Original Articles
Predictors of Outcome in Blunt Chest Trauma
B. Virgós Señora,
, A.C. Nebra Puertasa, C. Sánchez Polob, A. Broto Civerac, M.A. Suárez Pinillad
Corresponding author
beaagus@wanadoo.es
Correspondence: Dra. B. Virgós Señor. Avda. de Valencia, 51-53, escalera 1.a, 8.° B. 50005 Zaragoza. España
Correspondence: Dra. B. Virgós Señor. Avda. de Valencia, 51-53, escalera 1.a, 8.° B. 50005 Zaragoza. España
a Servicio de Medicina Intensiva, Hospital Universitario Miguel Servet, Zaragoza, Spain
b Servicio de Medicina Intensiva, Hospital Obispo Polanco, Teruel, Spain
c Servicio de Admisión, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
d Servicio de Medicina Intensiva, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
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"apellidos" => "Virgós Señor" "email" => array:1 [ 0 => "beaagus@wanadoo.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "A.C." "apellidos" => "Nebra Puertas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 2 => array:3 [ "nombre" => "C." "apellidos" => "Sánchez Polo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 3 => array:3 [ "nombre" => "A." "apellidos" => "Broto Civera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] 4 => array:3 [ "nombre" => "M.A." "apellidos" => "Suárez Pinilla" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Intensiva, Hospital Universitario Miguel Servet, Zaragoza, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Intensiva, Hospital Obispo Polanco, Teruel, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Servicio de Admisión, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] 3 => array:3 [ "entidad" => "Servicio de Medicina Intensiva, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dra. B. Virgós Señor. Avda. de Valencia, 51-53, escalera 1.<span class="elsevierStyleSup">a</span>, 8.° B. 50005 Zaragoza. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-12-02" "fechaAceptado" => "2004-02-17" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key Words" "identificador" => "xpalclavsec153169" "palabras" => array:5 [ 0 => "Thoracic trauma" 1 => "Multiple injuries" 2 => "Prognosis" 3 => "Mortality" 4 => "Mechanical ventilation" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec153168" "palabras" => array:5 [ 0 => "Traumatismo torácico" 1 => "Politraumatismo" 2 => "Pronóstico" 3 => "Mortalidad" 4 => "Ventilación mecánica" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p class="elsevierStyleSimplePara elsevierViewall">Thoracic trauma is often associated with polytrauma. Because mortality is high, the search for prognostic tools is useful.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">A total of 108 patients with blunt thoracic trauma, 73 of whom had multiple injuries, were studied in an intensive care unit (ICU). The variables named as potential predictors of outcome were the need for mechanical ventilation, duration of ventilation, and high positive end-expiratory pressure (PEEP); the presence of rib fractures, pulmonary contusion, pleural involvement (hemo-and/or pneumothorax), or lung infection; the need for emergency surgery; mean duration of ICU stay, and age. We also studied whether or not the mortality rate was higher in polytrauma patients. Student <span class="elsevierStyleItalic">t</span> and CH<span class="elsevierStyleSup">2</span> tests (95% confidence level) and multiple regression analysis (Hosmer-Lemeshow goodness of fit) were used to analyze the results.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The need for mechanical ventilation, radiographic evidence of pulmonary contusion, emergency surgery, and hemodynamic instability were risk factors for increased mortality. Higher risk of mortality was not demonstrated for patients with multiple injuries. For patients in need of mechanical ventilation, high PEEP was a predictor of poor prognosis.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The presence of the aforementioned predictors (mechanical ventilation, high PEEP, pulmonary contusion, emergency surgery, and hemodynamic instability) indicate serious injury to the lung parenchyma, which is the main determinant of outcome for patients with thoracic trauma.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p class="elsevierStyleSimplePara elsevierViewall">El traumatismo torácico suele producirse en el contexto de un politraumatismo. La mortalidad eleva-da de esta patología hace lógica la investigación de marcadores pronósticos.</p> <span class="elsevierStyleSectionTitle">Pacientes Y Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Estudio sobre 108 pacientes ingresa-dos en una unidad de cuidados intensivos, con traumatismo torácico cerrado, de los cuales 73 fueron politraumatizados. Analizamos, como marcadores pronósticos, la necesidad de ventilación mecánica, su duración, la presión positiva máxima final de la espiración, las fracturas costales, la contusión pulmonar, las alteraciones pleurales (hemo y/o neumotórax), la sobreinfección respiratoria, la inestabilidad hemodinámica, la necesidad de cirugía urgente, así como la estancia media y la edad. Estudiamos si fue mayor la mortalidad en los politraumatizados. Se emplearon como herramientas estadísticas las pruebas de la t de Student y de la CH<span class="elsevierStyleSup">2</span> (intervalo míni-mo de confianza del 95%), y se realizó un análisis de regresión logística (bondad de ajuste test de Hosmer-Lemeshow).</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">La necesidad de ventilación mecánica, la presencia radiológica de contusión pulmonar, la cirugía urgente y la inestabilidad hemodinámica comportan mayor mortalidad. No se demuestra mayor mortalidad en los en-fermos politraumatizados. En los pacientes con ventilación mecánica, la presión positiva máxima final de la espiración requerida es un indicador de mayor mortalidad.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Los marcadores positivos indican una mayor lesión en el parénquima pulmonar, lesión que es el de-terminante principal de la evolución de los pacientes con traumatismo torácico.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:26 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology of chest trauma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "JI LoCicero" 1 => "KL Mattox" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Surg Clin North Am" "fecha" => "1989" "volumen" => "69" "paginaInicial" => "15" "paginaFinal" => "19" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2911786" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiology of trauma deaths" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "CC Baker" 1 => "L Oppenheimer" 2 => "B Stephens" 3 => "FR Lewis" 4 => "DD Trunkey" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Surg" "fecha" => "1980" "volumen" => "140" "paginaInicial" => "144" "paginaFinal" => "150" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7396078" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Blunt thoracic trauma. Analysis of 515 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "RM Shorr" 1 => "M Crittenden" 2 => "M Indeck" 3 => "SL Hartunian" 4 => "A Rodríguez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Surg" "fecha" => "1987" "volumen" => "206" "paginaInicial" => "200" "paginaFinal" => "205" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3606246" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Traffic crash fatalities (1968-73). Injury and other factors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "JI Tonge" 1 => "MJ O'eilly" 2 => "A Davison" 3 => "NG Johnston" 4 => "IS Wilkey" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Med Sci Law" "fecha" => "1977" "volumen" => "17" "paginaInicial" => "9" "paginaFinal" => "24" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/840002" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An expanded definition of the adult respiratory distress syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "JF Murray" 1 => "MA Matthay" 2 => "M Luce" 3 => "MR Flick" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am Rev RespirDis" "fecha" => "1988" "volumen" => "138" "paginaInicial" => "720" "paginaFinal" => "723" "itemHostRev" => array:3 [ "pii" => "S0091674910015666" "estado" => "S300" "issn" => "00916749" ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary extraction of serotonin and propranolol in patients with adult respiratory distress syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "DR Morel" 1 => "F Dargent" 2 => "M Bachman" 3 => "PM Suter" 4 => "AF Junod" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1164/arrd.1985.132.3.479" "Revista" => array:6 [ "tituloSerie" => "Am Rev Respir Dis" "fecha" => "1985" "volumen" => "132" "paginaInicial" => "479" "paginaFinal" => "484" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4037520" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical presentation prognostic factors and outcome of ARDS in the European collaborative study (1985-1987)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A Artigas" 1 => "J Carlet" 2 => "JR McGall" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Adult respiratory distress syndrome" "paginaInicial" => "37" "paginaFinal" => "63" "serieFecha" => "1991" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The adult respiratory distress syndrome at Massachusets General Hospital" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "WM Zapol" 1 => "MJ Frikke" 2 => "H Pontoppidian" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Adult respiratory distress syndrome" "paginaInicial" => "367" "paginaFinal" => "380" "serieFecha" => "1991" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Correlation between crash severity, injury severity, and clinical course in car occupants with thoracic trauma: a technical and medical study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M Richter" 1 => "C Krettek" 2 => "D Otte" 3 => "B Wiesse" 4 => "M Stalp" 5 => "S Ernts" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Trauma" "fecha" => "2001" "volumen" => "51" "paginaInicial" => "10" "paginaFinal" => "16" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11468457" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "índices de gravedad en el paciente politraumático" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "DW Yates" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "El paciente politraumatizado" "paginaInicial" => "40" "paginaFinal" => "46" "serieFecha" => "2000" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "CT quantification of pleuropulmonary lesions in severe thoracic trauma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M Kunisch Hoppe" 1 => "G Bachmann" 2 => "M Hoppe" 3 => "B Weimar" 4 => "T Bauer" 5 => "B Zickmann" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfhar" "fecha" => "1998" "volumen" => "167" "paginaInicial" => "453" "paginaFinal" => "457" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Computed tomography in the management of blunt thoracic trauma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "GV Poole" 1 => "DB Morgan" 2 => "PE Cranston" 3 => "FF Muakkassa" 4 => "JA Griswold" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Trauma" "fecha" => "1993" "volumen" => "35" "paginaInicial" => "296" "paginaFinal" => "300" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8355312" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Asistencia prehospitalaria al paciente politraumatizado" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "JC Martínez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "El paciente politraumatizado" "paginaInicial" => "47" "paginaFinal" => "66" "serieFecha" => "2000" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of CT scan and transesophageal echocardiography in blunt thoracic trauma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G Cinella" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Intensive Care Med" "fecha" => "1999" "volumen" => "24" "paginaInicial" => "986" "paginaFinal" => "987" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9917204" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Echocardiography in the evaluation of thoracic trauma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "SB Jhonsonn" 1 => "PA Kearny" 2 => "MD Smith" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Surg Clin North Am" "fecha" => "1995" "volumen" => "75" "paginaInicial" => "193" "paginaFinal" => "205" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7899993" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Echocardiography in thoracic trauma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D Chan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Emerg Med Clin North Am" "fecha" => "1998" "volumen" => "16" "paginaInicial" => "191" "paginaFinal" => "207" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9496321" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of non invasive test of cardiac damage in suspected cardiac contusion" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "RT Potkin" 1 => "JA Werner" 2 => "GB Trobaugh" 3 => "CH Chestnut" 4 => "CJ Carrico" 5 => "A Hallstrom" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Circulation" "fecha" => "1982" "volumen" => "66" "paginaInicial" => "627" "paginaFinal" => "631" ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Optimum end expiratory airway pressure in patients with acute pulmonary failure" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P Suter" 1 => "H Fairley" 2 => "M Isemberg" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "N Engl J Med" "fecha" => "1975" "volumen" => "292" "paginaInicial" => "2984" "paginaFinal" => "2989" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of positive end expiratory pressure on tidal volume and recruitment in adult respiratory distress syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L Gattini" 1 => "P Pelosi" 2 => "S Crotti" 3 => "L D'Andrea" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Am J Respirat Cri Care Med" "fecha" => "1995" "volumen" => "151" "paginaInicial" => "1807" "paginaFinal" => "1814" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome" ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Engl J Med" "fecha" => "2000" "volumen" => "342" "paginaInicial" => "1301" "paginaFinal" => "1308" ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Resultados del tratamiento en 588 pacientes politraumatizados" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R Sonnerborn" 1 => "R Espinoza" 2 => "R Geni" 3 => "A Rodríguez" 4 => "E Power" 5 => "M Plaza de los Reyes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Med Chil" "fecha" => "1999" "volumen" => "126" "paginaInicial" => "1478" "paginaFinal" => "1482" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10349162" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib22" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Thoracic trauma: an analysis of 187 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P Segers" 1 => "P van Schil" 2 => "P Jorens" 3 => "F van den Brande" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Chir Belg" "fecha" => "2002" "volumen" => "101" "paginaInicial" => "277" "paginaFinal" => "282" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11868503" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib23" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predicition of prolonged ventilatory support in blunt thoracic trauma patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I Dimopoulou" 1 => "A Anthi" 2 => "M Lignos" 3 => "E Boukouvalas" 4 => "E Evangelou" 5 => "C Routso" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Intensive Care Med" "fecha" => "2002" "volumen" => "29" "paginaInicial" => "1010" "paginaFinal" => "1105" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib24" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Appraisal of early evaluation of blunt chest trauma: development of a standarized scorinf system for initial clinical decision making" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "HC Pape" 1 => "D Remmers" 2 => "J Rice" 3 => "M Ebisch" 4 => "C Krettek" 5 => "H Tschern" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Trauma" "fecha" => "2000" "volumen" => "49" "paginaInicial" => "496" "paginaFinal" => "504" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11003329" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib25" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M Sirmali" 1 => "H Türüt" 2 => "S Topcu" 3 => "E Gülhan" 4 => "U Yazici" 5 => "S Kaya" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur J Cardiothorac Surg" "fecha" => "2003" "volumen" => "24" "paginaInicial" => "133" "paginaFinal" => "138" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12853057" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib26" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chest injury due to blunt trauma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "ST Liman" 1 => "A Kuzucu" 2 => "AI Tastepe" 3 => "GN Ulasan" 4 => "S Topcu" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur J Cardiothorac Surg" "fecha" => "2003" "volumen" => "23" "paginaInicial" => "374" "paginaFinal" => "378" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12614809" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000004000000011/v1_201305141823/S1579212906603637/v1_201305141823/en/main.assets" "Apartado" => null "PDF" => 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 2 | 6 |
| 2024 October | 31 | 17 | 48 |
| 2024 September | 34 | 18 | 52 |
| 2024 August | 49 | 34 | 83 |
| 2024 July | 26 | 26 | 52 |
| 2024 June | 35 | 34 | 69 |
| 2024 May | 30 | 42 | 72 |
| 2024 April | 13 | 17 | 30 |
| 2024 March | 22 | 15 | 37 |
| 2024 February | 24 | 17 | 41 |
| 2023 March | 2 | 5 | 7 |
| 2023 February | 17 | 29 | 46 |
| 2023 January | 22 | 34 | 56 |
| 2022 December | 20 | 34 | 54 |
| 2022 November | 12 | 19 | 31 |
| 2022 October | 24 | 33 | 57 |
| 2022 September | 22 | 31 | 53 |
| 2022 August | 18 | 37 | 55 |
| 2022 July | 18 | 40 | 58 |
| 2022 June | 13 | 29 | 42 |
| 2022 May | 19 | 20 | 39 |
| 2022 April | 19 | 27 | 46 |
| 2022 March | 23 | 36 | 59 |
| 2022 February | 23 | 26 | 49 |
| 2022 January | 18 | 32 | 50 |
| 2021 December | 16 | 36 | 52 |
| 2021 November | 21 | 37 | 58 |
| 2021 October | 19 | 42 | 61 |
| 2021 September | 17 | 43 | 60 |
| 2021 August | 13 | 29 | 42 |
| 2021 July | 20 | 26 | 46 |
| 2021 June | 17 | 44 | 61 |
| 2021 May | 11 | 25 | 36 |
| 2021 April | 53 | 45 | 98 |
| 2021 March | 13 | 18 | 31 |
| 2021 February | 8 | 15 | 23 |
| 2021 January | 17 | 17 | 34 |
| 2020 December | 8 | 11 | 19 |
| 2020 November | 10 | 19 | 29 |
| 2020 October | 8 | 10 | 18 |
| 2020 September | 3 | 8 | 11 |
| 2020 August | 13 | 16 | 29 |
| 2020 July | 14 | 19 | 33 |
| 2020 June | 12 | 11 | 23 |
| 2020 May | 13 | 25 | 38 |
| 2020 April | 19 | 9 | 28 |
| 2020 March | 15 | 19 | 34 |
| 2020 February | 19 | 27 | 46 |
| 2020 January | 15 | 16 | 31 |
| 2019 December | 17 | 26 | 43 |
| 2019 November | 17 | 42 | 59 |
| 2019 October | 5 | 48 | 53 |
| 2019 September | 7 | 46 | 53 |
| 2019 August | 13 | 22 | 35 |
| 2019 July | 11 | 33 | 44 |
| 2019 June | 4 | 15 | 19 |
| 2019 May | 14 | 38 | 52 |
| 2019 April | 18 | 15 | 33 |
| 2019 March | 17 | 27 | 44 |
| 2019 February | 10 | 12 | 22 |
| 2019 January | 0 | 13 | 13 |
| 2018 December | 3 | 17 | 20 |
| 2018 November | 20 | 10 | 30 |
| 2018 October | 27 | 17 | 44 |
| 2018 September | 16 | 16 | 32 |
| 2018 May | 12 | 0 | 12 |
| 2018 April | 7 | 6 | 13 |
| 2018 March | 5 | 3 | 8 |
| 2018 February | 5 | 10 | 15 |
| 2018 January | 9 | 10 | 19 |
| 2017 December | 5 | 14 | 19 |
| 2017 November | 1 | 8 | 9 |
| 2017 October | 6 | 10 | 16 |
| 2017 September | 3 | 9 | 12 |
| 2017 August | 7 | 15 | 22 |
| 2017 July | 3 | 6 | 9 |
| 2017 June | 5 | 18 | 23 |
| 2017 May | 6 | 10 | 16 |
| 2017 April | 1 | 5 | 6 |
| 2017 March | 4 | 21 | 25 |
| 2017 February | 0 | 7 | 7 |
| 2017 January | 2 | 6 | 8 |
| 2016 December | 12 | 14 | 26 |
| 2016 November | 15 | 11 | 26 |
| 2016 October | 19 | 15 | 34 |
| 2016 September | 11 | 16 | 27 |
| 2016 August | 6 | 4 | 10 |
| 2016 July | 7 | 6 | 13 |
| 2016 June | 2 | 0 | 2 |
| 2016 May | 2 | 0 | 2 |
| 2016 April | 3 | 0 | 3 |
| 2016 March | 3 | 0 | 3 |
| 2016 February | 1 | 0 | 1 |
| 2016 January | 1 | 0 | 1 |
| 2015 December | 3 | 0 | 3 |
| 2015 November | 1 | 0 | 1 |
| 2015 October | 57 | 1 | 58 |
| 2015 September | 69 | 9 | 78 |
| 2015 August | 60 | 9 | 69 |
| 2015 July | 107 | 17 | 124 |
| 2015 June | 57 | 9 | 66 |
| 2015 May | 61 | 17 | 78 |
| 2015 April | 53 | 9 | 62 |
| 2015 March | 59 | 16 | 75 |
| 2015 February | 43 | 4 | 47 |
| 2015 January | 51 | 4 | 55 |
| 2014 December | 51 | 6 | 57 |
| 2014 November | 51 | 8 | 59 |
| 2014 October | 66 | 9 | 75 |
| 2014 September | 55 | 8 | 63 |
| 2014 August | 48 | 8 | 56 |
| 2014 July | 57 | 8 | 65 |
| 2014 June | 61 | 6 | 67 |
| 2014 May | 55 | 6 | 61 |
| 2014 April | 46 | 5 | 51 |
| 2014 March | 72 | 9 | 81 |
| 2014 February | 58 | 8 | 66 |
| 2014 January | 33 | 8 | 41 |
| 2013 December | 51 | 8 | 59 |
| 2013 November | 47 | 8 | 55 |
| 2013 October | 29 | 10 | 39 |
| 2013 September | 47 | 10 | 57 |
| 2013 August | 49 | 12 | 61 |
| 2013 July | 49 | 21 | 70 |
| 2013 June | 42 | 4 | 46 |
| 2013 May | 34 | 8 | 42 |
| 2013 April | 22 | 13 | 35 |
| 2013 March | 11 | 4 | 15 |
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