Original Articles
Bacterial Colonization and Home Mechanical Ventilation: Prevalence and Risk Factors
J.M. Rodríguez González-Moroa, G. Andrade Viverob, J. de Miguel Díeza, S. López Martína, C. Sánchezc, J.L. Izquierdo Alonsod, P. de Lucas Ramosa,
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pdr01m@saludalia.com
Correspondence: Dra. P. de Lucas Ramos. Servicio de Neumología. Hospital General Universitario Gregorio Marañón. C/ Dr. Esquerdo, 46. 28007 Madrid. España
Correspondence: Dra. P. de Lucas Ramos. Servicio de Neumología. Hospital General Universitario Gregorio Marañón. C/ Dr. Esquerdo, 46. 28007 Madrid. España
a Sección de Soporte Ventilatorio y Trastornos del Sueño, Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
b Servicio de Cuidados Intensivos, Hospital General Universitario Gregorio Marañón, Madrid, Spain
c Servicio de Microbiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
d Sección de Neumología, Hospital Universitario de Guadalajara, Guadalajara, Spain
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"apellidos" => "Rodríguez González-Moro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 1 => array:3 [ "nombre" => "G." "apellidos" => "Andrade Vivero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "J." "apellidos" => "de Miguel Díez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 3 => array:3 [ "nombre" => "S." "apellidos" => "López Martín" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 4 => array:3 [ "nombre" => "C." "apellidos" => "Sánchez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] 5 => array:3 [ "nombre" => "J.L." 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"apellidos" => "de Lucas Ramos" "email" => array:1 [ 0 => "pdr01m@saludalia.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Sección de Soporte Ventilatorio y Trastornos del Sueño, Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Servicio de Cuidados Intensivos, Hospital General Universitario Gregorio Marañón, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Servicio de Microbiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] 3 => array:3 [ "entidad" => "Sección de Neumología, Hospital Universitario de Guadalajara, Guadalajara, Spain" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dra. P. de Lucas Ramos. Servicio de Neumología. Hospital General Universitario Gregorio Marañón. C/ Dr. Esquerdo, 46. 28007 Madrid. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-04-07" "fechaAceptado" => "2004-03-02" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec153605" "palabras" => array:3 [ 0 => "Colonization" 1 => "Contamination" 2 => "Home mechanical ventilation" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec153606" "palabras" => array:3 [ 0 => "Colonización" 1 => "Contaminación" 2 => "Ventilación mecánica domiciliaria" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">TO investigate the prevalence of bacterial contamination of ventilators and colonization of patients, the bacteria implicated, and predisposing factors in noninvasive home ventilation.</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p class="elsevierStyleSimplePara elsevierViewall">Forty patients on a home noninvasive ventilation program (mean [SD] age: 63.1 [12] years; time on ventilation: 30.7 [25] months; daily use: 8.1 [2] hours) were enrolled in this descriptive cross-sectional study. Microbiological samples for semiquantitative cultures were swabbed from the ventilator (mask and tubing) and the nostrils. A questionnaire was completed on the underlying disease, time on the ventilation program, type of ventilator, presence of a humidifier, and attention to ventilator cleanliness and maintenance. We defined “colonization” as the presence of microorganisms in the nostrils without evidence of a host immune response, and “contamination” as the presence of surface microorganisms (on tubing or the nasal mask).</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Potentially pathogenic bacteria were isolated from 6 ventilators (15%) and the nasal swabs of 10 patients (25%). <span class="elsevierStyleItalic">Staphylococcus aureus</span> was the most frequently isolated one (in 5 ventilators and 6 patients—contamination coinciding with colonization in 3 cases). Other potentially pathogenic bacteria isolated were <span class="elsevierStyleItalic">Proteus</span> species (from the nostrils of 2 patients) and an unidentified gram-negative bacillus from the ventilator. On analysis by underlying disease, 60% of the patients with obesity had been colonized. No other findings of note were obtained for other diseases. Contamination and colonization correlated with attention to cleanliness and maintenance of the ventilator but not with type of ventilator, time on the ventilation program, or use of a humidifier.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Home mechanical ventilators are a potential source of nasal colonization. The most frequently encountered microorganism was <span class="elsevierStyleItalic">S. aureus.</span> The degree of ventilator cleaning and disinfection seems to affect contamination; thus it is necessary to impress on patients the need for adequate maintenance of their ventilators.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Conocer la prevalencia de contaminación bacteriana de los ventiladores utilizados en la ventilación mecánica no invasiva domiciliaria, la colonización en los pacientes, los microorganismos implicados y los factores favorecedores.</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se realizó un estudio descriptivo transversal en 40 pacientes en programa de ventilación mecánica no invasiva domiciliaria (edad media: 63,1 ± 12 años; tiempo en ventilación: 30,7 ± 25 meses; utilización diaria: 8,1 ± 2 h). Se tomaron muestras microbiológicas mediante escobi-llado del equipo de ventilación (mascarilla y tubuladuras) y de las fosas nasales para realizar cultivos semicuantitativos, y se completó un cuestionario que incluía enfermedad de base, tiempo en programa de ventilación, tipo de ventilador, existen-cia de humidificador y hábitos y grado de limpieza. Definimos como “colonización” la presencia de microorganismos en las fosas nasales sin evidencia de respuesta orgánica por parte del huésped, y “contaminación” como la presencia de microorganismos en una superficie (tubuladura y mascarilla nasal).</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se aislaron microorganismos potencialmen-te patógenos en las conexiones de 6 equipos (15%) y en el frotis nasal de 10 pacientes (25%). <span class="elsevierStyleItalic">Staphylococcus aureus</span> fue el aislado con mayor frecuencia (5 equipos y 6 pacientes; fue coincidente en 3 casos). Otros gérmenes aislados fueron <span class="elsevierStyleItalic">Proteus</span> spp. (2 casos en fosas nasales), <span class="elsevierStyleItalic">Streptococcus pneu-moniae</span> (2 casos en fosas nasales) y un bacilo gramnegativo no tipificable en las conexiones. Por patologías, el único dato destacable fue que en el 60% de los pacientes con obesidad existía colonización, sin que hubiera datos significativos en el resto de enfermedades. Existe correlación positiva entre el grado de limpieza macroscópico y los aislamientos, pero no entre la contaminación, la colonización y factores como tipo de ventilador, tiempo en ventilación o uso de humidificador.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Los equipos de ventilación mecánica do-miciliario pueden representar una fuente potencial de colonización nasal. El microorganismo más representativo en-contrado fue <span class="elsevierStyleItalic">S. aureus.</span> El grado de limpieza de los equipos parece influir en la contaminación, por lo que es necesario insistir en el adecuado mantenimiento de estos equipos.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:18 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Normativa sobre la ventilación mecánica a domicilio" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R Estopá Miró" 1 => "C Villasante Fernández-Montes" 2 => "P de Lucas Ramos" 3 => "L Ponce de León Martínez" 4 => "M Misterio" 5 => "JF Masa Jiménez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2001" "volumen" => "37" "paginaInicial" => "142" "paginaFinal" => "150" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11333540" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Noninvasive ventilation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S Mehta" 1 => "NS Hill" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/ajrccm.163.2.9906116" "Revista" => array:6 [ "tituloSerie" => "Am J Respir Crit Care Med" "fecha" => "2001" "volumen" => "163" "paginaInicial" => "540" "paginaFinal" => "577" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11179136" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Técnica de la ventilación mecánica domiciliaria. Inicio y seguimiento" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "JM Rodríguez González-Moro" 1 => "MJ Buendía García" 2 => "P de Lucas Ramos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2002" "volumen" => "38" "numero" => "Suppl" "paginaInicial" => "77" "paginaFinal" => "81" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11844439" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Los equipos de terapéutica respiratoria como factor de riesgo en las neumonías nosocomiales" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J Barbat" 1 => "A Torres" 2 => "J Arnaiz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "1986" "volumen" => "87" "paginaInicial" => "119" "paginaFinal" => "124" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prospective study of nosocomial pneumonia and of patient and circuit colonization during mechanical ventilation with circuit changes every 48 hours versus no change" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D Dreyfuss" 1 => "K Djedaini" 2 => "P Weber" 3 => "P Brun" 4 => "JJ Lanore" 5 => "J Rahmani" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/ajrccm/143.4_Pt_1.738" "Revista" => array:6 [ "tituloSerie" => "Am Rev Respir Dis" "fecha" => "1991" "volumen" => "143" "paginaInicial" => "738" "paginaFinal" => "743" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2008985" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Contaminated condensate in mechanical ventilator circuits is a risk factor for nosocomial pneumonia?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "DE Craven" 1 => "TA Goularte" 2 => "BA Make" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am Rev Respir Dis" "fecha" => "1984" "volumen" => "129" "paginaInicial" => "625" "paginaFinal" => "628" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6585160" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevention of infections transmitted by CPAP and non-invasive ventilation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D Benhamou" 1 => "A Cuvelier" 2 => "JF Muir" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Pneumol Clin" "fecha" => "2001" "volumen" => "57" "paginaInicial" => "73" "paginaFinal" => "78" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11353913" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of continuous positive airway pressure therapy on infectious complications in patients with obstructive sleep apnea syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "BM Sanner" 1 => "N Fluerenbrock" 2 => "A Kleiber-Imbeck" 3 => "JB Mueller" 4 => "W Sidec" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "50555" "Revista" => array:6 [ "tituloSerie" => "Respiration" "fecha" => "2001" "volumen" => "68" "paginaInicial" => "483" "paginaFinal" => "487" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11694810" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A Torres" 1 => "F Burgos" 2 => "P Casan" 3 => "J Gravalos" 4 => "J Martínez Moratalla" 5 => "T de Pi-Sunyer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:4 [ "titulo" => "Normativa sobre control microbiológico en los equipos de función y terapia respiratoria. Recomendaciones SEPARno. 18" "fecha" => "1995" "editorial" => "Doyma" "editorialLocalizacion" => "Barcelona" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P de Lucas Ramos" 1 => "JM Rodríguez González-Moro" 2 => "L Paz González" 3 => "A Santa-Cruz Siminiani" 4 => "JM Cubillo Marcos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2000" "volumen" => "36" "paginaInicial" => "545" "paginaFinal" => "550" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11149196" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Staphylococcus aureus infections" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "FD Lowy" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "N Engl J Med" "fecha" => "1998" "volumen" => "339" "paginaInicial" => "520" "paginaFinal" => "532" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nasal carriage as a source of Staphylococcus aureus bacteriemia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C von Eiff" 1 => "K Becker" 2 => "K Machika" 3 => "H Stammer" 4 => "G Peters" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM200101043440102" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2001" "volumen" => "344" "paginaInicial" => "11" "paginaFinal" => "16" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11136954" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnóstico y tratamiento de la neumonía nosocomial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A Torres" 1 => "MR de Celis" 2 => "S Bello" 3 => "J Blanquer" 4 => "J Dorca" 5 => "L Molinos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "1997" "volumen" => "33" "paginaInicial" => "346" "paginaFinal" => "350" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nosocomial infection in an intensive care unit: identification of risk factors. Infect Control Hosp" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R Fernández-Crehuet" 1 => "C Díaz Molina" 2 => "J de Irala" 3 => "D Martínez Concha" 4 => "I Salcedo Leal" 5 => "J Masa Calles" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Epidemiol" "fecha" => "1997" "volumen" => "18" "paginaInicial" => "825" "paginaFinal" => "830" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology of nosocomial pneumonia. New perspectives on an old disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "DE Craven" 1 => "KA Steger" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Chest" "fecha" => "1995" "volumen" => "108" "paginaInicial" => "1S" "paginaFinal" => "16S" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7634921" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association of noninvasive ventilation with nosocomial infections and survival in critically ill patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E Girou" 1 => "F Schortgen" 2 => "C Delclaux" 3 => "C Brun-Buisson" 4 => "F Blot" 5 => "Y Lefort" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "JAMA" "fecha" => "2000" "volumen" => "284" "paginaInicial" => "2376" "paginaFinal" => "2378" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11066190" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of non invasive positive pressure ventilation on mortality in patients admitted with acute respiratory failure: a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "SP Keenan" 1 => "PD Kemerman" 2 => "DJ Cook" 3 => "CM Martin" 4 => "D McCormack" 5 => "WJ Sibbald" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Crit Care Med" "fecha" => "1997" "volumen" => "25" "paginaInicial" => "1685" "paginaFinal" => "1692" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9377883" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Early use of non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease on general respiratory wards: a multicentre randomized controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "PK Plant" 1 => "JL Owen" 2 => "MW Elliot" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2000" "volumen" => "355" "paginaInicial" => "1931" "paginaFinal" => "1935" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10859037" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000004000000009/v1_201305150126/S1579212906603418/v1_201305150126/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/15792129/0000004000000009/v1_201305150126/S1579212906603418/v1_201305150126/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212906603418?idApp=UINPBA00003Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 2 | 7 |
| 2024 October | 27 | 17 | 44 |
| 2024 September | 32 | 8 | 40 |
| 2024 August | 44 | 37 | 81 |
| 2024 July | 29 | 23 | 52 |
| 2024 June | 27 | 21 | 48 |
| 2024 May | 31 | 21 | 52 |
| 2024 April | 17 | 21 | 38 |
| 2024 March | 23 | 13 | 36 |
| 2024 February | 23 | 19 | 42 |
| 2023 March | 2 | 3 | 5 |
| 2023 February | 19 | 19 | 38 |
| 2023 January | 15 | 39 | 54 |
| 2022 December | 16 | 37 | 53 |
| 2022 November | 15 | 22 | 37 |
| 2022 October | 22 | 37 | 59 |
| 2022 September | 14 | 27 | 41 |
| 2022 August | 13 | 27 | 40 |
| 2022 July | 17 | 35 | 52 |
| 2022 June | 14 | 32 | 46 |
| 2022 May | 16 | 32 | 48 |
| 2022 April | 22 | 19 | 41 |
| 2022 March | 18 | 34 | 52 |
| 2022 February | 17 | 19 | 36 |
| 2022 January | 11 | 29 | 40 |
| 2021 December | 10 | 38 | 48 |
| 2021 November | 13 | 35 | 48 |
| 2021 October | 30 | 40 | 70 |
| 2021 September | 29 | 41 | 70 |
| 2021 August | 9 | 28 | 37 |
| 2021 July | 12 | 20 | 32 |
| 2021 June | 14 | 35 | 49 |
| 2021 May | 10 | 26 | 36 |
| 2021 April | 28 | 30 | 58 |
| 2021 March | 19 | 16 | 35 |
| 2021 February | 9 | 10 | 19 |
| 2021 January | 11 | 6 | 17 |
| 2020 December | 11 | 9 | 20 |
| 2020 November | 8 | 17 | 25 |
| 2020 October | 11 | 10 | 21 |
| 2020 September | 6 | 6 | 12 |
| 2020 August | 15 | 4 | 19 |
| 2020 July | 9 | 13 | 22 |
| 2020 June | 4 | 5 | 9 |
| 2020 May | 19 | 14 | 33 |
| 2020 April | 7 | 5 | 12 |
| 2020 March | 32 | 8 | 40 |
| 2020 February | 16 | 10 | 26 |
| 2020 January | 36 | 11 | 47 |
| 2019 December | 20 | 16 | 36 |
| 2019 November | 8 | 7 | 15 |
| 2019 October | 6 | 6 | 12 |
| 2019 September | 24 | 10 | 34 |
| 2019 August | 14 | 5 | 19 |
| 2019 July | 10 | 18 | 28 |
| 2019 June | 8 | 14 | 22 |
| 2019 May | 15 | 10 | 25 |
| 2019 April | 15 | 33 | 48 |
| 2019 March | 12 | 24 | 36 |
| 2019 February | 11 | 10 | 21 |
| 2019 January | 7 | 10 | 17 |
| 2018 December | 11 | 9 | 20 |
| 2018 November | 24 | 7 | 31 |
| 2018 October | 24 | 7 | 31 |
| 2018 September | 7 | 25 | 32 |
| 2018 May | 3 | 0 | 3 |
| 2018 April | 9 | 7 | 16 |
| 2018 March | 3 | 2 | 5 |
| 2018 February | 3 | 7 | 10 |
| 2018 January | 8 | 5 | 13 |
| 2017 December | 7 | 3 | 10 |
| 2017 November | 7 | 3 | 10 |
| 2017 October | 8 | 9 | 17 |
| 2017 September | 5 | 5 | 10 |
| 2017 August | 8 | 16 | 24 |
| 2017 July | 4 | 5 | 9 |
| 2017 June | 6 | 23 | 29 |
| 2017 May | 5 | 11 | 16 |
| 2017 April | 3 | 5 | 8 |
| 2017 March | 2 | 31 | 33 |
| 2017 February | 0 | 4 | 4 |
| 2017 January | 2 | 1 | 3 |
| 2016 December | 7 | 10 | 17 |
| 2016 November | 10 | 16 | 26 |
| 2016 October | 16 | 16 | 32 |
| 2016 September | 16 | 17 | 33 |
| 2016 August | 7 | 6 | 13 |
| 2016 July | 7 | 8 | 15 |
| 2016 March | 3 | 0 | 3 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 51 | 1 | 52 |
| 2015 September | 38 | 11 | 49 |
| 2015 August | 38 | 7 | 45 |
| 2015 July | 55 | 12 | 67 |
| 2015 June | 55 | 5 | 60 |
| 2015 May | 63 | 10 | 73 |
| 2015 April | 49 | 13 | 62 |
| 2015 March | 49 | 8 | 57 |
| 2015 February | 36 | 3 | 39 |
| 2015 January | 46 | 3 | 49 |
| 2014 December | 36 | 5 | 41 |
| 2014 November | 49 | 4 | 53 |
| 2014 October | 48 | 9 | 57 |
| 2014 September | 37 | 6 | 43 |
| 2014 August | 34 | 7 | 41 |
| 2014 July | 23 | 4 | 27 |
| 2014 June | 53 | 7 | 60 |
| 2014 May | 53 | 7 | 60 |
| 2014 April | 44 | 9 | 53 |
| 2014 March | 65 | 10 | 75 |
| 2014 February | 53 | 15 | 68 |
| 2014 January | 42 | 6 | 48 |
| 2013 December | 43 | 11 | 54 |
| 2013 November | 32 | 7 | 39 |
| 2013 October | 36 | 6 | 42 |
| 2013 September | 36 | 18 | 54 |
| 2013 August | 39 | 15 | 54 |
| 2013 July | 49 | 15 | 64 |
| 2013 June | 32 | 8 | 40 |
| 2013 May | 34 | 9 | 43 |
| 2013 April | 32 | 10 | 42 |
| 2013 March | 6 | 2 | 8 |
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