Statistics

 array:24 [
  "pii" => "S1579212919300564"
  "issn" => "15792129"
  "doi" => "10.1016/j.arbr.2019.03.001"
  "estado" => "S300"
  "fechaPublicacion" => "2019-05-01"
  "aid" => "1967"
  "copyright" => "SEPAR"
  "copyrightAnyo" => "2018"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Arch Bronconeumol. 2019;55:271-2"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 203
    "formatos" => array:3 [
      "EPUB" => 26
      "HTML" => 139
      "PDF" => 38
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0300289618303028"
      "issn" => "03002896"
      "doi" => "10.1016/j.arbres.2018.07.012"
      "estado" => "S300"
      "fechaPublicacion" => "2019-05-01"
      "aid" => "1967"
      "copyright" => "SEPAR"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "cita" => "Arch Bronconeumol. 2019;55:271-2"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 314
        "formatos" => array:3 [
          "EPUB" => 24
          "HTML" => 203
          "PDF" => 87
        ]
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta Cient&#237;fica</span>"
        "titulo" => "Trasplante pulmonar bilateral en un paciente con una restricci&#243;n severa de la cavidad pleural derecha"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "271"
            "paginaFinal" => "272"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Bilateral Lung Transplantation in a Patient With Severe Right Pleural Cavity Restriction"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 558
                "Ancho" => 1300
                "Tamanyo" => 142598
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cortes de TAC en los que se aprecia un colapso del pulm&#243;n derecho a expensas de la presencia de m&#250;ltiples bronquiectasias&#44; tan solo quedan aireadas las &#225;reas de pulm&#243;n enfisematoso&#44; con cambios bullosos&#46; Tambi&#233;n se visualiza peque&#241;o nivel hidroa&#233;reo sugestivo de sobreinfecci&#243;n en los cambios bullosos descritos&#46; Se objetiva&#44; adem&#225;s&#44; una importante hiperinsuflaci&#243;n del pulm&#243;n izquierdo con extensas &#225;reas de enfisema panacinar en el l&#243;bulo superior&#46; Dicha hiperinsuflaci&#243;n&#44; sumada al colapso del pulm&#243;n derecho&#44; provoca un importante desplazamiento del mediastino hacia el lado contralateral&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Jos&#233; Luis Campo-Ca&#241;averal de la Cruz, David G&#243;mez de Antonio, &#193;lvaro S&#225;nchez Calle, Alejandra Romero Rom&#225;n"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "Jos&#233; Luis"
                "apellidos" => "Campo-Ca&#241;averal de la Cruz"
              ]
              1 => array:2 [
                "nombre" => "David"
                "apellidos" => "G&#243;mez de Antonio"
              ]
              2 => array:2 [
                "nombre" => "&#193;lvaro"
                "apellidos" => "S&#225;nchez Calle"
              ]
              3 => array:2 [
                "nombre" => "Alejandra"
                "apellidos" => "Romero Rom&#225;n"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1579212919300564"
          "doi" => "10.1016/j.arbr.2019.03.001"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212919300564?idApp=UINPBA00003Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289618303028?idApp=UINPBA00003Z"
      "url" => "/03002896/0000005500000005/v1_201905020909/S0300289618303028/v1_201905020909/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1579212919300576"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2019.03.002"
    "estado" => "S300"
    "fechaPublicacion" => "2019-05-01"
    "aid" => "1973"
    "copyright" => "SEPAR"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Arch Bronconeumol. 2019;55:272-4"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 203
      "formatos" => array:3 [
        "EPUB" => 29
        "HTML" => 131
        "PDF" => 43
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
      "titulo" => "Graphical Analysis Methods in Obstructive Spirometry&#58; Does a Picture Speak More Than a Thousand Words&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "272"
          "paginaFinal" => "274"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "M&#233;todos de an&#225;lisis gr&#225;fico de obstrucci&#243;n espirom&#233;trica&#58; &#191;una imagen vale m&#225;s que mil palabras&#63;"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1673
              "Ancho" => 2500
              "Tamanyo" => 166046
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; Measuring angle <span class="elsevierStyleItalic">&#946;</span>&#46; &#40;b&#41; Area under the curve method&#46; &#40;c&#41; Central and peripheral concavity&#46; Each method is described in the text&#46;</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Ao&#58; obstructive area&#59; AR area&#58; area of the rectangle&#59; At&#58; area of the triangle&#59; Au&#58; area between the hypotenuse of the triangle and the expiratory forced expiration curve&#59; AUC&#58; area under the curve&#59; FEF50&#37;&#58; forced expiratory flow at 50&#37; of vital capacity&#59; FEF75&#37;&#58; forced expiratory flow at 75&#37; of vital capacity&#59; L&#47;s&#58; liters per second&#59; PEF&#58; peak expiratory flow&#59; Ref&#58; reference&#59; RV&#58; residual volume&#59; TLC&#58; total lung capacity&#59; Xp&#58; extrapolation of PEF in the abscissa&#46;</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Graphics adapted from Dominelli et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">5</span></a> Lee et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">11</span></a> and Johns et al&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">15</span></a></p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Joaqu&#237;n Maritano Furcada, C&#233;sar Ignacio Rodr&#237;guez, Esteban Javier Wainstein, Hern&#225;n Javier Benito"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Joaqu&#237;n"
              "apellidos" => "Maritano Furcada"
            ]
            1 => array:2 [
              "nombre" => "C&#233;sar Ignacio"
              "apellidos" => "Rodr&#237;guez"
            ]
            2 => array:2 [
              "nombre" => "Esteban Javier"
              "apellidos" => "Wainstein"
            ]
            3 => array:2 [
              "nombre" => "Hern&#225;n Javier"
              "apellidos" => "Benito"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0300289618303119"
        "doi" => "10.1016/j.arbres.2018.07.018"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289618303119?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212919300576?idApp=UINPBA00003Z"
    "url" => "/15792129/0000005500000005/v1_201905020905/S1579212919300576/v1_201905020905/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1579212919301144"
    "issn" => "15792129"
    "doi" => "10.1016/j.arbr.2018.07.026"
    "estado" => "S300"
    "fechaPublicacion" => "2019-05-01"
    "aid" => "1975"
    "copyright" => "SEPAR"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Arch Bronconeumol. 2019;55:269-70"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 164
      "formatos" => array:3 [
        "EPUB" => 27
        "HTML" => 78
        "PDF" => 59
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
      "titulo" => "Combined Pulmonary Fibrosis and Emphysema Versus Idiopathic Pulmonary Fibrosis Versus Emphysema&#58; A Clinical Perspective"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "269"
          "paginaFinal" => "270"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Comparaci&#243;n con perspectiva cl&#237;nica de la combinaci&#243;n de fibrosis pulmonar y enfisema&#44; la fibrosis pulmonar idiop&#225;tica y el enfisema"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Maria Aurora Mendes, Miguel Guimar&#227;es, Sofia Neves, S&#233;rgio Campainha"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Maria Aurora"
              "apellidos" => "Mendes"
            ]
            1 => array:2 [
              "nombre" => "Miguel"
              "apellidos" => "Guimar&#227;es"
            ]
            2 => array:2 [
              "nombre" => "Sofia"
              "apellidos" => "Neves"
            ]
            3 => array:2 [
              "nombre" => "S&#233;rgio"
              "apellidos" => "Campainha"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0300289618303132"
        "doi" => "10.1016/j.arbres.2018.07.020"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289618303132?idApp=UINPBA00003Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212919301144?idApp=UINPBA00003Z"
    "url" => "/15792129/0000005500000005/v1_201905020905/S1579212919301144/v1_201905020905/en/main.assets"
  ]
  "en" => array:16 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Scientific Letter</span>"
    "titulo" => "Bilateral Lung Transplantation in a Patient With Severe Right Pleural Cavity Restriction"
    "tieneTextoCompleto" => true
    "saludo" => "To the Editor&#44;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "271"
        "paginaFinal" => "272"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Jos&#233; Luis Campo-Ca&#241;averal de la Cruz, David G&#243;mez de Antonio, &#193;lvaro S&#225;nchez Calle, Alejandra Romero Rom&#225;n"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "Jos&#233; Luis"
            "apellidos" => "Campo-Ca&#241;averal de la Cruz"
            "email" => array:1 [
              0 => "jluiscampo82&#64;gmail&#46;com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "David"
            "apellidos" => "G&#243;mez de Antonio"
          ]
          2 => array:2 [
            "nombre" => "&#193;lvaro"
            "apellidos" => "S&#225;nchez Calle"
          ]
          3 => array:2 [
            "nombre" => "Alejandra"
            "apellidos" => "Romero Rom&#225;n"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servicio de Cirug&#237;a Tor&#225;cica y Trasplante Pulmonar&#44; Hospital Universitario Puerta de Hierro-Majadahonda&#44; Madrid&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Trasplante pulmonar bilateral en un paciente con una restricci&#243;n severa de la cavidad pleural derecha"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 558
            "Ancho" => 1300
            "Tamanyo" => 142598
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">CT slices showing a collapsed right lung due to the presence of multiple bronchiectasis&#46; Only the areas of emphysematous lung are aerated&#44; with bullous changes&#46; A small air-fluid level suggestive of superinfection over the bullous parenchyma can also be visualized&#46; Moreover&#44; major hyperinflation is present in the left lung with extensive areas of panacinar emphysema in the upper lobe&#46; This hyperinflation&#44; along with the collapse of the right lung&#44; produces a significant shift in the mediastinum toward the contralateral side&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Lung transplantation has become a standard treatment for patients with terminal respiratory failure who have exhausted all therapeutic alternatives and have a limited life expectancy&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Lobar transplantation&#44; as a variant of lung trasnplantation&#44; involves the use of lung lobes instead of the entire graft&#46; The objective is to adapt the size of the donor organ to the chest cavity of the recipient&#46; This way&#44; patients with severe pleural cavity restriction&#44; either due to their underlying disease or because they are pediatric patients&#44; avoid excesive time on the waiting list until a suitable sized donor is found&#46; Several groups have published their experience with lobar transplantation and have reported acceptable results&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">1&#44;2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">We report the case of a 54-year-old man with COPD diagnosis associated with right pulmonary parenchymal destruction&#44; especially of the right lower lobe&#44; due to bronchiectasis &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; In fact&#44; lung perfusion scintigraphy determined 6&#46;5&#37; perfusion on the right side and 93&#46;5&#37; on the left&#46; Such a significant restriction of the right cavity led us to consider a right-sided bilobar transplant &#40;middle and right lower lobes&#41; via posterolateral thoracotomy&#44; followed by a left-sided single-lung transplant using central extracorporeal membrane oxygenation &#40;ECMO&#41;&#44; in the supine position&#46; The unusual right-sided approach and the manner of protecting the newly implanted lobar graft are 2 technical details that make this case interesting&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">With regard to lung volumes&#44; the recipient had a total lung capacity of 6&#46;8<span class="elsevierStyleHsp" style=""></span>l predicted and 6&#46;5<span class="elsevierStyleHsp" style=""></span>l real&#46; The donor was 60 years old&#44; and had a PaO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span> ratio of 436&#44; a normal chest X-ray and bronchoscopy&#44; and a total lung capacity of 6&#46;7<span class="elsevierStyleHsp" style=""></span>l&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The recipient was initially positioned in left lateral decubitus&#44; and a right posterolateral thoracotomy was performed&#46; After removing lung adhesionsespecially in the right lower lobe destroyed by bronchiectasis&#44; a right pneumonectomy was carried out&#46; The pulmonary hilum was prepared in a conventional manner&#44; opening the pericardium around the pulmonary veins and artery and cutting the bronchus 2 cartilages away from the main carina&#46; Meanwhile&#44; a right upper lobectomy was performed on the back tablet&#44; preserving the middle and lower lobes&#46; In order to retain a sufficiently large left atrial cuff&#44; the right superior pulmonary vein was ligated outside instead of cutting the atrium&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Despite the unusual approach and the longer procedure time&#44; the right transplantation was completed without incident&#46; The pulmonary artery was then isolated with a double tourniquet&#44; keeping it closed in order to protect the newly transplanted lobar graft from anterograde blood flow&#46; In that situation&#44; without arterial flow toward the graft and without ventilation&#44; the posterolateral thoracotomy was closed and the patient was placed in a supine position&#46; A bilateral thoracotomy with a transverse sternotomy was performed and central ECMO was initiated&#46; The tourniquet on the right pulmonary artery was then opened&#44; allowing reperfusion of the lobar graft after starting the ventilation&#46; Left lung transplantation was then performed in the usual manner&#46; Cold ischemia time was 8 and 10<span class="elsevierStyleHsp" style=""></span>h for the right and left grafts&#44; respectively&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Given the recipient&#39;s good heart function&#44; confirmed during the procedure with transesophageal echocardiography&#44; and in order to protect the grafts&#44; we decided to switch central ECMO to a peripheral veno-venous configuration&#46; We did this using the femoral vein for the extraction of blood and the internal jugular vein to infuse the blood oxygenated by assistance&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The first chest x-ray showed bilateral edema&#44; and given that the patient was on venous-venous ECMO&#44; the case was classified as primary graft dysfunction grade 3<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">3</span></a>&#46; However&#44; 6 days after transplantation&#44; PaO<span class="elsevierStyleInf">2</span>&#47;FiO<span class="elsevierStyleInf">2</span> ratio improved remarkably and the chest X-ray was almost normal Therefore ECMO therapy was discontinued&#46; An early tracheostomy was performed on postoperative day 4&#44; and the patient was weaned off all ventilatory support by day 50&#46; ICU and hospital lenght of stay were 54 and 122 days respectively&#46; Other complications included superficial dehiscence of the surgical incision&#44; which was treated with vacuum therapy&#46; The patient also developed an episode of acute cellular rejection A1 and renal failure&#44; but both situations had been resolved by the time of discharge&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">In short&#44; lobar transplantation is a valuable option to optimize lung donation and to adapt the graft size in special situations&#44; such as pediatric cases or small chest cavities&#46; Usually these recipients cannot wait for a perfect sized donor&#46; However&#44; it is important to consider some type of cardiorespiratory assistance to protect lobar grafts during both the intraoperative &#40;cardiopulmonary bypass or ECMO&#41; and postoperative period &#40;mainly ECMO&#41;&#44; depending on the clinical scenario and preferences of the surgical group&#46; In this particular case&#44; lobar transplantation was combined with an unusual approach&#44; a posterolateral thoracotomy&#46; For that reason&#44; until central ECMO was established&#44; we decided to maintain the lobar graft without blood flow and without ventilation&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Other alternative surgical strategies for this transplant were considered&#44; but ruled out&#46; The possibility of right pneumonectomy&#44; with the implantation of a single left lung&#44; was rejected due to problems that might occur in association with the healing of the bronchial stump and pneumonectomy cavity&#46; Performing the transplant using peripheral veno-arterial ECMO was also ruled out due to the risk of cannulas displacement during intraoperative positional changes&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">In conclusion&#44; given that the patient&#39;s right cavity could only accommodate 2 lobes&#44; and that the best approach for this procedure was posterolateral thoracotomy&#44; we believe that maintaining the bilobar graft without blood flow or ventilation until the establishment of cardiorespiratory assistance was a valid strategy&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Campo-Ca&#241;averal de la Cruz JL&#44; G&#243;mez de Antonio D&#44; S&#225;nchez Calle &#193;&#44; Romero Rom&#225;n A&#46; Trasplante pulmonar bilateral en un paciente con una restricci&#243;n severa de la cavidad pleural derecha&#46; Arch Bronconeumol&#46; 2019&#59;55&#58;271&#8211;272&#46;</p>"
      ]
    ]
    "multimedia" => array:1 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 558
            "Ancho" => 1300
            "Tamanyo" => 142598
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">CT slices showing a collapsed right lung due to the presence of multiple bronchiectasis&#46; Only the areas of emphysematous lung are aerated&#44; with bullous changes&#46; A small air-fluid level suggestive of superinfection over the bullous parenchyma can also be visualized&#46; Moreover&#44; major hyperinflation is present in the left lung with extensive areas of panacinar emphysema in the upper lobe&#46; This hyperinflation&#44; along with the collapse of the right lung&#44; produces a significant shift in the mediastinum toward the contralateral side&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:3 [
            0 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term outcomes of bilateral lobar lung transplantation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46; Inci"
                            1 => "M&#46;M&#46; Schuurmans"
                            2 => "P&#46; Kestenholz"
                            3 => "D&#46; Schneiter"
                            4 => "S&#46; Hillinger"
                            5 => "I&#46; Opitz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Eur J Cardiothorac Surg"
                        "fecha" => "2013"
                        "volumen" => "43"
                        "paginaInicial" => "1220"
                        "paginaFinal" => "1225"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lobar lung transplantation from decesased donors&#58; a valid option for small-sized patients with cystic fibrosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Stanzi"
                            1 => "H&#46; Decaluwe"
                            2 => "W&#46; Coosemans"
                            3 => "P&#46; de Leyn"
                            4 => "P&#46; Nafteus"
                            5 => "H&#46; van Veer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Transplant Proc"
                        "fecha" => "2014"
                        "volumen" => "46"
                        "paginaInicial" => "3154"
                        "paginaFinal" => "3159"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "Report of the ISHLT Working Group on Primary Lung Graft Dysfunction&#44; part I&#58; definition and grading &#8211; a 2016 Consensous Group statement of the International Society for Heart and Lung Transplantation"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46;I&#46; Snell"
                            1 => "R&#46;D&#46; Yusen"
                            2 => "D&#46; Weill"
                            3 => "M&#46; Strueber"
                            4 => "E&#46; Garrity"
                            5 => "A&#46; Reed"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Heart Lung Transplant"
                        "fecha" => "2017"
                        "volumen" => "36"
                        "paginaInicial" => "1097"
                        "paginaFinal" => "1103"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack404933"
        "titulo" => "Acknowledgements"
        "texto" => "<p id="par0060" class="elsevierStylePara elsevierViewall">We thank the Departments of Respiratory Medicine&#44; Anesthesiology and Transplant Coordination of the Hospital Universitario Puerta de Hierro-Majadahonda&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15792129/0000005500000005/v1_201905020905/S1579212919300564/v1_201905020905/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "49861"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Scientific letters"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005500000005/v1_201905020905/S1579212919300564/v1_201905020905/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212919300564?idApp=UINPBA00003Z"
]