Letter to the Editor
Usefulness of Diaphragmatic Ultrasound in Preoperative Evaluation
Utilidad de la ecografía diafragmática en la evaluación preoperatoria
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B) Diafragma en zona de aposición con transductor lineal y medición de grosor en espiración máxima. C) Diafragma en zona de aposición con transductor lineal y medición de grosor en inspiración máxima. B) y C) para cálculo de Fracción de Acortamiento preoperatoria.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Samuel Pecho-Silva, Ana Claudia Navarro-Solsol" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Samuel" "apellidos" => "Pecho-Silva" ] 1 => array:2 [ "nombre" => "Ana Claudia" "apellidos" => "Navarro-Solsol" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1579212920302664" "doi" => "10.1016/j.arbr.2020.09.003" "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/S1579212920302664?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S030028962030168X?idApp=UINPBA00003Z" "url" => "/03002896/0000005600000011/v2_202011100719/S030028962030168X/v2_202011100719/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S1579212920302949" "issn" => "15792129" "doi" => "10.1016/j.arbr.2020.05.013" "estado" => "S300" "fechaPublicacion" => "2020-11-01" "aid" => "2505" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Arch Bronconeumol. 2020;56:765-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Dual Antibiotic Therapy for Outpatient Management of Community-acquired Pneumonia?" 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A 52-year-old man, family doctor by profession, presented with a 10-day history of cough and myalgia. Dyspnea and fever on examination. Laboratory tests: normal white cell count, ferritin 545.7 ng/mL (>322), and erythrocyte sedimentation rate 53 m/n (0–20). PCR positive for SARS-CoV-2. A— Posterior-anterior chest X-ray: slight opacity in the periphery of the left hemitorax, middle field. B—Lateral chest X-ray with no obvious findings. C—DTS: Image no. 8 (anterior). Extensive opacity in anterior region of left hemitorax (arrows). D—DTS: Image no. 14 (central). Bilateral pulmonary opacities, in the left suprahilar region (arrow) and right lower lobe (arrow). E—DTS: Image no. 36 (posterior). Oval opacity in retro-cardiac region (arrow). F—Non-contrast chest CT scan, sagittal reconstruction. Oval opacity in the periphery of the left lower lobe (arrow).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Inmaculada Calvo, Sara SantaCruz-Calvo, María Gracia Aranzana, Patricia Mármol, Jorge Ángel Luque, Inmaculada Peral, Eva María Quijada, Cristina Gómez, Celia Borrego, Jorge Marín" "autores" => array:10 [ 0 => array:2 [ "nombre" => "Inmaculada" "apellidos" => "Calvo" ] 1 => array:2 [ "nombre" => "Sara" "apellidos" => "SantaCruz-Calvo" ] 2 => array:2 [ "nombre" => "María Gracia" "apellidos" => "Aranzana" ] 3 => array:2 [ "nombre" => "Patricia" "apellidos" => "Mármol" ] 4 => array:2 [ "nombre" => "Jorge Ángel" "apellidos" => "Luque" ] 5 => array:2 [ "nombre" => "Inmaculada" "apellidos" => "Peral" ] 6 => array:2 [ "nombre" => "Eva María" "apellidos" => "Quijada" ] 7 => array:2 [ "nombre" => "Cristina" "apellidos" => "Gómez" ] 8 => array:2 [ "nombre" => "Celia" "apellidos" => "Borrego" ] 9 => array:2 [ "nombre" => "Jorge" "apellidos" => "Marín" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0300289620302209" "doi" => "10.1016/j.arbres.2020.06.017" "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/S0300289620302209?idApp=UINPBA00003Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157921292030269X?idApp=UINPBA00003Z" "url" => "/15792129/0000005600000011/v1_202011120627/S157921292030269X/v1_202011120627/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Usefulness of Diaphragmatic Ultrasound in Preoperative Evaluation" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "764" "paginaFinal" => "765" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Samuel Pecho-Silva, Ana Claudia Navarro-Solsol" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Samuel" "apellidos" => "Pecho-Silva" "email" => array:1 [ 0 => "samuelpechosilva@gmail.com" ] "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Ana Claudia" "apellidos" => "Navarro-Solsol" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Escuela de Medicina, Universidad Científica del Sur, Lima, Peru" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento Académico de Clínicas Médicas, Universidad Peruana Cayetano Heredia, Lima, Peru" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Universidad Nacional de Ucayali, Pucallpa, Peru" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Utilidad de la ecografía diafragmática en la evaluación preoperatoria" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 664 "Ancho" => 1674 "Tamanyo" => 117337 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Diaphragmatic dome in 2D and anatomical M modes with convex transducer showing displacement of the dome in vital capacity. (B) Diaphragm in zone of apposition with linear transducer and measurement of thickness in maximum expiration. (C) Diaphragm in zone of apposition with linear transducer and measurement of thickness in minimum expiration. (B and C) For calculation of preoperative shortening fraction.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with interest the editorial published in your journal on the usefulness of diaphragmatic ultrasound (DUS).<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> We would like to mention another use for DUS in addition to those proposed by the authors<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a>: the preoperative evaluation (PE) of patients scheduled to undergo cardiovascular surgery. Measuring the diaphragmatic shortening fraction (DSF) in the preoperative period can help detect patients at increased risk of postoperative complications.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> A DSF of less than 20% is considered low and confers a high risk. Normal DSF is 36% to 38%, and a DSF of less than 38% is associated with postoperative complications.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2,3</span></a> A reduction in DSF of more than 10% measured 1 day after surgery has also been associated with postoperative complications such as prolonged stay in the intensive care unit.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We report the case of a 78-year-old man with diabetes mellitus, kidney failure, active smoking, and mild malnutrition who was scheduled for elective cardiovascular surgery for myocardial revascularization. In the PE, the patient had a NYHA functional class II and ASA score of II.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> Pulmonary and cardiovascular physical examinations were normal. Spirometry was normal and oxygen saturation was 94%.</p><p id="par0015" class="elsevierStylePara elsevierViewall">We measured the DSF of the right diaphragm in the zone of apposition using a portable multifrequency linear transducer that was placed longitudinally on the right anterior axillary line between the seventh and eighth intercostal space.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> DSF was 40%, so we were confident that the risk of complications would be very low (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). While the patient's characteristics did not suggest a particularly high risk, the clinical evaluation performed with predictive scales for postoperative complications indicated a moderate risk (6.6%) of myocardial infarction, pulmonary edema, ventricular fibrillation, and cardiac arrest, and a very high risk (42.1%) of perioperative pulmonary complications according to the ARISCAT scale,<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> the clinical scale that we routinely use for PE. A very high risk on the ARISCAT scale prompts us to perform other pre-surgery evaluations; however, in this case the decision was made on the basis of the DSF. This finding was reported to the cardiovascular surgeon and the decision was made to schedule surgery. DSF 24<span class="elsevierStyleHsp" style=""></span>h after surgery was 38%.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> The patient had no immediate cardiopulmonary complications, was extubated early, left the intensive care unit on the third day, and showed very good postoperative progress.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">We share the authors’ view that DUS, with all its advantages, has become one of the best tools in the pulmonologist's diagnostic arsenal,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> thanks to its non-invasive nature, low cost, wide availability, use at the bedside, absence of adverse effects, and acceptable reproducibility. It has very few disadvantages, and is an excellent addition to the clinical PE of patients with a high risk of complications estimated by ARISCAT.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have not received funding for this work.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "⋆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Pecho-Silva S, Navarro-Solsol AC. Utilidad de la ecografía diafragmática en la evaluación preoperatoria. Arch Bronconeumol. 2020;56:764–765.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 664 "Ancho" => 1674 "Tamanyo" => 117337 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Diaphragmatic dome in 2D and anatomical M modes with convex transducer showing displacement of the dome in vital capacity. (B) Diaphragm in zone of apposition with linear transducer and measurement of thickness in maximum expiration. (C) Diaphragm in zone of apposition with linear transducer and measurement of thickness in minimum expiration. (B and C) For calculation of preoperative shortening fraction.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ecografía diafragmática: una herramienta de novedosa a rutinaria" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Sayas Catalán" 1 => "A. Hernández-Voth" 2 => "M.V. Villena Garrido" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arbres.2019.06.020" "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2020" "volumen" => "56" "paginaInicial" => "201" "paginaFinal" => "203" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31383496" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diaphragm thickening in cardiac surgery: a perioperative prospective ultrasound study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.-H. Moury" 1 => "A. Cuisinier" 2 => "M. Durand" 3 => "J.-L. Bosson" 4 => "O. Chavanon" 5 => "J.-F. Payen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s13613-019-0521-z" "Revista" => array:5 [ "tituloSerie" => "Ann Intensive Care" "fecha" => "2019" "volumen" => "9" "paginaInicial" => "50" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31016412" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Preoperative diaphragm function is associated with postoperative pulmonary complications after cardiac surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y.A. Cavayas" 1 => "R. Eljaiek" 2 => "É. Rodrigue" 3 => "Y. Lamarche" 4 => "M. Girard" 5 => "H.T. Wang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/CCM.0000000000004027" "Revista" => array:6 [ "tituloSerie" => "Crit Care Med" "fecha" => "2019" "volumen" => "47" "paginaInicial" => "e966" "paginaFinal" => "e974" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31609771" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Postoperative pulmonary complications" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Miskovic" 1 => "A.B. Lumb" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/bja/aex002" "Revista" => array:6 [ "tituloSerie" => "Br J Anaesth" "fecha" => "2017" "volumen" => "118" "paginaInicial" => "317" "paginaFinal" => "334" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28186222" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sonographic evaluation of diaphragmatic dysfunction: technique interpretation, and clinical applications" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C. Dass" 1 => "F. Dako" 2 => "S. Simpson" 3 => "N. Marchetti" 4 => "R. Steiner" 5 => "G. Criner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/RTI.0000000000000436" "Revista" => array:7 [ "tituloSerie" => "J Thorac Imaging" "fecha" => "2019" "volumen" => "34" "paginaInicial" => "W131" "paginaFinal" => "W140" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31385877" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0954611100909776" "estado" => "S300" "issn" => "09546111" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15792129/0000005600000011/v1_202011120627/S1579212920302664/v1_202011120627/en/main.assets" "Apartado" => array:4 [ "identificador" => "45358" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15792129/0000005600000011/v1_202011120627/S1579212920302664/v1_202011120627/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1579212920302664?idApp=UINPBA00003Z" ]
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| 2023 February | 38 | 17 | 55 |
| 2023 January | 30 | 41 | 71 |
| 2022 December | 47 | 54 | 101 |
| 2022 November | 64 | 32 | 96 |
| 2022 October | 52 | 31 | 83 |
| 2022 September | 47 | 22 | 69 |
| 2022 August | 56 | 45 | 101 |
| 2022 July | 33 | 46 | 79 |
| 2022 June | 52 | 40 | 92 |
| 2022 May | 36 | 35 | 71 |
| 2022 April | 35 | 37 | 72 |
| 2022 March | 42 | 42 | 84 |
| 2022 February | 21 | 16 | 37 |
| 2021 March | 8 | 0 | 8 |
| 2020 December | 1 | 0 | 1 |
Show all
