Recabamos las siguientes variables&#58; edad&#44; sexo&#44; SAPS 3<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">26</span></a>&#44; fechas de ingreso y alta hospitalaria y de la UCI&#44; necesidad y duraci&#243;n de la VNI o VM invasiva&#44; muerte&#44; orden de no intubar al ingreso en UCI&#44; comorbilidades &#40;EPOC&#44; diabetes mellitus&#44; insuficiencia card&#237;aca congestiva&#44; insuficiencia renal cr&#243;nica&#44; insuficiencia hep&#225;tica cr&#243;nica&#44; alcoholismo&#44; inmunosupresi&#243;n o infecci&#243;n por VIH&#41;&#44; hospitalizaciones durante el a&#241;o anterior&#44; caracter&#237;sticas fisiol&#243;gicas en el momento del ingreso y antes de aplicar la ventilaci&#243;n &#40;temperatura&#44; presi&#243;n arterial media&#44; frecuencia respiratoria&#44; frecuencia card&#237;aca y puntuaci&#243;n en la escala de coma de Glasgow &#91;Glasgow Coma Scale &#8211;GCS&#8211;&#93;&#41;&#44; pruebas anal&#237;ticas en el momento del ingreso &#40;recuentos leucocitario y plaquetario&#44; hemoglobina&#44; lactato&#44; urea&#44; creatinina&#44; bilirrubina y alb&#250;mina&#41; y gasometr&#237;a arterial &#40;pH&#44; PaCO<span class="elsevierStyleInf">2</span>&#44; PaO<span class="elsevierStyleInf">2</span>&#41; en el momento de la hospitalizaci&#243;n&#44; antes de la aplicaci&#243;n de la asistencia respiratoria&#46; Tambi&#233;n recabamos otras variables&#44; tales como el n&#250;mero de cuadrantes de la radiograf&#237;a de t&#243;rax afectados en el momento del ingreso en la UCI&#44; FiO<span class="elsevierStyleInf">2</span> inicial&#44; origen de la neumon&#237;a &#40;adquirida en la comunidad o nosocomial&#41;&#44; uso de f&#225;rmacos vasoactivos durante m&#225;s de una hora en las primeras 24<span class="elsevierStyleHsp" style=""></span>h&#44; cultivos de esputo positivos o detecci&#243;n de ant&#237;geno urinario mediante inmunoan&#225;lisis enzim&#225;tico de <span class="elsevierStyleItalic">Streptococcus pneumonie</span> o <span class="elsevierStyleItalic">Legionella pneumophila</span>&#44; e idoneidad de la pauta antibi&#243;tica inicial&#44; y se calcul&#243; la puntuaci&#243;n CURB65<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">27</span></a>&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Aspectos &#233;ticos</span><p id="par0045" class="elsevierStylePara elsevierViewall">El comit&#233; de &#233;tica del Hospital Son Ll&#224;tzer &#40;Palma de Mallorca&#44; Espa&#241;a&#41; aprob&#243; este estudio de una cohorte hist&#243;rica en diciembre de 2014 y&#44; debido a las caracter&#237;sticas del dise&#241;o del estudio&#44; eximi&#243; a los investigadores del requisito de obtener el consentimiento&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">An&#225;lisis estad&#237;stico</span><p id="par0050" class="elsevierStylePara elsevierViewall">Para las comparaciones de variables cualitativas o categ&#243;ricas&#44; expresadas mediante cifras y porcentajes&#44; se utiliz&#243; la prueba de Chi-cuadrado&#46; Las variables continuas se expresaron mediante la media y DE y&#44; si con la prueba de Kolmogorov-Smirnov se determinaba que la distribuci&#243;n era normal&#44; se compararon entre grupos mediante la prueba de la <span class="elsevierStyleItalic">t</span> de Student para datos independientes&#46; En caso contrario&#44; las variables continuas se expresaron mediante la mediana y el rango intercuart&#237;lico y se compararon mediante la prueba de la <span class="elsevierStyleItalic">U</span> de Mann-Whitney&#46; Todos los an&#225;lisis fueron bilaterales y los valores de <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;05 se consideraron significativos&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Se efectuaron an&#225;lisis de Kaplan-Meier de la probabilidad acumulada de supervivencia o de la probabilidad de permanecer con ventilaci&#243;n mec&#225;nica en funci&#243;n de la asistencia respiratoria utilizada&#46; Los grupos se compararon por medio de la prueba del orden logar&#237;tmico&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">En el an&#225;lisis multivariante&#44; la asistencia respiratoria se introdujo como variable &#250;nica con tres categor&#237;as distintas&#58; la categor&#237;a de referencia fue la VM invasiva&#44; con una oportunidad relativa ajustada a 1&#44; que se compar&#243; con el &#233;xito y con el fracaso de la VNI&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Considerando que&#44; en un estudio observacional&#44; las asociaciones en las comparaciones no ajustadas podr&#237;an llevar a error&#44; se efectu&#243; un an&#225;lisis del &#237;ndice de propensi&#243;n con el objetivo de reducir al m&#237;nimo el sesgo en las estimaciones del efecto del soporte ventilatorio inicial&#46; Definimos el <span class="elsevierStyleItalic">score</span> de propensi&#243;n de los pacientes tratados con VM invasiva o VNI como la probabilidad condicional de ser intubado en el primer abordaje en funci&#243;n de las covariables del sujeto&#44; y la calculamos utilizando un modelo de regresi&#243;n log&#237;stica m&#250;ltiple&#46; La capacidad predictiva del modelo final se evalu&#243; mediante la curva de caracter&#237;sticas operativas del receptor &#40;ROC&#41;&#44; de la que se calcul&#243; el &#225;rea bajo la curva &#40;AUC&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">En el an&#225;lisis de regresi&#243;n log&#237;stica multivariante con eliminaci&#243;n secuencial de variables hacia atr&#225;s se incluy&#243; el tipo de asistencia respiratoria y las variables que en el an&#225;lisis univariante se asociaron con la mortalidad &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleInf">in</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;10 y <span class="elsevierStyleItalic">p</span><span class="elsevierStyleInf">out</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Una vez construido el modelo multivariante&#44; el &#237;ndice de propensi&#243;n se a&#241;adi&#243; como variable independiente para calcular el riesgo ajustado de mortalidad hospitalaria&#46; Los datos se procesaron con la versi&#243;n 17&#46;0 del programa inform&#225;tico SPSS&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Resultados</span><p id="par0075" class="elsevierStylePara elsevierViewall">Durante el periodo del estudio ingresaron en nuestra UCI 399 pacientes con neumon&#237;a&#46; En la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a> se presenta el diagrama de flujo de estos pacientes&#46; En el estudio participaron 159&#44; de los cuales 113 &#40;71&#37;&#41; fueron conectados a VM invasiva y 46 &#40;29&#37;&#41; a VNI como primera asistencia respiratoria&#46; La VNI fracas&#243; en 27 de estos 46 pacientes &#40;59&#37;&#41; que precisaron intubaci&#243;n&#46; En el Anexo 1 se muestra el histograma del soporte ventilatorio aplicado a los pacientes a lo largo del estudio&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">En funci&#243;n del primer tipo de asistencia respiratoria aplicada&#44; se observ&#243; que los pacientes con VM invasiva inicial eran m&#225;s j&#243;venes&#59; la proporci&#243;n de insuficiencia renal cr&#243;nica y la de inmunosupresi&#243;n en este grupo era m&#225;s alta&#59; eran enfermos m&#225;s graves &#40;por SAPS 3&#44; proporci&#243;n de f&#225;rmacos vasoactivos requeridos&#44; concentraciones de lactato&#44; puntuaci&#243;n en la GCS&#44; y concentraciones de alb&#250;mina y de bilirrubina total&#41;&#59; y sus valores de PaCO<span class="elsevierStyleInf">2</span> en el momento del ingreso en la UCI eran m&#225;s bajos que en el caso de los de los pacientes tratados con VNI inicialmente &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">El grupo de pacientes en el que el uso inicial de VNI fracas&#243; precis&#243; dosis m&#225;s altas de f&#225;rmacos vasoactivos y mostr&#243; puntuaciones CURB65 m&#225;s altas respecto al grupo en el que la VNI fue exitosa &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 1</a>&#41;&#46; El uso de f&#225;rmacos vasoactivos se asoci&#243; con fracaso de la VNI&#44; con una oportunidad relativa de 7&#44;8 &#40;IC 95&#37;&#44; 1&#44;8 a 33&#44;2&#41;&#44; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;006&#46; En los pacientes con &#233;xito de la VNI&#44; las duraciones de la estancia en UCI y de la estancia hospitalaria fueron m&#225;s cortas que en los pacientes con fracaso de la VNI&#44; mientras que la duraci&#243;n de la VNI fue similar en ambos grupos &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 2</a>&#41;&#46; El fracaso de la VNI se consider&#243; precoz en diecinueve &#40;70&#37;&#41; pacientes&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">El inicio de soporte respiratorio se retras&#243; m&#225;s en el grupo con VM invasiva inicial que en el que se conect&#243; a VNI inicialmente &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46; No se observaron diferencias significativas entre los grupos de fracaso y de &#233;xito de la VNI&#44; ni entre los grupos de VM invasiva de primera l&#237;nea y de fracaso de la VNI &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 2</a>&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">En comparaci&#243;n con los pacientes que en primera instancia recibieron VM invasiva&#44; los pacientes con fracaso de la VNI eran mayores&#44; presentaron mayor porcentaje de insuficiencia renal cr&#243;nica y valores de PaCO<span class="elsevierStyleInf">2</span> m&#225;s altos &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 1</a>&#41;&#46; Adem&#225;s&#44; en este grupo de pacientes&#44; la intubaci&#243;n fue m&#225;s tard&#237;a &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y las duraciones de la VM invasiva y de la estancia en la UCI fueron m&#225;s prolongadas&#44; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007 &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41; y <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001 &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 2</a>&#41;&#44; respectivamente&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">En relaci&#243;n a las caracter&#237;sticas cl&#237;nicas de la neumon&#237;a&#44; no se observaron diferencias significativas entre los grupos de tratamiento &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 1</a>&#41;&#46; En total&#44; siete pacientes &#40;4&#37;&#41; recibieron un tratamiento antibi&#243;tico inicial inadecuado&#59; tres en el grupo de VM invasiva &#40;<span class="elsevierStyleItalic">Pseudomonas aeruginosa</span>&#44; virus <span class="elsevierStyleItalic">Herpes simplex</span> m&#225;s virus <span class="elsevierStyleItalic">Influenza</span> H1N1 y virus <span class="elsevierStyleItalic">Herpes simplex</span>&#41;&#44; tres en el grupo de fracaso de la VNI &#40;<span class="elsevierStyleItalic">Enterococcus faecium</span>&#44; <span class="elsevierStyleItalic">Aspergillus fumigatus</span> y virus <span class="elsevierStyleItalic">Herpes simplex</span>&#41; y uno en el grupo de &#233;xito de la VNI &#40;virus <span class="elsevierStyleItalic">Influenza</span> H1N1&#41;&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 3</a> se presentan los diagn&#243;sticos microbiol&#243;gicos de las neumon&#237;as&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">Los pacientes con neumon&#237;a nosocomial eran mayoritariamente varones y presentaban m&#225;s comorbilidades&#44; recuentos leucocitarios y concentraciones de bilirrubina m&#225;s bajos que los pacientes con neumon&#237;a adquirida en la comunidad &#40;<a class="elsevierStyleCrossRef" href="#sec0070">Anexo 2</a>&#41;&#46; Asimismo&#44; sus estancias fueron m&#225;s prolongadas &#40;diferencia media de 17 d&#237;as &#40;IC 95&#37;&#44; 7-28 d&#237;as&#44; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;009&#41;&#46;</p><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">An&#225;lisis de la mortalidad</span><p id="par0110" class="elsevierStylePara elsevierViewall">En el an&#225;lisis univariante &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 2</a>&#41;&#44; los pacientes tratados inicialmente con VM invasiva no presentaron diferencias significativas en la mortalidad hospitalaria en comparaci&#243;n a los pacientes tratados con VNI inicial &#40;37&#37;&#41; ni con los pacientes que fracasaron en la VNI &#40;56&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 2</a>&#41;&#44; aunque esta &#250;ltima diferencia fue cl&#237;nicamente importante &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3</a>&#41;&#46; En el an&#225;lisis multivariante de todos los pacientes que recibieron soporte ventilatorio &#40;invasivo y no invasivo&#41;&#44; las variables que se asociaron con la mortalidad hospitalaria en el modelo final fueron la edad&#44; la puntuaci&#243;n SAPS 3&#44; la inmunosupresi&#243;n y el fracaso de la VNI&#44; en comparaci&#243;n con VM invasiva de primera l&#237;nea &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 4</a>&#41;&#46; Al ajustar este modelo al &#237;ndice de propensi&#243;n de recibir VM invasiva o VNI de primera l&#237;nea como covariable explicativa&#44; el riesgo de muerte aument&#243; 4&#44;31 veces &#40;IC 95&#37;&#44; 1&#44;33-13&#44;94&#59; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41; en los pacientes con fracaso de la VNI&#44; en comparaci&#243;n con aquellos que fueron sometidos a VM invasiva de primera l&#237;nea &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 4</a>&#41;&#46; El &#225;rea bajo la curva del modelo del <span class="elsevierStyleItalic">score</span> de propensi&#243;n fue de 0&#44;82 &#40;IC 95&#37;&#44; 0&#44;74-0&#44;89&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">En los grupos de VM invasiva de primera l&#237;nea y de fracaso de la VNI no hubo diferencias entre supervivientes y no supervivientes seg&#250;n el tiempo de retraso de la intubaci&#243;n &#40;<a class="elsevierStyleCrossRef" href="#fig0020">fig&#46; 4</a>&#41;&#59; entre los pacientes con fracaso precoz y tard&#237;o de la VNI no se observaron diferencias en la mortalidad hospitalaria &#40;50 vs&#46; 58&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;5&#44; respectivamente&#41;&#46; Adem&#225;s&#44; al evaluar conjuntamente a los pacientes intubados&#44; no se observ&#243; ninguna asociaci&#243;n entre el retraso de la intubaci&#243;n y la mortalidad hospitalaria &#40;OR 1&#44;01 &#91;IC 95&#37;&#44; 1&#44;00-1&#44;01&#93;&#44; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;36&#41;&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Discusi&#243;n</span><p id="par0120" class="elsevierStylePara elsevierViewall">En nuestro estudio&#44; la aplicaci&#243;n de VNI de primera l&#237;nea a pacientes sin EPOC con neumon&#237;a ingresados en la UCI no se asoci&#243; a un tiempo de ingreso m&#225;s corto ni una reducci&#243;n de la mortalidad hospitalaria&#44; en comparaci&#243;n con el tratamiento con VM invasiva de primera l&#237;nea&#46; De hecho&#44; la tasa de fracaso de la VNI con necesidad de tratamiento de rescate mediante VM invasiva fue alta y se asoci&#243; con mala evoluci&#243;n&#44; prolongaci&#243;n de las estancias en UCI y hospital&#44; mayor duraci&#243;n de la VM invasiva&#46; En el an&#225;lisis multivariante ajustado&#44; se relacion&#243; adem&#225;s con mayor mortalidad hospitalaria&#44; en comparaci&#243;n con la VM invasiva de primera l&#237;nea&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">El presente estudio acrecienta la preocupaci&#243;n ya existente por los efectos nocivos del fracaso de la VNI en estos pacientes<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">1&#44;7&#44;12&#44;13&#44;18&#44;28&#44;29</span></a>&#44; puesto que los pacientes que inicialmente no cumpl&#237;an los criterios de VM invasiva y <span class="elsevierStyleItalic">a priori</span> parec&#237;an tener un pron&#243;stico m&#225;s favorable por presentar puntuaciones SAPS 3 m&#225;s bajas&#44; finalmente evolucionaron peor que aquellos a los que se intub&#243; directamente&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Desde los a&#241;os 90&#44; existe cierta controversia respecto a los efectos de la VNI en comparaci&#243;n con la oxigenoterapia convencional en pacientes con insuficiencia respiratoria aguda hipox&#233;mica que no est&#233; causada por insuficiencia card&#237;aca aguda o exacerbaci&#243;n de la EPOC&#46; El uso es particularmente controvertido en pacientes inmunocompetentes con neumon&#237;a o con s&#237;ndrome de distr&#233;s respiratorio agudo&#46; Algunos estudios han descrito efectos beneficiosos en relaci&#243;n con los porcentajes de intubaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">6&#44;20</span></a> o la mortalidad<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">20</span></a>&#44; mientras que otros han advertido de sus efectos potencialmente perjudiciales en caso de fracaso<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">1&#44;9&#44;11&#8211;13&#44;15&#44;18&#44;21&#44;30&#8211;32</span></a>&#44; especialmente en pacientes que no padecen EPOC<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">7&#44;9&#44;11</span></a>&#46; Es probable que esta discordancia entre trabajos sea debida a diferencias en los tipos de estudio &#40;ensayos cl&#237;nicos&#44; registros y series de casos&#41; o en la casu&#237;stica de pacientes&#44; a la variabilidad en la gravedad de los participantes<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">21&#44;33</span></a> y a diferencias en los criterios de exclusi&#243;n de los estudios&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Para minimizar estos errores&#44; en nuestro estudio excluimos a los pacientes con EPOC&#44; aquellos con orden de no reanimar y los que no precisaban soporte ventilatorio&#46; La exclusi&#243;n de los pacientes con EPOC o con orden de no reanimar confiri&#243; solidez a nuestros resultados&#44; debido a que en el an&#225;lisis de los efectos de la VNI sobre la evoluci&#243;n de pacientes con neumon&#237;a existen factores de confusi&#243;n<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">6&#44;34</span></a>&#46; La exclusi&#243;n de los pacientes que en ning&#250;n momento precisaron asistencia respiratoria&#44; a diferencia de los estudios aleatorizados<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">6&#44;20&#44;32</span></a>&#44; nos permiti&#243; comparar los efectos de ambos tipos de asistencia en los casos en los que la oxigenoterapia&#44; junto con el tratamiento m&#233;dico&#44; se consider&#243; insuficiente&#44; y contribuy&#243; a asegurar que el an&#225;lisis no inclu&#237;a pacientes que hab&#237;an recibido asistencia respiratoria innecesaria&#46; Asimismo&#44; en nuestro centro&#44; los pacientes con neumon&#237;a que precisaron soporte ventilatorio o tratamiento vasoactivo fueron ingresados en la UCI&#44; y es improbable que se haya introducido un sesgo en la selecci&#243;n de los pacientes&#44; aparte del relativo a la decisi&#243;n del equipo m&#233;dico responsable de iniciar asistencia respiratoria&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Los niveles de PaCO<span class="elsevierStyleInf">2</span> fueron m&#225;s altos entre los pacientes tratados con VNI que en aquellos que recibieron VM invasiva de primera l&#237;nea&#46; Puesto que los pacientes con EPOC fueron excluidos del estudio&#44; la hipercapnia probablemente se debi&#243; a insuficiencia respiratoria aguda&#44; ya que se acompa&#241;&#243; de acidosis leve&#44; sin que se observasen diferencias entre grupos en la GCS&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">La tasa de fracaso de la VNI fue mayor que en ensayos cl&#237;nicos<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">6&#44;20&#44;32&#44;34&#44;35</span></a>&#44; pero similar a las descritas en estudios observacionales<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">1&#44;7&#44;9&#8211;11&#44;13</span></a>&#46; Nuestros pacientes eran pacientes cr&#237;ticos&#58; un 60&#37; precis&#243; f&#225;rmacos vasoactivos&#44; y la mortalidad hospitalaria global fue de un 36&#37;&#44; porcentaje que concuerda con el esperado de acuerdo a las puntuaciones SAPS 3<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">26</span></a>&#46; Respecto a las comorbilidades&#44; los pacientes del grupo de VNI de primera l&#237;nea eran de mayor edad y con mayor proporci&#243;n de insuficiencia renal cr&#243;nica que en el grupo tratado con VM invasiva de primera l&#237;nea&#46; Por el contrario&#44; las puntuaciones SAPS 3 y el porcentaje de inmunosupresi&#243;n fueron m&#225;s altos en el grupo de VM invasiva de primera l&#237;nea&#44; lo que es indicativo de que los pacientes de este grupo eran m&#225;s graves&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Pese a la r&#225;pida aplicaci&#243;n de la primera t&#233;cnica ventilatoria&#44; VM invasiva o VNI&#44; los pacientes en los que la VNI fracas&#243; fueron intubados con un retraso cl&#237;nicamente significativo&#44; en comparaci&#243;n con los pacientes tratados con VM invasiva de primera l&#237;nea&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Queremos resaltar que la mortalidad hospitalaria fue mayor en el grupo con fracaso de la VNI que en el grupo tratado con VM invasiva &#40;56 vs&#46; 35&#37;&#41;&#44; aunque la diferencia no alcanz&#243; la significaci&#243;n estad&#237;stica&#44; probablemente debido al peque&#241;o tama&#241;o de la muestra&#46; En algunos estudios&#44; el retraso de la intubaci&#243;n tras el fracaso de la VNI se ha asociado con mayor mortalidad<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">8</span></a>&#46; Esta mala evoluci&#243;n se podr&#237;a explicar por disnea persistente durante el tratamiento con VNI&#44; que causar&#237;a mayor trabajo respiratorio y que finalmente conducir&#237;a a la intubaci&#243;n&#46; Adem&#225;s&#44; la intubaci&#243;n y sedaci&#243;n tempranas pueden reducir el trabajo respiratorio&#44; los episodios de falta de sincron&#237;a y el biotrauma<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">36</span></a>&#46; Eventualmente&#44; los altos vol&#250;menes corrientes administrados durante la VNI tambi&#233;n podr&#237;an haber incrementado el da&#241;o pulmonar inducido por el ventilador<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">17</span></a> y&#44; en consecuencia&#44; la mortalidad<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">37</span></a>&#46; Desafortunadamente&#44; no registramos datos de los par&#225;metros fisiol&#243;gicos y ventilatorios del periodo de VNI&#46; Moister et al&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">18</span></a> tambi&#233;n hallaron un aumento de complicaciones de la intubaci&#243;n en pacientes en los que la VNI hab&#237;a fracasado&#44; en comparaci&#243;n con aquellos a los que se intub&#243; directamente&#46; Estos argumentos podr&#237;an explicar&#44; en parte&#44; el aumento de mortalidad observado en los pacientes con fracaso de la VNI&#46; No obstante&#44; en nuestro estudio no se observ&#243; ninguna asociaci&#243;n entre el retraso de la intubaci&#243;n y la mortalidad&#46; Del mismo modo&#44; Thille et al&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">30&#44;</span></a> no observaron diferencias en el tiempo transcurrido hasta la intubaci&#243;n al comparar supervivientes y no supervivientes&#44; mostrando valores muy parecidos a los nuestros y contrapuestos a los descritos por Carrillo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">8</span></a>&#46; Esa falta de asociaci&#243;n con un aumento de la mortalidad podr&#237;a quiz&#225;s explicarse por la brevedad del retraso de la intubaci&#243;n en nuestro estudio&#44; puesto que un 70&#37; de pacientes fueron intubados en el plazo de 48<span class="elsevierStyleHsp" style=""></span>h&#46; Adem&#225;s&#44; no observamos diferencias entre grupos respecto a la idoneidad del tratamiento antibi&#243;tico que pudieran explicar las diferencias observadas en la mortalidad&#44; y el microorganismo causante no se identific&#243; en m&#225;s de un tercio de los pacientes&#44; tal como se ha descrito en otros trabajos<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">38</span></a>&#46; En nuestro estudio&#44; los pacientes con fracaso de la VNI precisaron&#44; inevitablemente&#44; VM invasiva&#44; pero desconocemos si la VNI habr&#237;a sido satisfactoria en algunos de los pacientes que recibieron VM invasiva de primera l&#237;nea&#46; No podemos descartar que el fracaso de la VNI&#44; m&#225;s que un factor que empeore el pron&#243;stico&#44; sea un marcador de gravedad que otros indicadores no han podido detectar &#40;SAPS 3 o necesidad de f&#225;rmacos vasoactivos&#41;&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">En la pr&#225;ctica cl&#237;nica&#44; determinar si un paciente sin EPOC con neumon&#237;a grave debe ser intubado directamente o se debe probar el tratamiento VNI es una decisi&#243;n que se debe tomar con prontitud&#46; En nuestro estudio&#44; la &#250;nica variable asociada con el fracaso de la VNI fue el uso de f&#225;rmacos vasoactivos en las primeras 24<span class="elsevierStyleHsp" style=""></span>h desde el ingreso en la UCI&#44; lo que concuerda con lo observado en otros estudios<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">13&#44;30</span></a>&#46; Cabe se&#241;alar que los par&#225;metros respiratorios asociados con la gravedad de la neumon&#237;a&#44; como la oxigenaci&#243;n &#40;determinada mediante el cociente PaO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span>&#41;&#44; el n&#250;mero de cuadrantes afectados en la radiograf&#237;a o la presencia de bacteriemia&#44; no difirieron entre los pacientes con &#233;xito y fracaso de la VNI&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Entre las limitaciones de nuestro estudio&#44; debemos subrayar su car&#225;cter unic&#233;ntrico y retrospectivo&#44; lo que obliga a considerar estos resultados con precauci&#243;n&#46; En segundo lugar&#44; para determinar la necesidad o el tipo de asistencia respiratoria no se sigui&#243; un protocolo&#44; sino que la decisi&#243;n se tom&#243; a criterio del equipo m&#233;dico responsable del paciente&#46; Tercero&#44; no registramos la cronolog&#237;a de la administraci&#243;n del tratamiento m&#233;dico no ventilatorio inicial&#44; como&#44; por ejemplo&#44; antibi&#243;ticos o reposici&#243;n del volumen de fluidos&#46; Cuarto&#44; durante el periodo del estudio se introdujeron cambios en la pol&#237;tica de tratamiento del centro&#44; como la implementaci&#243;n de la Campa&#241;a para sobrevivir a la sepsis<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">39</span></a>&#44; que podr&#237;an haber modificado la evoluci&#243;n de los pacientes&#46; Por &#250;ltimo&#44; la heterogeneidad en las caracter&#237;sticas basales de los diferentes grupos por tipo de asistencia respiratoria podr&#237;a haber inducido a errores en la interpretaci&#243;n de los resultados&#46; Para reducir al m&#237;nimo estas importantes deficiencias&#44; ajustamos el an&#225;lisis de mortalidad por &#237;ndice de propensi&#243;n&#44; que defini&#243; la probabilidad de intubaci&#243;n en primera instancia de acuerdo con algunas covariables del sujeto&#44; aunque el m&#233;todo utilizado no es capaz de eliminar completamente el sesgo en la asignaci&#243;n del tratamiento<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">40</span></a>&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conclusiones</span><p id="par0170" class="elsevierStylePara elsevierViewall">La evoluci&#243;n de los pacientes sin EPOC con neumon&#237;a que precisaban asistencia respiratoria y que en primera instancia fueron conectados a VNI no fue mejor que la de los pacientes inicialmente conectados a VM invasiva&#46; El fracaso de la VNI se asoci&#243; con mayor duraci&#243;n de VM&#44; estancia en la UCI m&#225;s prolongada y mayor mortalidad hospitalaria&#44; en comparaci&#243;n con los pacientes tratados con VM invasiva de primera l&#237;nea&#46; La necesidad de f&#225;rmacos vasoactivos disuade de aplicar VNI de primera l&#237;nea&#44; debido a que se ha observado un alto porcentaje de fracasos de la VNI&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Autor&#237;a&#47;colaboradores</span><p id="par0175" class="elsevierStylePara elsevierViewall">B&#250;squeda bibliogr&#225;fica&#58; Gemma Rialp&#44; Daniel Mu&#241;iz&#44; Maria Romero&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Recogida de datos&#58; Gemma Rialp&#44; Catalina Forteza&#44; Daniel Mu&#241;iz&#44; Maria Romero&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Dise&#241;o del estudio&#58; Gemma Rialp&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">An&#225;lisis de los datos&#58; Gemma Rialp&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Preparaci&#243;n del manuscrito&#58; Gemma Rialp&#44; Catalina Forteza&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Revisi&#243;n del manuscrito&#58; Daniel Mu&#241;iz&#44; Maria Romero&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicto de intereses</span><p id="par0205" 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">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El uso de ventilaci&#243;n no invasiva &#40;VNI&#41; en pacientes sin EPOC con neumon&#237;a es motivo de controversia&#44; debido a la elevada tasa de fracasos y a los efectos potencialmente nocivos de dicho fracaso&#46; La finalidad de este estudio fue evaluar la evoluci&#243;n de los pacientes en funci&#243;n de cu&#225;l hab&#237;a sido el primer tipo de soporte ventilatorio aplicado&#44; VNI o ventilaci&#243;n mec&#225;nica invasiva &#40;VM&#41;&#44; e identificar factores de predicci&#243;n del fracaso de la VNI&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio de una cohorte hist&#243;rica de 159 pacientes sin EPOC con neumon&#237;a ingresados en la UCI que recibieron soporte ventilatorio&#46; Los pacientes se clasificaron en dos grupos&#44; VM invasiva y VNI&#46; Se efectuaron an&#225;lisis univariantes y multivariantes de los datos demogr&#225;ficos y cl&#237;nicos&#46; El an&#225;lisis de mortalidad se ajust&#243; por &#237;ndice de propensi&#243;n a ser conectado a VM invasiva como tratamiento inicial&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Ciento trece pacientes fueron conectados a VM invasiva como tratamiento ventilatorio inicial y 46 a VNI&#44; 27 de los cuales precisaron intubaci&#243;n&#46; La mortalidad hospitalaria fue del 35&#44; 37 y 56&#37;&#44; respectivamente&#44; y no se observaron diferencias significativas entre grupos&#46; En el an&#225;lisis ajustado a la propensi&#243;n &#40;expresada mediante &#40;OR &#91;IC 95&#37;&#93;&#41;&#44; la mortalidad hospitalaria se asoci&#243; con la edad &#40;1&#44;05 &#91;1&#44;02 - 1&#44;08&#93;&#41;&#44; la puntuaci&#243;n SAPS3 &#40;1&#44;03 &#91;1&#44;00 - 1&#44;07&#93;&#41;&#44; la inmunosupresi&#243;n &#40;2&#44;52 &#91;1&#44;02 - 6&#44;27&#93;&#41; y el fracaso de la VNI&#44; en comparaci&#243;n con la VM invasiva de primera l&#237;nea &#40;4&#44;3 &#91;1&#44;33 - 13&#44;94&#93;&#41;&#46; En comparaci&#243;n con la VM invasiva&#44; el fracaso de la VNI retras&#243; la intubaci&#243;n &#40;<span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#44; prolong&#243; la duraci&#243;n de la VM invasiva &#40;<span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#41; y la estancia en la UCI &#40;<span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; El fracaso de la VNI se asoci&#243; con la necesidad de recibir f&#225;rmacos vasoactivos &#40;OR 7&#44;8 &#91;IC 95&#37;&#44; 1&#44;8 - 33&#44;2&#93;&#44; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;006&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En pacientes sin EPOC con neumon&#237;a&#44; la VNI como tratamiento ventilatorio inicial no se asoci&#243; con mejor evoluci&#243;n&#44; en comparaci&#243;n con la VM invasiva de primera l&#237;nea&#46; El fracaso de la VNI se relacion&#243; con duraciones m&#225;s prolongadas de la MV y la estancia hospitalaria&#44; y con mayor mortalidad hospitalaria&#46; El uso de f&#225;rmacos vasoactivos fue predictivo del fracaso de la VNI&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "M&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The use of noninvasive ventilation &#40;NIV&#41; in non-COPD patients with pneumonia is controversial due to its high rate of failure and the potentially harmful effects when NIV fails&#46; The purpose of the study was to evaluate outcomes of the first ventilatory treatment applied&#44; NIV or invasive mechanical ventilation &#40;MV&#41;&#44; and to identify predictors of NIV failure&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Historical cohort study of 159 non-COPD patients with pneumonia admitted to the ICU with ventilatory support&#46; Subjects were divided into 2 groups&#58; invasive MV or NIV&#46; Univariate and multivariate analyses with demographic and clinical data were performed&#46; Analysis of mortality was adjusted for the propensity of receiving first-line invasive MV&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">One hundred and thirteen subjects received first-line invasive MV and 46 received first-line NIV&#44; of which 27 needed intubation&#46; Hospital mortality was 35&#44; 37 and 56&#37;&#44; respectively&#44; with no significant differences among groups&#46; In the propensity-adjusted analysis &#40;expressed as OR &#91;95&#37; CI&#93;&#41;&#44; hospital mortality was associated with age &#40;1&#46;05 &#91;1&#46;02-1&#46;08&#93;&#41;&#44; SAPS3 &#40;1&#46;03 &#91;1&#46;00-1&#46;07&#93;&#41;&#44; immunosuppression &#40;2&#46;52 &#91;1&#46;02-6&#46;27&#93;&#41; and NIV failure compared to first-line invasive MV &#40;4&#46;3 &#91;1&#46;33-13&#46;94&#93;&#41;&#46; Compared with invasive MV&#44; NIV failure delayed intubation &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;004&#41;&#44; and prolonged the length of invasive MV &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;007&#41; and ICU stay &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; NIV failure was associated with need for vasoactive drugs &#40;OR 7&#46;8 &#91;95&#37; CI&#44; 1&#46;8-33&#46;2&#93;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;006&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In non-COPD subjects with pneumonia&#44; first-line NIV was not associated with better outcome compared with first-line invasive MV&#46; NIV failure was associated with longer duration of MV and hospital stay&#44; and with increased hospital mortality&#46; The use of vasoactive drugs predicted NIV failure&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introduction"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Methods"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Results"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusions"
          ]
        ]
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:2 [
          0 => array:3 [
            "apendice" => "<p id="par0215" class="elsevierStylePara elsevierViewall"></p><elsevierMultimedia ident="fig0025"></elsevierMultimedia>"
            "etiqueta" => "Anexo 1"
            "identificador" => "sec0070"
          ]
          1 => array:4 [
            "apendice" => "<p id="par0210" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></p>"
            "etiqueta" => "Anexo 2"
            "titulo" => "Caracter&#237;sticas demogr&#225;ficas y cl&#237;nicas de los pacientes seg&#250;n el origen de la neumon&#237;a"
            "identificador" => "sec0065"
          ]
        ]
      ]
    ]
    "multimedia" => array:10 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1240
            "Ancho" => 1503
            "Tamanyo" => 117996
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Diagrama de flujo de pacientes a lo largo del estudio&#46;</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">EPOC&#58; enfermedad pulmonar obstructiva cr&#243;nica&#59; VM&#58; ventilaci&#243;n mec&#225;nica&#59; VNI&#58; ventilaci&#243;n mec&#225;nica no invasiva&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1210
            "Ancho" => 1525
            "Tamanyo" => 93061
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Curva de Kaplan-Meier de la probabilidad de permanecer con ventilaci&#243;n mec&#225;nica de los pacientes intubados en funci&#243;n de la asistencia respiratoria utilizada&#46; VMI&#58; ventilaci&#243;n mec&#225;nica invasiva&#59; VNI&#58; ventilaci&#243;n mec&#225;nica no invasiva&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figura 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1191
            "Ancho" => 1514
            "Tamanyo" => 85826
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        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Curvas de Kaplan-Meier de la probabilidad acumulada de supervivencia de los pacientes intubados en funci&#243;n de la asistencia respiratoria utilizada&#46;</p> <p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">VMI&#58; ventilaci&#243;n mec&#225;nica invasiva&#59; VNI&#58; ventilaci&#243;n mec&#225;nica no invasiva&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "fig0020"
        "etiqueta" => "Figura 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 1571
            "Ancho" => 1412
            "Tamanyo" => 126907
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Retraso en la intubaci&#243;n en supervivientes &#40;cajas gris oscuro&#41; y no supervivientes &#40;cajas gris claro&#41; en funci&#243;n de la asistencia respiratoria utilizada en primer lugar&#46; Los resultados se muestran con un diagrama de caja &#40;mediana y rango intercuart&#237;lico&#41;&#46;</p> <p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">VMI&#58; ventilaci&#243;n mec&#225;nica invasiva&#59; VNI&#58; ventilaci&#243;n mec&#225;nica no invasiva&#46;</p>"
        ]
      ]
      4 => array:7 [
        "identificador" => "fig0025"
        "etiqueta" => "Figura B1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr5.jpeg"
            "Alto" => 1219
            "Ancho" => 1546
            "Tamanyo" => 59358
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Histograma de la asistencia respiratoria utilizada a lo largo del periodo de estudio &#40;barra negra&#44; grupo de ventilaci&#243;n mec&#225;nica invasiva&#59; barra gris&#44; grupo de &#233;xito de la ventilaci&#243;n mec&#225;nica no invasiva&#59; y barra blanca&#44; grupo de fracaso de la ventilaci&#243;n mec&#225;nica no invasiva&#41;&#46; El tiempo se muestra en cuartiles&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">En las columnas de VNI&#44; los s&#237;mbolos indican diferencias entre el conjunto de grupos de VNI y el grupo de VM invasiva&#46; Los s&#237;mbolos en la columna de &#233;xito de la VNI indican diferencias entre los grupos de &#233;xito y de fracaso de la VNI&#46; Los s&#237;mbolos en la columna de fracaso de la VNI indican diferencias entre los grupos de fracaso de la VNI y de VM invasiva&#46;</p><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">c&#47;n&#58; comunitaria&#47;nosocomial&#59; DE&#58; desviaci&#243;n est&#225;ndar&#59; VIH&#58; virus de la inmunodeficiencia humana&#59; PAM&#58; presi&#243;n arterial media&#59; GCS&#58; Glascow Coma Score&#59; VM&#58; ventilaci&#243;n mec&#225;nica&#59; VNI&#58; ventilaci&#243;n mec&#225;nica no invasiva&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">VM no invasiva</th><th class="td" title="table-head  " align="left" valign="top" scope="col">VM invasiva &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>113&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#201;xito de la VNI &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Fracaso de la VNI &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad &#40;a&#241;os&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68&#44;6 &#40;16&#44;1&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&#44;6 &#40;16&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&#44;8 &#40;17&#44;2&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&#44;6 &#40;16&#44;3&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Varones&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69 &#40;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#40;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69 &#40;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Comorbilidades&#58;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Insuficiencia card&#237;aca cr&#243;nica&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;11&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hepatopat&#237;a cr&#243;nica&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;15&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Insuficiencia renal cr&#243;nica&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;22&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;22&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;8&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25 &#40;22&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Alcoholismo&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;20&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Inmunosupresi&#243;n&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;17&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40 &#40;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40 &#40;35&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Infecci&#243;n por VIH&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;12&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>M&#225;s de 1 comorbilidad&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;20&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hospitalizaci&#243;n &#60;1 a&#241;o&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35 &#40;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35 &#40;31&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">SAPS 3&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&#44;0 &#40;10&#44;6&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#44;3 &#40;14&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&#44;3 &#40;10&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#44;3 &#40;14&#44;8&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">CURB65&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;8 &#40;0&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;7 &#40;1&#44;0&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;0 &#40;0&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;7 &#40;1&#44;0&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Temperatura &#40;&#176;C&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#44;8 &#40;0&#44;9&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37&#44;2 &#40;1&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#44;8 &#40;0&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37&#44;2 &#40;1&#44;2&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PAM &#40;mmHg&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">82 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">79 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">79 &#40;19&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Vasopresores en las primeras 24</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">h&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;41&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76 &#40;67&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76 &#40;67&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Lactato &#40;mmol&#47;l&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;7 &#40;1&#44;5&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;6 &#40;2&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;7 &#40;1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;6 &#40;2&#44;5&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">GCS&#44; puntuaci&#243;n media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;8 &#40;0&#44;4&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;3 &#40;3&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;8 &#40;0&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;3 &#40;3&#44;4&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Frecuencia respiratoria &#40;rpm&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;10&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">pH&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;32 &#40;0&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;35 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;33 &#40;0&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;35 &#40;1&#44;1&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PaCO</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#40;mmHg&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">51 &#40;18&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50 &#40;17&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42 &#40;14&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PaO</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#40;mmHg&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">71 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">86 &#40;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73 &#40;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">86 &#40;52&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PaO</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#47;FiO</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#40;mmHg&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">119 &#40;62&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">149 &#40;106&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">105 &#40;45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">149 &#40;106&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Recuento leucocitario &#40;&#215;10</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">9</span></span><span class="elsevierStyleItalic">&#47;l&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;2 &#40;7&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;1 &#40;8&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;6 &#40;8&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;1 &#40;8&#44;8&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Recuento plaquetario &#40;&#215;10</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">9</span></span><span class="elsevierStyleItalic">&#47;l&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">257 &#40;153&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">207 &#40;128&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">274 &#40;170&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">207 &#40;128&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Hemoglobina &#40;g&#47;dl&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;2 &#40;1&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;9 &#40;2&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;1 &#40;1&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;9 &#40;2&#44;4&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Creatinina &#40;mg&#47;dl&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;48 &#40;0&#44;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;44 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;53 &#40;0&#44;93&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;44 &#40;1&#44;1&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Alb&#250;mina &#40;g&#47;dl&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;6 &#40;0&#44;6&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;4 &#40;0&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;6 &#40;0&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;4 &#40;0&#44;7&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Bilirrubina total &#40;mg&#47;dl&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;82 &#40;0&#44;56&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;5 &#40;2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;74 &#40;0&#44;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;5 &#40;2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Caracter&#237;sticas de la neumon&#237;a</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Origen de la neumon&#237;a c&#47;n&#44; n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#47;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84&#47;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#47;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84&#47;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>N&#250;mero de cuadrantes en la radiograf&#237;a&#44; media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;2 &#40;1&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;2 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;3 &#40;1&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;2 &#40;1&#44;1&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Bacteriemia&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;20&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Idoneidad de los antibi&#243;ticos&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42 &#40;91&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">110&#40;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;89&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">110 &#40;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "leyenda" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">En las columnas de VNI&#44; los s&#237;mbolos indican diferencias entre el conjunto de grupos de VNI y el grupo de VM invasiva&#46; Los s&#237;mbolos en la columna de &#233;xito de la VNI indican diferencias entre los grupos de &#233;xito y de fracaso de la VNI&#46; Los s&#237;mbolos en la columna de fracaso de la VNI indican diferencias entre los grupos de fracaso de la VNI y de VM invasiva&#46;</p><p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">DE&#58; duraci&#243;n de la estancia&#59; VM&#58; ventilaci&#243;n mec&#225;nica&#59; VNI&#58; ventilaci&#243;n mec&#225;nica no invasiva&#59; UCI&#58; unidad de cuidados intensivos&#46;</p>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">VM no invasiva</th><th class="td" title="table-head  " align="left" valign="top" scope="col">VM invasiva &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>113&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#201;xito de la VNI &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Fracaso de la VNI &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Retraso en el soporte ventilatorio inicial &#40;h&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;83 &#91;0&#44;1&#8211;4&#44;4&#93;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;73 &#91;0&#44;1&#8211;2&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;8 &#91;&#8211;0&#44;1&#8211;5&#44;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;7 &#91;0&#44;2&#8211;14&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Retraso de la intubaci&#243;n &#40;h&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&#44;1 &#91;3&#44;2&#8211;60&#44;3&#93;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;7 &#91;0&#44;2&#8211;19&#44;4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">D&#237;as con VM invasiva &#40;d&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;3 &#91;6&#44;7&#8211;29&#44;0&#93;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;3 &#91;2&#44;3&#44;3&#44;3&#8211;14&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Horas con VM no invasiva &#40;h&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;0 &#91;2&#8211;8&#44;8&#8211;23&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;8 &#91;2&#44;4&#8211;28&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">DE en UCI &#40;d&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;6 &#91;3&#44;6&#8211;9&#44;9&#8211;21&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;4 &#91;2&#44;2&#8211;6&#93;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&#44;1 &#91;12&#44;1&#8211;35&#44;0&#93;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;2 &#91;1&#8211;5&#44;5&#44;6&#44;6&#8211;19&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>DE en UCI de supervivientes &#40;d&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;3 &#91;2&#44;3&#44;3&#8211;9&#44;9&#8211;14&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;4 &#91;1&#44;2&#44;2&#8211;6&#93;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#44;3 &#91;4&#8211;7&#44;7&#8211;11&#44;11&#8211;31&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;2 &#91;2&#8211;5&#44;5&#44;6&#44;6&#8211;18&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>DE en UCI de no supervivientes &#40;d&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&#44;1 &#91;9&#44;7&#8211;44&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;1 &#91;1&#44;6&#8211;3&#44;4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#44;0 &#91;12&#44;1&#8211;45&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;5 &#91;2&#44;0&#8211;22&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DE hospitalaria &#40;d&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#44;3 &#91;1&#8211;3&#44;3&#8211;13&#44;13&#8211;36&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;1 &#91;9&#44;0&#8211;19&#44;4&#93;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#44;4 &#91;18&#44;1&#8211;45&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#44;5 &#91;1&#44;7&#8211;11&#44;11&#8211;38&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>DE hospitalaria de supervivientes &#40;d&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#44;6 &#91;3&#44;9&#8211;13&#44;13&#8211;34&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;3 &#91;9&#44;3&#8211;20&#44;0&#93;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#91;24&#44;1&#8211;48&#44;4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#44;6 &#91;15&#44;4&#8211;45&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>DE hospitalaria de no supervivientes &#40;d&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#44;0 &#91;12&#44;1&#8211;44&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#44;1 &#91;2&#44;4&#8211;8&#44;8&#8211;11&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&#44;4 &#91;12&#44;2&#8211;45&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;4 &#91;1&#44;1&#8211;6&#44;6&#8211;30&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Mortalidad en la UCI&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;41&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35 &#40;31&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Mortalidad hospitalaria&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;11&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40 &#40;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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            0 => array:3 [
              "identificador" => "tblfn0015"
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            1 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "&#42;&#42;"
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            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas de los resultados de los diferentes grupos de soporte ventilatorio&#46; Para las variables continuas&#44; se indica la mediana y el rango intercuart&#237;lico</p>"
        ]
      ]
      7 => array:8 [
        "identificador" => "tbl0020"
        "etiqueta" => "Tabla 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
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            "identificador" => "at3"
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Poblaci&#243;n total &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>159&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Grupo de VM invasiva &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>113&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#201;xito de la VM no invasiva &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Fracaso de la VM no invasiva &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Desconocido&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36 &#40;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;30&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Streptococcus pneumoniae</span>&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37 &#40;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26 &#40;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;26&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Virus&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;10&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;11&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bacterias Gram-negativas&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;4&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bacterias Gram-positivas&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;11&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Broncoaspiraci&#243;n&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;4&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Neumon&#237;a at&#237;pica&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;7&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">F&#250;ngica&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;4&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Pneumocystis jirovecii</span>&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;4&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Polimicrobiana&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Otras&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Diagn&#243;sticos microbiol&#243;gicos de las neumon&#237;as de todos los pacientes</p>"
        ]
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      8 => array:8 [
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          0 => array:3 [
            "identificador" => "at4"
            "detalle" => "Tabla "
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        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Modelo no ajustado</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Modelo ajustado</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad &#40;a&#241;os&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;05 &#40;1&#44;02 a 1&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;05 &#40;1&#44;02 a 1&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">SAPS 3</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;04 &#40;1&#44;01 a 1&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;03 &#40;1&#44;00 a 1&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Inmunosupresi&#243;n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;89 &#40;1&#44;25 a 6&#44;73&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;52 &#40;1&#44;02 a 6&#46;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Asistencia respiratoria</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#201;xito de la VM no invasiva vs&#46; invasiva&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;23 &#40;0&#44;05 a 1&#44;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;46 &#40;0&#44;08 a 2&#44;73&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fracaso de la VM no invasiva vs&#46; invasiva&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;90 &#40;1&#44;06 a 7&#44;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;31 &#40;1&#44;33 a 13&#44;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "es" => "<p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis de regresi&#243;n log&#237;stica de la mortalidad hospitalaria en todos los pacientes con asistencia respiratoria&#46; La asistencia respiratoria se ha categorizado tomando como referencia la VM invasiva como tratamiento inicial&#46; Se muestra el modelo antes y despu&#233;s de ajustarlo al &#237;ndice de propensi&#243;n y de ser conectado a VM invasiva como primer tratamiento ventilatorio</p>"
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          "leyenda" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">DE&#58; desviaci&#243;n est&#225;ndar&#59; GCS&#58; Glasgow Coma Scale&#59; PAM&#58; presi&#243;n arterial media&#59; VIH&#58; virus de la inmunodeficiencia humana&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Adquirida en la comunidad &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>120&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Nosocomial &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad &#40;a&#241;os&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Varones&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66 &#40;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31 &#40;80&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Comorbilidades&#58;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Insuficiencia card&#237;aca cr&#243;nica&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hepatopat&#237;a cr&#243;nica&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Insuficiencia renal cr&#243;nica&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Alcoholismo&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Inmunosupresi&#243;n&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Infecci&#243;n por VIH&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>M&#225;s de 1 comorbilidad&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75 &#40;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26 &#40;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hospitalizaci&#243;n &#60;1 a&#241;o&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34 &#40;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">SAPS 3&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Temperatura &#40;&#176;C&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37&#44;0 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37&#44;0 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PAM &#40;mmHg&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">81 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">79 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Vasopresores en las primeras 24<span class="elsevierStyleHsp" style=""></span>h&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74 &#40;62&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Lactato &#40;mmol&#47;l&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;5 &#40;2&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;9 &#40;1&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">GCS&#44; puntuaci&#243;n media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Frecuencia respiratoria &#40;lpm&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">pH&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33 &#40;0&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;36 &#40;0&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PaCO</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#40;mmHg&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PaO</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#40;mmHg&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84 &#40;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75 &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PaO</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#47;FiO</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#40;mmHg&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">148 &#40;105&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">118 &#40;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Recuento leucocitario &#40;&#215;10</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">9</span></span><span class="elsevierStyleItalic">&#47;l&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;2 &#40;8&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;0 &#40;6&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Recuento plaquetario &#40;&#215;10</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">9</span></span><span class="elsevierStyleItalic">&#47;l&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">215 &#40;132&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">240 &#40;151&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;32&nbsp;\t\t\t\t\t\t\n
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El papel de la ventilación no invasiva como tratamiento ventilatorio inicial en pacientes con neumonía y sin enfermedad pulmonar obstructiva crónica
Role of First-Line Noninvasive Ventilation in Non-COPD Subjects With Pneumonia
Gemma Rialpa,c,
Corresponding author
grialp@gmail.com

Autor para correspondencia.
, Catalina Fortezaa,c, Daniel Muñizb,c, Maria Romeroa,c
a Servicio de Cuidados Intensivos, Hospital Son Llàtzer, Palma de Mallorca, Islas Baleares, España
b Servicio de Cuidados Intensivos, Hospital Comarcal d’Inca, Inca, Islas Baleares, España
c Instituto de Investigación Sanitaria de Palma (IDISPA), Fundación de Investigación Sanitaria Illes Balears, Hospital Universitario Son Espases, Palma de Mallorca, Islas Baleares, España
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pero su utilidad en pacientes sin EPOC con neumon&#237;a grave sigue siendo motivo de controversia&#44; debido al elevado porcentaje de fracasos de la VNI<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">6&#44;9</span></a>&#46; En este sentido&#44; existe una cierta preocupaci&#243;n por los efectos de la VNI en la evoluci&#243;n de estos pacientes&#44; ya que se ha descrito que no aporta efectos beneficiosos e incluso que empeora la evoluci&#243;n&#44; especialmente cuando fracasa<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">1&#44;6&#44;10&#8211;16</span></a> y&#44; en particular&#44; cuando retrasa la intubaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">8</span></a>&#46; Se han propuesto varias explicaciones que podr&#237;an justificar la mala evoluci&#243;n observada en pacientes que precisan intubaci&#243;n tras el fracaso de la VNI&#44; tales como el retraso en la intubaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">8</span></a>&#44; el eventual elevado volumen corriente espirado durante la VNI<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">17</span></a> o complicaciones de la propia intubaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">18</span></a>&#46; Asimismo&#44; pacientes con neumon&#237;a grave suelen presentar comorbilidades&#44; como EPOC&#44; insuficiencia card&#237;aca o inmunosupresi&#243;n<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">19&#44;20</span></a> que pueden confundir en la evaluaci&#243;n de la eficacia de la VNI&#46; A pesar de esto&#44; la VNI se usa con frecuencia en servicios de urgencias y unidades de cuidados intensivos &#40;UCI&#41; para tratar la neumon&#237;a y con el objetivo de evitar la intubaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">21&#44;22</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El objetivo principal de este estudio fue evaluar los efectos de la VNI&#44; en comparaci&#243;n con la VM invasiva como tratamiento ventilatorio inicial&#44; sobre la mortalidad hospitalaria en la pr&#225;ctica cl&#237;nica real&#44; en pacientes sin EPOC con neumon&#237;a que precisaban soporte ventilatorio&#46; Los objetivos secundarios fueron evaluar los efectos de la VNI sobre la duraci&#243;n de la estancia e identificar factores capaces de predecir el fracaso de la VNI&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Entorno y poblaci&#243;n del estudio</span><p id="par0020" class="elsevierStylePara elsevierViewall">En el estudio se incluyeron pacientes con diagn&#243;stico principal de neumon&#237;a que hab&#237;an sido ingresados consecutivamente en nuestra UCI desde marzo de 2002 hasta octubre de 2012&#46; Los pacientes se identificaron a trav&#233;s de la base de datos de informes de la UCI&#46; El equipo m&#233;dico revis&#243; los episodios seleccionados y confirm&#243; que el diagn&#243;stico de neumon&#237;a hab&#237;a sido el motivo del ingreso en UCI&#46; La neumon&#237;a se defini&#243; por la presencia de infiltrados pulmonares en la radiograf&#237;a de t&#243;rax en el momento del ingreso en la UCI y de s&#237;ntomas &#40;tos&#44; esputo purulento&#44; disnea o fiebre&#41; y signos &#40;crepitantes o recuento leucocitario superior a 12&#44;0<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">9</span>&#47;l o inferior a 4&#44;0<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">9</span>&#47;l&#41; de infecci&#243;n de v&#237;as respiratorias<a class="elsevierStyleCrossRef" href="#bib0315"><span class="elsevierStyleSup">23</span></a>&#46; El diagn&#243;stico cl&#237;nico de EPOC se determin&#243; por la constataci&#243;n de un cociente FEV<span class="elsevierStyleInf">1</span>&#47;FVC posbroncodilataci&#243;n inferior a 0&#44;70 o&#44; alternativamente&#44; por antecedentes de disnea&#44; tos cr&#243;nica y&#47;o expectoraci&#243;n&#44; y exposici&#243;n a los factores de riesgo de la enfermedad del paciente<a class="elsevierStyleCrossRef" href="#bib0320"><span class="elsevierStyleSup">24</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Los datos se recabaron consultando las historias cl&#237;nicas electr&#243;nicas de los pacientes en las que el uso de dispositivos m&#233;dicos y de perfusiones intravenosas se registra de manera autom&#225;tica &#40;Optum Clinical Solutions<span class="elsevierStyleSup">&#174;</span>&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">En el an&#225;lisis no se incluy&#243; a los pacientes con neumon&#237;a que no hab&#237;an precisado asistencia respiratoria&#46; A continuaci&#243;n&#44; los pacientes incluidos se clasificaron en dos grupos&#44; en funci&#243;n del primer tipo de asistencia aplicada&#58; VM invasiva o VNI&#46; Consideramos que la VNI hab&#237;a fracasado si el paciente hab&#237;a precisado intubaci&#243;n por la neumon&#237;a en alg&#250;n momento&#46; Se defini&#243; como fracaso precoz de la VNI la necesidad de intubaci&#243;n en las 48<span class="elsevierStyleHsp" style=""></span>h siguientes a su inicio<a class="elsevierStyleCrossRef" href="#bib0325"><span class="elsevierStyleSup">25</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Todos los pacientes recibieron tratamiento habitual seg&#250;n las normas asistenciales de nuestra unidad&#46; Los m&#233;dicos intensivistas del equipo decidieron la necesidad de asistencia respiratoria y el tipo de soporte a aplicar &#40;invasivo o no invasivo&#41; de forma no protocolizada&#46; La interfaz utilizada en todos los episodios de ventilaci&#243;n no invasiva fue una m&#225;scara oronasal&#44; y en todos los pacientes intubados se siguieron los protocolos de sedaci&#243;n-analgesia y de retirada del soporte ventilatorio&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Recogida de datos</span><p id="par0040" class="elsevierStylePara elsevierViewall">Recabamos las siguientes variables&#58; 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hemoglobina&#44; lactato&#44; urea&#44; creatinina&#44; bilirrubina y alb&#250;mina&#41; y gasometr&#237;a arterial &#40;pH&#44; PaCO<span class="elsevierStyleInf">2</span>&#44; PaO<span class="elsevierStyleInf">2</span>&#41; en el momento de la hospitalizaci&#243;n&#44; antes de la aplicaci&#243;n de la asistencia respiratoria&#46; Tambi&#233;n recabamos otras variables&#44; tales como el n&#250;mero de cuadrantes de la radiograf&#237;a de t&#243;rax afectados en el momento del ingreso en la UCI&#44; FiO<span class="elsevierStyleInf">2</span> inicial&#44; origen de la neumon&#237;a &#40;adquirida en la comunidad o nosocomial&#41;&#44; uso de f&#225;rmacos vasoactivos durante m&#225;s de una hora en las primeras 24<span class="elsevierStyleHsp" style=""></span>h&#44; cultivos de esputo positivos o detecci&#243;n de ant&#237;geno urinario mediante inmunoan&#225;lisis enzim&#225;tico de <span class="elsevierStyleItalic">Streptococcus pneumonie</span> o <span class="elsevierStyleItalic">Legionella pneumophila</span>&#44; e idoneidad de la pauta antibi&#243;tica inicial&#44; y se calcul&#243; la puntuaci&#243;n CURB65<a class="elsevierStyleCrossRef" href="#bib0335"><span class="elsevierStyleSup">27</span></a>&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Aspectos &#233;ticos</span><p id="par0045" class="elsevierStylePara elsevierViewall">El comit&#233; de &#233;tica del Hospital Son Ll&#224;tzer &#40;Palma de Mallorca&#44; Espa&#241;a&#41; aprob&#243; este estudio de una cohorte hist&#243;rica en diciembre de 2014 y&#44; debido a las caracter&#237;sticas del dise&#241;o del estudio&#44; eximi&#243; a los investigadores del requisito de obtener el consentimiento&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">An&#225;lisis estad&#237;stico</span><p id="par0050" class="elsevierStylePara elsevierViewall">Para las comparaciones de variables cualitativas o categ&#243;ricas&#44; expresadas mediante cifras y porcentajes&#44; se utiliz&#243; la prueba de Chi-cuadrado&#46; Las variables continuas se expresaron mediante la media y DE y&#44; si con la prueba de Kolmogorov-Smirnov se determinaba que la distribuci&#243;n era normal&#44; se compararon entre grupos mediante la prueba de la <span class="elsevierStyleItalic">t</span> de Student para datos independientes&#46; En caso contrario&#44; las variables continuas se expresaron mediante la mediana y el rango intercuart&#237;lico y se compararon mediante la prueba de la <span class="elsevierStyleItalic">U</span> de Mann-Whitney&#46; Todos los an&#225;lisis fueron bilaterales y los valores de <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#8804;<span class="elsevierStyleHsp" style=""></span>0&#44;05 se consideraron significativos&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Se efectuaron an&#225;lisis de Kaplan-Meier de la probabilidad acumulada de supervivencia o de la probabilidad de permanecer con ventilaci&#243;n mec&#225;nica en funci&#243;n de la asistencia respiratoria utilizada&#46; Los grupos se compararon por medio de la prueba del orden logar&#237;tmico&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">En el an&#225;lisis multivariante&#44; la asistencia respiratoria se introdujo como variable &#250;nica con tres categor&#237;as distintas&#58; la categor&#237;a de referencia fue la VM invasiva&#44; con una oportunidad relativa ajustada a 1&#44; que se compar&#243; con el &#233;xito y con el fracaso de la VNI&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Considerando que&#44; en un estudio observacional&#44; las asociaciones en las comparaciones no ajustadas podr&#237;an llevar a error&#44; se efectu&#243; un an&#225;lisis del &#237;ndice de propensi&#243;n con el objetivo de reducir al m&#237;nimo el sesgo en las estimaciones del efecto del soporte ventilatorio inicial&#46; Definimos el <span class="elsevierStyleItalic">score</span> de propensi&#243;n de los pacientes tratados con VM invasiva o VNI como la probabilidad condicional de ser intubado en el primer abordaje en funci&#243;n de las covariables del sujeto&#44; y la calculamos utilizando un modelo de regresi&#243;n log&#237;stica m&#250;ltiple&#46; La capacidad predictiva del modelo final se evalu&#243; mediante la curva de caracter&#237;sticas operativas del receptor &#40;ROC&#41;&#44; de la que se calcul&#243; el &#225;rea bajo la curva &#40;AUC&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">En el an&#225;lisis de regresi&#243;n log&#237;stica multivariante con eliminaci&#243;n secuencial de variables hacia atr&#225;s se incluy&#243; el tipo de asistencia respiratoria y las variables que en el an&#225;lisis univariante se asociaron con la mortalidad &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleInf">in</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;10 y <span class="elsevierStyleItalic">p</span><span class="elsevierStyleInf">out</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#46; Una vez construido el modelo multivariante&#44; el &#237;ndice de propensi&#243;n se a&#241;adi&#243; como variable independiente para calcular el riesgo ajustado de mortalidad hospitalaria&#46; Los datos se procesaron con la versi&#243;n 17&#46;0 del programa inform&#225;tico SPSS&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Resultados</span><p id="par0075" class="elsevierStylePara elsevierViewall">Durante el periodo del estudio ingresaron en nuestra UCI 399 pacientes con neumon&#237;a&#46; En la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a> se presenta el diagrama de flujo de estos pacientes&#46; En el estudio participaron 159&#44; de los cuales 113 &#40;71&#37;&#41; fueron conectados a VM invasiva y 46 &#40;29&#37;&#41; a VNI como primera asistencia respiratoria&#46; La VNI fracas&#243; en 27 de estos 46 pacientes &#40;59&#37;&#41; que precisaron intubaci&#243;n&#46; En el Anexo 1 se muestra el histograma del soporte ventilatorio aplicado a los pacientes a lo largo del estudio&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">En funci&#243;n del primer tipo de asistencia respiratoria aplicada&#44; se observ&#243; que los pacientes con VM invasiva inicial eran m&#225;s j&#243;venes&#59; la proporci&#243;n de insuficiencia renal cr&#243;nica y la de inmunosupresi&#243;n en este grupo era m&#225;s alta&#59; eran enfermos m&#225;s graves &#40;por SAPS 3&#44; proporci&#243;n de f&#225;rmacos vasoactivos requeridos&#44; concentraciones de lactato&#44; puntuaci&#243;n en la GCS&#44; y concentraciones de alb&#250;mina y de bilirrubina total&#41;&#59; y sus valores de PaCO<span class="elsevierStyleInf">2</span> en el momento del ingreso en la UCI eran m&#225;s bajos que en el caso de los de los pacientes tratados con VNI inicialmente &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">El grupo de pacientes en el que el uso inicial de VNI fracas&#243; precis&#243; dosis m&#225;s altas de f&#225;rmacos vasoactivos y mostr&#243; puntuaciones CURB65 m&#225;s altas respecto al grupo en el que la VNI fue exitosa &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 1</a>&#41;&#46; El uso de f&#225;rmacos vasoactivos se asoci&#243; con fracaso de la VNI&#44; con una oportunidad relativa de 7&#44;8 &#40;IC 95&#37;&#44; 1&#44;8 a 33&#44;2&#41;&#44; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;006&#46; En los pacientes con &#233;xito de la VNI&#44; las duraciones de la estancia en UCI y de la estancia hospitalaria fueron m&#225;s cortas que en los pacientes con fracaso de la VNI&#44; mientras que la duraci&#243;n de la VNI fue similar en ambos grupos &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 2</a>&#41;&#46; El fracaso de la VNI se consider&#243; precoz en diecinueve &#40;70&#37;&#41; pacientes&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">El inicio de soporte respiratorio se retras&#243; m&#225;s en el grupo con VM invasiva inicial que en el que se conect&#243; a VNI inicialmente &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#46; No se observaron diferencias significativas entre los grupos de fracaso y de &#233;xito de la VNI&#44; ni entre los grupos de VM invasiva de primera l&#237;nea y de fracaso de la VNI &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 2</a>&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">En comparaci&#243;n con los pacientes que en primera instancia recibieron VM invasiva&#44; los pacientes con fracaso de la VNI eran mayores&#44; presentaron mayor porcentaje de insuficiencia renal cr&#243;nica y valores de PaCO<span class="elsevierStyleInf">2</span> m&#225;s altos &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 1</a>&#41;&#46; Adem&#225;s&#44; en este grupo de pacientes&#44; la intubaci&#243;n fue m&#225;s tard&#237;a &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41; y las duraciones de la VM invasiva y de la estancia en la UCI fueron m&#225;s prolongadas&#44; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007 &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41; y <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001 &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 2</a>&#41;&#44; respectivamente&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">En relaci&#243;n a las caracter&#237;sticas cl&#237;nicas de la neumon&#237;a&#44; no se observaron diferencias significativas entre los grupos de tratamiento &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 1</a>&#41;&#46; En total&#44; siete pacientes &#40;4&#37;&#41; recibieron un tratamiento antibi&#243;tico inicial inadecuado&#59; tres en el grupo de VM invasiva &#40;<span class="elsevierStyleItalic">Pseudomonas aeruginosa</span>&#44; virus <span class="elsevierStyleItalic">Herpes simplex</span> m&#225;s virus <span class="elsevierStyleItalic">Influenza</span> H1N1 y virus <span class="elsevierStyleItalic">Herpes simplex</span>&#41;&#44; tres en el grupo de fracaso de la VNI &#40;<span class="elsevierStyleItalic">Enterococcus faecium</span>&#44; <span class="elsevierStyleItalic">Aspergillus fumigatus</span> y virus <span class="elsevierStyleItalic">Herpes simplex</span>&#41; y uno en el grupo de &#233;xito de la VNI &#40;virus <span class="elsevierStyleItalic">Influenza</span> H1N1&#41;&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 3</a> se presentan los diagn&#243;sticos microbiol&#243;gicos de las neumon&#237;as&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">Los pacientes con neumon&#237;a nosocomial eran mayoritariamente varones y presentaban m&#225;s comorbilidades&#44; recuentos leucocitarios y concentraciones de bilirrubina m&#225;s bajos que los pacientes con neumon&#237;a adquirida en la comunidad &#40;<a class="elsevierStyleCrossRef" href="#sec0070">Anexo 2</a>&#41;&#46; Asimismo&#44; sus estancias fueron m&#225;s prolongadas &#40;diferencia media de 17 d&#237;as &#40;IC 95&#37;&#44; 7-28 d&#237;as&#44; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;009&#41;&#46;</p><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">An&#225;lisis de la mortalidad</span><p id="par0110" class="elsevierStylePara elsevierViewall">En el an&#225;lisis univariante &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 2</a>&#41;&#44; los pacientes tratados inicialmente con VM invasiva no presentaron diferencias significativas en la mortalidad hospitalaria en comparaci&#243;n a los pacientes tratados con VNI inicial &#40;37&#37;&#41; ni con los pacientes que fracasaron en la VNI &#40;56&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 2</a>&#41;&#44; aunque esta &#250;ltima diferencia fue cl&#237;nicamente importante &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3</a>&#41;&#46; En el an&#225;lisis multivariante de todos los pacientes que recibieron soporte ventilatorio &#40;invasivo y no invasivo&#41;&#44; las variables que se asociaron con la mortalidad hospitalaria en el modelo final fueron la edad&#44; la puntuaci&#243;n SAPS 3&#44; la inmunosupresi&#243;n y el fracaso de la VNI&#44; en comparaci&#243;n con VM invasiva de primera l&#237;nea &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 4</a>&#41;&#46; Al ajustar este modelo al &#237;ndice de propensi&#243;n de recibir VM invasiva o VNI de primera l&#237;nea como covariable explicativa&#44; el riesgo de muerte aument&#243; 4&#44;31 veces &#40;IC 95&#37;&#44; 1&#44;33-13&#44;94&#59; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41; en los pacientes con fracaso de la VNI&#44; en comparaci&#243;n con aquellos que fueron sometidos a VM invasiva de primera l&#237;nea &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 4</a>&#41;&#46; El &#225;rea bajo la curva del modelo del <span class="elsevierStyleItalic">score</span> de propensi&#243;n fue de 0&#44;82 &#40;IC 95&#37;&#44; 0&#44;74-0&#44;89&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">En los grupos de VM invasiva de primera l&#237;nea y de fracaso de la VNI no hubo diferencias entre supervivientes y no supervivientes seg&#250;n el tiempo de retraso de la intubaci&#243;n &#40;<a class="elsevierStyleCrossRef" href="#fig0020">fig&#46; 4</a>&#41;&#59; entre los pacientes con fracaso precoz y tard&#237;o de la VNI no se observaron diferencias en la mortalidad hospitalaria &#40;50 vs&#46; 58&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;5&#44; respectivamente&#41;&#46; Adem&#225;s&#44; al evaluar conjuntamente a los pacientes intubados&#44; no se observ&#243; ninguna asociaci&#243;n entre el retraso de la intubaci&#243;n y la mortalidad hospitalaria &#40;OR 1&#44;01 &#91;IC 95&#37;&#44; 1&#44;00-1&#44;01&#93;&#44; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;36&#41;&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Discusi&#243;n</span><p id="par0120" class="elsevierStylePara elsevierViewall">En nuestro estudio&#44; la aplicaci&#243;n de VNI de primera l&#237;nea a pacientes sin EPOC con neumon&#237;a ingresados en la UCI no se asoci&#243; a un tiempo de ingreso m&#225;s corto ni una reducci&#243;n de la mortalidad hospitalaria&#44; en comparaci&#243;n con el tratamiento con VM invasiva de primera l&#237;nea&#46; De hecho&#44; la tasa de fracaso de la VNI con necesidad de tratamiento de rescate mediante VM invasiva fue alta y se asoci&#243; con mala evoluci&#243;n&#44; prolongaci&#243;n de las estancias en UCI y hospital&#44; mayor duraci&#243;n de la VM invasiva&#46; En el an&#225;lisis multivariante ajustado&#44; se relacion&#243; adem&#225;s con mayor mortalidad hospitalaria&#44; en comparaci&#243;n con la VM invasiva de primera l&#237;nea&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">El presente estudio acrecienta la preocupaci&#243;n ya existente por los efectos nocivos del fracaso de la VNI en estos pacientes<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">1&#44;7&#44;12&#44;13&#44;18&#44;28&#44;29</span></a>&#44; puesto que los pacientes que inicialmente no cumpl&#237;an los criterios de VM invasiva y <span class="elsevierStyleItalic">a priori</span> parec&#237;an tener un pron&#243;stico m&#225;s favorable por presentar puntuaciones SAPS 3 m&#225;s bajas&#44; finalmente evolucionaron peor que aquellos a los que se intub&#243; directamente&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Desde los a&#241;os 90&#44; existe cierta controversia respecto a los efectos de la VNI en comparaci&#243;n con la oxigenoterapia convencional en pacientes con insuficiencia respiratoria aguda hipox&#233;mica que no est&#233; causada por insuficiencia card&#237;aca aguda o exacerbaci&#243;n de la EPOC&#46; El uso es particularmente controvertido en pacientes inmunocompetentes con neumon&#237;a o con s&#237;ndrome de distr&#233;s respiratorio agudo&#46; Algunos estudios han descrito efectos beneficiosos en relaci&#243;n con los porcentajes de intubaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">6&#44;20</span></a> o la mortalidad<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">20</span></a>&#44; mientras que otros han advertido de sus efectos potencialmente perjudiciales en caso de fracaso<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">1&#44;9&#44;11&#8211;13&#44;15&#44;18&#44;21&#44;30&#8211;32</span></a>&#44; especialmente en pacientes que no padecen EPOC<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">7&#44;9&#44;11</span></a>&#46; Es probable que esta discordancia entre trabajos sea debida a diferencias en los tipos de estudio &#40;ensayos cl&#237;nicos&#44; registros y series de casos&#41; o en la casu&#237;stica de pacientes&#44; a la variabilidad en la gravedad de los participantes<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">21&#44;33</span></a> y a diferencias en los criterios de exclusi&#243;n de los estudios&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Para minimizar estos errores&#44; en nuestro estudio excluimos a los pacientes con EPOC&#44; aquellos con orden de no reanimar y los que no precisaban soporte ventilatorio&#46; La exclusi&#243;n de los pacientes con EPOC o con orden de no reanimar confiri&#243; solidez a nuestros resultados&#44; debido a que en el an&#225;lisis de los efectos de la VNI sobre la evoluci&#243;n de pacientes con neumon&#237;a existen factores de confusi&#243;n<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">6&#44;34</span></a>&#46; La exclusi&#243;n de los pacientes que en ning&#250;n momento precisaron asistencia respiratoria&#44; a diferencia de los estudios aleatorizados<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">6&#44;20&#44;32</span></a>&#44; nos permiti&#243; comparar los efectos de ambos tipos de asistencia en los casos en los que la oxigenoterapia&#44; junto con el tratamiento m&#233;dico&#44; se consider&#243; insuficiente&#44; y contribuy&#243; a asegurar que el an&#225;lisis no inclu&#237;a pacientes que hab&#237;an recibido asistencia respiratoria innecesaria&#46; Asimismo&#44; en nuestro centro&#44; los pacientes con neumon&#237;a que precisaron soporte ventilatorio o tratamiento vasoactivo fueron ingresados en la UCI&#44; y es improbable que se haya introducido un sesgo en la selecci&#243;n de los pacientes&#44; aparte del relativo a la decisi&#243;n del equipo m&#233;dico responsable de iniciar asistencia respiratoria&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Los niveles de PaCO<span class="elsevierStyleInf">2</span> fueron m&#225;s altos entre los pacientes tratados con VNI que en aquellos que recibieron VM invasiva de primera l&#237;nea&#46; Puesto que los pacientes con EPOC fueron excluidos del estudio&#44; la hipercapnia probablemente se debi&#243; a insuficiencia respiratoria aguda&#44; ya que se acompa&#241;&#243; de acidosis leve&#44; sin que se observasen diferencias entre grupos en la GCS&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">La tasa de fracaso de la VNI fue mayor que en ensayos cl&#237;nicos<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">6&#44;20&#44;32&#44;34&#44;35</span></a>&#44; pero similar a las descritas en estudios observacionales<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">1&#44;7&#44;9&#8211;11&#44;13</span></a>&#46; Nuestros pacientes eran pacientes cr&#237;ticos&#58; un 60&#37; precis&#243; f&#225;rmacos vasoactivos&#44; y la mortalidad hospitalaria global fue de un 36&#37;&#44; porcentaje que concuerda con el esperado de acuerdo a las puntuaciones SAPS 3<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">26</span></a>&#46; Respecto a las comorbilidades&#44; los pacientes del grupo de VNI de primera l&#237;nea eran de mayor edad y con mayor proporci&#243;n de insuficiencia renal cr&#243;nica que en el grupo tratado con VM invasiva de primera l&#237;nea&#46; Por el contrario&#44; las puntuaciones SAPS 3 y el porcentaje de inmunosupresi&#243;n fueron m&#225;s altos en el grupo de VM invasiva de primera l&#237;nea&#44; lo que es indicativo de que los pacientes de este grupo eran m&#225;s graves&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Pese a la r&#225;pida aplicaci&#243;n de la primera t&#233;cnica ventilatoria&#44; VM invasiva o VNI&#44; los pacientes en los que la VNI fracas&#243; fueron intubados con un retraso cl&#237;nicamente significativo&#44; en comparaci&#243;n con los pacientes tratados con VM invasiva de primera l&#237;nea&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Queremos resaltar que la mortalidad hospitalaria fue mayor en el grupo con fracaso de la VNI que en el grupo tratado con VM invasiva &#40;56 vs&#46; 35&#37;&#41;&#44; aunque la diferencia no alcanz&#243; la significaci&#243;n estad&#237;stica&#44; probablemente debido al peque&#241;o tama&#241;o de la muestra&#46; En algunos estudios&#44; el retraso de la intubaci&#243;n tras el fracaso de la VNI se ha asociado con mayor mortalidad<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">8</span></a>&#46; Esta mala evoluci&#243;n se podr&#237;a explicar por disnea persistente durante el tratamiento con VNI&#44; que causar&#237;a mayor trabajo respiratorio y que finalmente conducir&#237;a a la intubaci&#243;n&#46; Adem&#225;s&#44; la intubaci&#243;n y sedaci&#243;n tempranas pueden reducir el trabajo respiratorio&#44; los episodios de falta de sincron&#237;a y el biotrauma<a class="elsevierStyleCrossRef" href="#bib0380"><span class="elsevierStyleSup">36</span></a>&#46; Eventualmente&#44; los altos vol&#250;menes corrientes administrados durante la VNI tambi&#233;n podr&#237;an haber incrementado el da&#241;o pulmonar inducido por el ventilador<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">17</span></a> y&#44; en consecuencia&#44; la mortalidad<a class="elsevierStyleCrossRef" href="#bib0385"><span class="elsevierStyleSup">37</span></a>&#46; Desafortunadamente&#44; no registramos datos de los par&#225;metros fisiol&#243;gicos y ventilatorios del periodo de VNI&#46; Moister et al&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">18</span></a> tambi&#233;n hallaron un aumento de complicaciones de la intubaci&#243;n en pacientes en los que la VNI hab&#237;a fracasado&#44; en comparaci&#243;n con aquellos a los que se intub&#243; directamente&#46; Estos argumentos podr&#237;an explicar&#44; en parte&#44; el aumento de mortalidad observado en los pacientes con fracaso de la VNI&#46; No obstante&#44; en nuestro estudio no se observ&#243; ninguna asociaci&#243;n entre el retraso de la intubaci&#243;n y la mortalidad&#46; Del mismo modo&#44; Thille et al&#46;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">30&#44;</span></a> no observaron diferencias en el tiempo transcurrido hasta la intubaci&#243;n al comparar supervivientes y no supervivientes&#44; mostrando valores muy parecidos a los nuestros y contrapuestos a los descritos por Carrillo et al&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">8</span></a>&#46; Esa falta de asociaci&#243;n con un aumento de la mortalidad podr&#237;a quiz&#225;s explicarse por la brevedad del retraso de la intubaci&#243;n en nuestro estudio&#44; puesto que un 70&#37; de pacientes fueron intubados en el plazo de 48<span class="elsevierStyleHsp" style=""></span>h&#46; Adem&#225;s&#44; no observamos diferencias entre grupos respecto a la idoneidad del tratamiento antibi&#243;tico que pudieran explicar las diferencias observadas en la mortalidad&#44; y el microorganismo causante no se identific&#243; en m&#225;s de un tercio de los pacientes&#44; tal como se ha descrito en otros trabajos<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">38</span></a>&#46; En nuestro estudio&#44; los pacientes con fracaso de la VNI precisaron&#44; inevitablemente&#44; VM invasiva&#44; pero desconocemos si la VNI habr&#237;a sido satisfactoria en algunos de los pacientes que recibieron VM invasiva de primera l&#237;nea&#46; No podemos descartar que el fracaso de la VNI&#44; m&#225;s que un factor que empeore el pron&#243;stico&#44; sea un marcador de gravedad que otros indicadores no han podido detectar &#40;SAPS 3 o necesidad de f&#225;rmacos vasoactivos&#41;&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">En la pr&#225;ctica cl&#237;nica&#44; determinar si un paciente sin EPOC con neumon&#237;a grave debe ser intubado directamente o se debe probar el tratamiento VNI es una decisi&#243;n que se debe tomar con prontitud&#46; En nuestro estudio&#44; la &#250;nica variable asociada con el fracaso de la VNI fue el uso de f&#225;rmacos vasoactivos en las primeras 24<span class="elsevierStyleHsp" style=""></span>h desde el ingreso en la UCI&#44; lo que concuerda con lo observado en otros estudios<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">13&#44;30</span></a>&#46; Cabe se&#241;alar que los par&#225;metros respiratorios asociados con la gravedad de la neumon&#237;a&#44; como la oxigenaci&#243;n &#40;determinada mediante el cociente PaO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span>&#41;&#44; el n&#250;mero de cuadrantes afectados en la radiograf&#237;a o la presencia de bacteriemia&#44; no difirieron entre los pacientes con &#233;xito y fracaso de la VNI&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Entre las limitaciones de nuestro estudio&#44; debemos subrayar su car&#225;cter unic&#233;ntrico y retrospectivo&#44; lo que obliga a considerar estos resultados con precauci&#243;n&#46; En segundo lugar&#44; para determinar la necesidad o el tipo de asistencia respiratoria no se sigui&#243; un protocolo&#44; sino que la decisi&#243;n se tom&#243; a criterio del equipo m&#233;dico responsable del paciente&#46; Tercero&#44; no registramos la cronolog&#237;a de la administraci&#243;n del tratamiento m&#233;dico no ventilatorio inicial&#44; como&#44; por ejemplo&#44; antibi&#243;ticos o reposici&#243;n del volumen de fluidos&#46; Cuarto&#44; durante el periodo del estudio se introdujeron cambios en la pol&#237;tica de tratamiento del centro&#44; como la implementaci&#243;n de la Campa&#241;a para sobrevivir a la sepsis<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">39</span></a>&#44; que podr&#237;an haber modificado la evoluci&#243;n de los pacientes&#46; Por &#250;ltimo&#44; la heterogeneidad en las caracter&#237;sticas basales de los diferentes grupos por tipo de asistencia respiratoria podr&#237;a haber inducido a errores en la interpretaci&#243;n de los resultados&#46; Para reducir al m&#237;nimo estas importantes deficiencias&#44; ajustamos el an&#225;lisis de mortalidad por &#237;ndice de propensi&#243;n&#44; que defini&#243; la probabilidad de intubaci&#243;n en primera instancia de acuerdo con algunas covariables del sujeto&#44; aunque el m&#233;todo utilizado no es capaz de eliminar completamente el sesgo en la asignaci&#243;n del tratamiento<a class="elsevierStyleCrossRef" href="#bib0400"><span class="elsevierStyleSup">40</span></a>&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conclusiones</span><p id="par0170" class="elsevierStylePara elsevierViewall">La evoluci&#243;n de los pacientes sin EPOC con neumon&#237;a que precisaban asistencia respiratoria y que en primera instancia fueron conectados a VNI no fue mejor que la de los pacientes inicialmente conectados a VM invasiva&#46; El fracaso de la VNI se asoci&#243; con mayor duraci&#243;n de VM&#44; estancia en la UCI m&#225;s prolongada y mayor mortalidad hospitalaria&#44; en comparaci&#243;n con los pacientes tratados con VM invasiva de primera l&#237;nea&#46; La necesidad de f&#225;rmacos vasoactivos disuade de aplicar VNI de primera l&#237;nea&#44; debido a que se ha observado un alto porcentaje de fracasos de la VNI&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Autor&#237;a&#47;colaboradores</span><p id="par0175" class="elsevierStylePara elsevierViewall">B&#250;squeda bibliogr&#225;fica&#58; Gemma Rialp&#44; Daniel Mu&#241;iz&#44; Maria Romero&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Recogida de datos&#58; Gemma Rialp&#44; Catalina Forteza&#44; Daniel Mu&#241;iz&#44; Maria Romero&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Dise&#241;o del estudio&#58; Gemma Rialp&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">An&#225;lisis de los datos&#58; Gemma Rialp&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Preparaci&#243;n del manuscrito&#58; Gemma Rialp&#44; Catalina Forteza&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Revisi&#243;n del manuscrito&#58; Daniel Mu&#241;iz&#44; Maria Romero&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicto de intereses</span><p id="par0205" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El uso de ventilaci&#243;n no invasiva &#40;VNI&#41; en pacientes sin EPOC con neumon&#237;a es motivo de controversia&#44; debido a la elevada tasa de fracasos y a los efectos potencialmente nocivos de dicho fracaso&#46; La finalidad de este estudio fue evaluar la evoluci&#243;n de los pacientes en funci&#243;n de cu&#225;l hab&#237;a sido el primer tipo de soporte ventilatorio aplicado&#44; VNI o ventilaci&#243;n mec&#225;nica invasiva &#40;VM&#41;&#44; e identificar factores de predicci&#243;n del fracaso de la VNI&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio de una cohorte hist&#243;rica de 159 pacientes sin EPOC con neumon&#237;a ingresados en la UCI que recibieron soporte ventilatorio&#46; Los pacientes se clasificaron en dos grupos&#44; VM invasiva y VNI&#46; Se efectuaron an&#225;lisis univariantes y multivariantes de los datos demogr&#225;ficos y cl&#237;nicos&#46; El an&#225;lisis de mortalidad se ajust&#243; por &#237;ndice de propensi&#243;n a ser conectado a VM invasiva como tratamiento inicial&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Ciento trece pacientes fueron conectados a VM invasiva como tratamiento ventilatorio inicial y 46 a VNI&#44; 27 de los cuales precisaron intubaci&#243;n&#46; La mortalidad hospitalaria fue del 35&#44; 37 y 56&#37;&#44; respectivamente&#44; y no se observaron diferencias significativas entre grupos&#46; En el an&#225;lisis ajustado a la propensi&#243;n &#40;expresada mediante &#40;OR &#91;IC 95&#37;&#93;&#41;&#44; la mortalidad hospitalaria se asoci&#243; con la edad &#40;1&#44;05 &#91;1&#44;02 - 1&#44;08&#93;&#41;&#44; la puntuaci&#243;n SAPS3 &#40;1&#44;03 &#91;1&#44;00 - 1&#44;07&#93;&#41;&#44; la inmunosupresi&#243;n &#40;2&#44;52 &#91;1&#44;02 - 6&#44;27&#93;&#41; y el fracaso de la VNI&#44; en comparaci&#243;n con la VM invasiva de primera l&#237;nea &#40;4&#44;3 &#91;1&#44;33 - 13&#44;94&#93;&#41;&#46; En comparaci&#243;n con la VM invasiva&#44; el fracaso de la VNI retras&#243; la intubaci&#243;n &#40;<span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;004&#41;&#44; prolong&#243; la duraci&#243;n de la VM invasiva &#40;<span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;007&#41; y la estancia en la UCI &#40;<span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; El fracaso de la VNI se asoci&#243; con la necesidad de recibir f&#225;rmacos vasoactivos &#40;OR 7&#44;8 &#91;IC 95&#37;&#44; 1&#44;8 - 33&#44;2&#93;&#44; <span class="elsevierStyleItalic">p<span class="elsevierStyleHsp" style=""></span></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;006&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En pacientes sin EPOC con neumon&#237;a&#44; la VNI como tratamiento ventilatorio inicial no se asoci&#243; con mejor evoluci&#243;n&#44; en comparaci&#243;n con la VM invasiva de primera l&#237;nea&#46; El fracaso de la VNI se relacion&#243; con duraciones m&#225;s prolongadas de la MV y la estancia hospitalaria&#44; y con mayor mortalidad hospitalaria&#46; El uso de f&#225;rmacos vasoactivos fue predictivo del fracaso de la VNI&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The use of noninvasive ventilation &#40;NIV&#41; in non-COPD patients with pneumonia is controversial due to its high rate of failure and the potentially harmful effects when NIV fails&#46; The purpose of the study was to evaluate outcomes of the first ventilatory treatment applied&#44; NIV or invasive mechanical ventilation &#40;MV&#41;&#44; and to identify predictors of NIV failure&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Historical cohort study of 159 non-COPD patients with pneumonia admitted to the ICU with ventilatory support&#46; Subjects were divided into 2 groups&#58; invasive MV or NIV&#46; Univariate and multivariate analyses with demographic and clinical data were performed&#46; Analysis of mortality was adjusted for the propensity of receiving first-line invasive MV&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">One hundred and thirteen subjects received first-line invasive MV and 46 received first-line NIV&#44; of which 27 needed intubation&#46; Hospital mortality was 35&#44; 37 and 56&#37;&#44; respectively&#44; with no significant differences among groups&#46; In the propensity-adjusted analysis &#40;expressed as OR &#91;95&#37; CI&#93;&#41;&#44; hospital mortality was associated with age &#40;1&#46;05 &#91;1&#46;02-1&#46;08&#93;&#41;&#44; SAPS3 &#40;1&#46;03 &#91;1&#46;00-1&#46;07&#93;&#41;&#44; immunosuppression &#40;2&#46;52 &#91;1&#46;02-6&#46;27&#93;&#41; and NIV failure compared to first-line invasive MV &#40;4&#46;3 &#91;1&#46;33-13&#46;94&#93;&#41;&#46; Compared with invasive MV&#44; NIV failure delayed intubation &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;004&#41;&#44; and prolonged the length of invasive MV &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;007&#41; and ICU stay &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;001&#41;&#46; NIV failure was associated with need for vasoactive drugs &#40;OR 7&#46;8 &#91;95&#37; CI&#44; 1&#46;8-33&#46;2&#93;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;006&#41;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In non-COPD subjects with pneumonia&#44; first-line NIV was not associated with better outcome compared with first-line invasive MV&#46; NIV failure was associated with longer duration of MV and hospital stay&#44; and with increased hospital mortality&#46; The use of vasoactive drugs predicted NIV failure&#46;</p></span>"
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            "titulo" => "Caracter&#237;sticas demogr&#225;ficas y cl&#237;nicas de los pacientes seg&#250;n el origen de la neumon&#237;a"
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          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Diagrama de flujo de pacientes a lo largo del estudio&#46;</p> <p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">EPOC&#58; enfermedad pulmonar obstructiva cr&#243;nica&#59; VM&#58; ventilaci&#243;n mec&#225;nica&#59; VNI&#58; ventilaci&#243;n mec&#225;nica no invasiva&#46;</p>"
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        "etiqueta" => "Figura 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1210
            "Ancho" => 1525
            "Tamanyo" => 93061
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        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Curva de Kaplan-Meier de la probabilidad de permanecer con ventilaci&#243;n mec&#225;nica de los pacientes intubados en funci&#243;n de la asistencia respiratoria utilizada&#46; VMI&#58; ventilaci&#243;n mec&#225;nica invasiva&#59; VNI&#58; ventilaci&#243;n mec&#225;nica no invasiva&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figura 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1191
            "Ancho" => 1514
            "Tamanyo" => 85826
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Curvas de Kaplan-Meier de la probabilidad acumulada de supervivencia de los pacientes intubados en funci&#243;n de la asistencia respiratoria utilizada&#46;</p> <p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">VMI&#58; ventilaci&#243;n mec&#225;nica invasiva&#59; VNI&#58; ventilaci&#243;n mec&#225;nica no invasiva&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "fig0020"
        "etiqueta" => "Figura 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 1571
            "Ancho" => 1412
            "Tamanyo" => 126907
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Retraso en la intubaci&#243;n en supervivientes &#40;cajas gris oscuro&#41; y no supervivientes &#40;cajas gris claro&#41; en funci&#243;n de la asistencia respiratoria utilizada en primer lugar&#46; Los resultados se muestran con un diagrama de caja &#40;mediana y rango intercuart&#237;lico&#41;&#46;</p> <p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">VMI&#58; ventilaci&#243;n mec&#225;nica invasiva&#59; VNI&#58; ventilaci&#243;n mec&#225;nica no invasiva&#46;</p>"
        ]
      ]
      4 => array:7 [
        "identificador" => "fig0025"
        "etiqueta" => "Figura B1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr5.jpeg"
            "Alto" => 1219
            "Ancho" => 1546
            "Tamanyo" => 59358
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Histograma de la asistencia respiratoria utilizada a lo largo del periodo de estudio &#40;barra negra&#44; grupo de ventilaci&#243;n mec&#225;nica invasiva&#59; barra gris&#44; grupo de &#233;xito de la ventilaci&#243;n mec&#225;nica no invasiva&#59; y barra blanca&#44; grupo de fracaso de la ventilaci&#243;n mec&#225;nica no invasiva&#41;&#46; El tiempo se muestra en cuartiles&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Tabla "
            "rol" => "short"
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        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">En las columnas de VNI&#44; los s&#237;mbolos indican diferencias entre el conjunto de grupos de VNI y el grupo de VM invasiva&#46; Los s&#237;mbolos en la columna de &#233;xito de la VNI indican diferencias entre los grupos de &#233;xito y de fracaso de la VNI&#46; Los s&#237;mbolos en la columna de fracaso de la VNI indican diferencias entre los grupos de fracaso de la VNI y de VM invasiva&#46;</p><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">c&#47;n&#58; comunitaria&#47;nosocomial&#59; DE&#58; desviaci&#243;n est&#225;ndar&#59; VIH&#58; virus de la inmunodeficiencia humana&#59; PAM&#58; presi&#243;n arterial media&#59; GCS&#58; Glascow Coma Score&#59; VM&#58; ventilaci&#243;n mec&#225;nica&#59; VNI&#58; ventilaci&#243;n mec&#225;nica no invasiva&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">VM no invasiva</th><th class="td" title="table-head  " align="left" valign="top" scope="col">VM invasiva &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>113&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#201;xito de la VNI &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Fracaso de la VNI &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad &#40;a&#241;os&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68&#44;6 &#40;16&#44;1&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&#44;6 &#40;16&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&#44;8 &#40;17&#44;2&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&#44;6 &#40;16&#44;3&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Varones&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69 &#40;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#40;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">69 &#40;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Comorbilidades&#58;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Insuficiencia card&#237;aca cr&#243;nica&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;11&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hepatopat&#237;a cr&#243;nica&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;15&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Insuficiencia renal cr&#243;nica&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;22&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;22&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;8&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25 &#40;22&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Alcoholismo&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;20&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Inmunosupresi&#243;n&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;17&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40 &#40;35&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40 &#40;35&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Infecci&#243;n por VIH&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;12&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>M&#225;s de 1 comorbilidad&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;20&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hospitalizaci&#243;n &#60;1 a&#241;o&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35 &#40;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35 &#40;31&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">SAPS 3&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&#44;0 &#40;10&#44;6&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#44;3 &#40;14&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">57&#44;3 &#40;10&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&#44;3 &#40;14&#44;8&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">CURB65&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;8 &#40;0&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;7 &#40;1&#44;0&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;0 &#40;0&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;7 &#40;1&#44;0&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Temperatura &#40;&#176;C&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#44;8 &#40;0&#44;9&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37&#44;2 &#40;1&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#44;8 &#40;0&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37&#44;2 &#40;1&#44;2&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PAM &#40;mmHg&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">82 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">79 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">80 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">79 &#40;19&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Vasopresores en las primeras 24</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">h&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;41&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76 &#40;67&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;59&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">76 &#40;67&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Lactato &#40;mmol&#47;l&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;7 &#40;1&#44;5&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;6 &#40;2&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;7 &#40;1&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;6 &#40;2&#44;5&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">GCS&#44; puntuaci&#243;n media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;8 &#40;0&#44;4&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;3 &#40;3&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;8 &#40;0&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;3 &#40;3&#44;4&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Frecuencia respiratoria &#40;rpm&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;10&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">pH&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;32 &#40;0&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;35 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;33 &#40;0&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;35 &#40;1&#44;1&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PaCO</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#40;mmHg&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">51 &#40;18&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50 &#40;17&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42 &#40;14&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PaO</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#40;mmHg&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">71 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">86 &#40;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73 &#40;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">86 &#40;52&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PaO</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#47;FiO</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#40;mmHg&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">119 &#40;62&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">149 &#40;106&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">105 &#40;45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">149 &#40;106&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Recuento leucocitario &#40;&#215;10</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">9</span></span><span class="elsevierStyleItalic">&#47;l&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;2 &#40;7&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;1 &#40;8&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;6 &#40;8&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;1 &#40;8&#44;8&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Recuento plaquetario &#40;&#215;10</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">9</span></span><span class="elsevierStyleItalic">&#47;l&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">257 &#40;153&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">207 &#40;128&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">274 &#40;170&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">207 &#40;128&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Hemoglobina &#40;g&#47;dl&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;9 &#40;2&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;1 &#40;1&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;9 &#40;2&#44;4&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Creatinina &#40;mg&#47;dl&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;48 &#40;0&#44;82&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;44 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;53 &#40;0&#44;93&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;44 &#40;1&#44;1&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Alb&#250;mina &#40;g&#47;dl&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;4 &#40;0&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;6 &#40;0&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;4 &#40;0&#44;7&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Bilirrubina total &#40;mg&#47;dl&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;82 &#40;0&#44;56&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;5 &#40;2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;74 &#40;0&#44;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;5 &#40;2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Caracter&#237;sticas de la neumon&#237;a</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Origen de la neumon&#237;a c&#47;n&#44; n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#47;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84&#47;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#47;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84&#47;29&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>N&#250;mero de cuadrantes en la radiograf&#237;a&#44; media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;2 &#40;1&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;2 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;3 &#40;1&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;2 &#40;1&#44;1&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Bacteriemia&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;20&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Idoneidad de los antibi&#243;ticos&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">110&#40;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24 &#40;89&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">110 &#40;97&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " colspan="3" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">VM no invasiva</th><th class="td" title="table-head  " align="left" valign="top" scope="col">VM invasiva &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>113&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Total &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#201;xito de la VNI &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Fracaso de la VNI &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Retraso en el soporte ventilatorio inicial &#40;h&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;83 &#91;0&#44;1&#8211;4&#44;4&#93;<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#42;&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;73 &#91;0&#44;1&#8211;2&#44;6&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;8 &#91;&#8211;0&#44;1&#8211;5&#44;5&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;7 &#91;0&#44;2&#8211;14&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Retraso de la intubaci&#243;n &#40;h&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&#44;1 &#91;3&#44;2&#8211;60&#44;3&#93;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;7 &#91;0&#44;2&#8211;19&#44;4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">D&#237;as con VM invasiva &#40;d&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;3 &#91;6&#44;7&#8211;29&#44;0&#93;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;3 &#91;2&#44;3&#44;3&#44;3&#8211;14&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Horas con VM no invasiva &#40;h&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#44;0 &#91;2&#8211;8&#44;8&#8211;23&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;8 &#91;2&#44;4&#8211;28&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">DE en UCI &#40;d&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;6 &#91;3&#44;6&#8211;9&#44;9&#8211;21&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;4 &#91;2&#44;2&#8211;6&#93;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&#44;1 &#91;12&#44;1&#8211;35&#44;0&#93;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;2 &#91;1&#8211;5&#44;5&#44;6&#44;6&#8211;19&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>DE en UCI de supervivientes &#40;d&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#44;3 &#91;2&#44;3&#44;3&#8211;9&#44;9&#8211;14&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;4 &#91;1&#44;2&#44;2&#8211;6&#93;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#44;3 &#91;4&#8211;7&#44;7&#8211;11&#44;11&#8211;31&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;2 &#91;2&#8211;5&#44;5&#44;6&#44;6&#8211;18&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>DE en UCI de no supervivientes &#40;d&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&#44;1 &#91;9&#44;7&#8211;44&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&#44;1 &#91;1&#44;6&#8211;3&#44;4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#44;0 &#91;12&#44;1&#8211;45&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;5 &#91;2&#44;0&#8211;22&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">DE hospitalaria &#40;d&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#44;3 &#91;1&#8211;3&#44;3&#8211;13&#44;13&#8211;36&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;1 &#91;9&#44;0&#8211;19&#44;4&#93;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#44;4 &#91;18&#44;1&#8211;45&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&#44;5 &#91;1&#44;7&#8211;11&#44;11&#8211;38&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>DE hospitalaria de supervivientes &#40;d&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#44;6 &#91;3&#44;9&#8211;13&#44;13&#8211;34&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#44;3 &#91;9&#44;3&#8211;20&#44;0&#93;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#44;3 &#91;24&#44;1&#8211;48&#44;4&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#44;6 &#91;15&#44;4&#8211;45&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>DE hospitalaria de no supervivientes &#40;d&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#44;0 &#91;12&#44;1&#8211;44&#44;7&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&#44;1 &#91;2&#44;4&#8211;8&#44;8&#8211;11&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&#44;4 &#91;12&#44;2&#8211;45&#44;3&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&#44;4 &#91;1&#44;1&#8211;6&#44;6&#8211;30&#93;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Mortalidad en la UCI&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0 &#40;0&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;41&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35 &#40;31&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Mortalidad hospitalaria&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;37&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;11&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">&#42;</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40 &#40;35&#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
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Poblaci&#243;n total &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>159&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Grupo de VM invasiva &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>113&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">&#201;xito de la VM no invasiva &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Fracaso de la VM no invasiva &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Desconocido&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">53 &#40;33&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36 &#40;32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9 &#40;47&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;30&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Streptococcus pneumoniae</span>&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37 &#40;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26 &#40;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;26&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Virus&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;10&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;11&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bacterias Gram-negativas&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;4&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Bacterias Gram-positivas&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;11&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Broncoaspiraci&#243;n&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;4&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Neumon&#237;a at&#237;pica&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;7&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">F&#250;ngica&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;4&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Pneumocystis jirovecii</span>&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;4&#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="table-entry ; entry_with_role_rowhead " align="left" valign="top">Polimicrobiana&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Otras&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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          "es" => "<p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Diagn&#243;sticos microbiol&#243;gicos de las neumon&#237;as de todos los pacientes</p>"
        ]
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                  <table border="0" frame="\n
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Modelo no ajustado</th><th class="td" title="table-head  " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Modelo ajustado</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad &#40;a&#241;os&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;05 &#40;1&#44;02 a 1&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;05 &#40;1&#44;02 a 1&#44;08&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">SAPS 3</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;04 &#40;1&#44;01 a 1&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;03 &#40;1&#44;00 a 1&#44;07&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Inmunosupresi&#243;n</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;89 &#40;1&#44;25 a 6&#44;73&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;52 &#40;1&#44;02 a 6&#46;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Asistencia respiratoria</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#201;xito de la VM no invasiva vs&#46; invasiva&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;23 &#40;0&#44;05 a 1&#44;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;46 &#40;0&#44;08 a 2&#44;73&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fracaso de la VM no invasiva vs&#46; invasiva&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;90 &#40;1&#44;06 a 7&#44;95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#44;31 &#40;1&#44;33 a 13&#44;94&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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        "descripcion" => array:1 [
          "es" => "<p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis de regresi&#243;n log&#237;stica de la mortalidad hospitalaria en todos los pacientes con asistencia respiratoria&#46; La asistencia respiratoria se ha categorizado tomando como referencia la VM invasiva como tratamiento inicial&#46; Se muestra el modelo antes y despu&#233;s de ajustarlo al &#237;ndice de propensi&#243;n y de ser conectado a VM invasiva como primer tratamiento ventilatorio</p>"
        ]
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      9 => array:5 [
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        "mostrarDisplay" => true
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">DE&#58; desviaci&#243;n est&#225;ndar&#59; GCS&#58; Glasgow Coma Scale&#59; PAM&#58; presi&#243;n arterial media&#59; VIH&#58; virus de la inmunodeficiencia humana&#46;</p>"
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            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Adquirida en la comunidad &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>120&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Nosocomial &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>39&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Edad &#40;a&#241;os&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">65 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Varones&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66 &#40;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31 &#40;80&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;006&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Comorbilidades&#58;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Insuficiencia card&#237;aca cr&#243;nica&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hepatopat&#237;a cr&#243;nica&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Insuficiencia renal cr&#243;nica&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Alcoholismo&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;95&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Inmunosupresi&#243;n&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18 &#40;46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Infecci&#243;n por VIH&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>M&#225;s de 1 comorbilidad&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75 &#40;63&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">26 &#40;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hospitalizaci&#243;n &#60;1 a&#241;o&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34 &#40;28&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19 &#40;49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">SAPS 3&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;93&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Temperatura &#40;&#176;C&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37&#44;0 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37&#44;0 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PAM &#40;mmHg&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">81 &#40;19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">79 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Vasopresores en las primeras 24<span class="elsevierStyleHsp" style=""></span>h&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74 &#40;62&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21 &#40;54&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Lactato &#40;mmol&#47;l&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;5 &#40;2&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;9 &#40;1&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">GCS&#44; puntuaci&#243;n media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Frecuencia respiratoria &#40;lpm&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;69&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">pH&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33 &#40;0&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&#44;36 &#40;0&#44;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PaCO</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#40;mmHg&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PaO</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#40;mmHg&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">84 &#40;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">75 &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">PaO</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#47;FiO</span><span class="elsevierStyleInf"><span class="elsevierStyleItalic">2</span></span><span class="elsevierStyleItalic">&#40;mmHg&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">148 &#40;105&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">118 &#40;61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Recuento leucocitario &#40;&#215;10</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">9</span></span><span class="elsevierStyleItalic">&#47;l&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;2 &#40;8&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;0 &#40;6&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Recuento plaquetario &#40;&#215;10</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">9</span></span><span class="elsevierStyleItalic">&#47;l&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">215 &#40;132&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">240 &#40;151&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Hemoglobina &#40;g&#47;dl&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#44;2 &#40;2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#44;2 &#40;2&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Creatinina &#40;mg&#47;dl&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;4 &#40;0&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;5 &#40;1&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Alb&#250;mina &#40;g&#47;dl&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;5 &#40;0&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;3 &#40;0&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Bilirrubina total &#40;mg&#47;dl&#41;&#44; media &#40;DE&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&#44;4 &#40;2&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;8 &#40;0&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Caracter&#237;sticas de la neumon&#237;a</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>N&#250;mero de cuadrantes en la radiograf&#237;a&#44; media &#40;DE&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;2 &#40;1&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#44;3 &#40;1&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Bacteriemia&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7 &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Idoneidad de los antibi&#243;ticos&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">116 &#40;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36 &#40;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                    0 => array:2 [
                      "titulo" => "Noninvasive mechanical ventilation in acute respiratory failure&#58; trends in use and outcomes"
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                            0 => "D&#46; Schnell"
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                        "volumen" => "40"
                        "paginaInicial" => "582"
                        "paginaFinal" => "591"
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                    0 => array:2 [
                      "titulo" => "Non-invasive positive pressure ventilation for treatment of respiratory failure due to exacerbations of chronic obstructive pulmonary disease"
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                        0 => array:2 [
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                          "autores" => array:4 [
                            0 => "F&#46;S&#46; Ram"
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                            2 => "J&#46; Lightowler"
                            3 => "J&#46;A&#46; Wedzicha"
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                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Cochrane Database Syst Rev&#46;"
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                        "paginaInicial" => "CD004104"
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Article information
ISSN: 03002896
Original language: Spanish
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