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      "titulo" => "Diagnostic and Treatment Challenge of Left Anomalous Bronchial Artery&#58; A Case of Recurrent Stridor in a 15-Month-Old Boy"
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            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A &#8211; Thoracic computed tomography angiography &#40;CTA&#41;&#44; in axial plane&#44; showing the anomalous artery&#44; originating in the right side of the descending thoracic aorta &#40;AoD&#41;&#44; encircling the left main bronchus at the point of bronchial stenosis&#46; The anomalous bronchial artery originates two bronchial arteries&#44; right and left&#46; The five arrows point to 1&#58; the origin at the aorta&#59; 2&#58; the first branch&#44; which is a normal right intercostobronchial branch&#59; 3&#58; the second branch&#44; which is an aberrant bronchial trunk&#59; 4 and 5&#58; the two vessels originate from the bronchial trunk to form right and left bronchial arteries&#46;</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">B &#8211; Computerized tomography reconstruction arteriography view showing the tortuosity of the anomalous bronchial artery described in a &#40;<elsevierMultimedia ident="202108020524369151"></elsevierMultimedia>&#41;&#46;</p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">C &#8211; Dynamic image showing the anomalous bronchial artery tortuous path around the left main bronchus&#46;</p> <p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">D &#8211; Endovascular embolization of the abnormal vessel&#44; occluded with 12 microcoils&#46;</p>"
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            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chest X-ray&#44; PA projection &#40;A&#41;&#46; Extensive subcutaneous emphysema in right chest wall and supraclavicular and cervical region&#44; along with pneumomediastinum &#40;arrows&#41;&#46; Poorly delimited mass in the right upper lobe &#40;asterisk&#41;&#44; apparently communicating with a bronchus leading to that lobe &#40;arrowheads&#41;&#46; Chest CT without intravenous contrast medium&#44; pulmonary parenchyma window&#46; Multiplanar reconstructions in coronal &#40;B&#41; and axial &#40;C&#41; planes&#44; with minimum intensity projection &#40;D&#41;&#46; The air cavity is clearly seen surrounding the treated mass &#40;arrowheads in B and C&#41;&#44; communicating with a bronchial branch to that lobe &#40;arrowheads in D&#41;&#44; along with pneumomediastinum &#40;white arrows&#41; and extensive subcutaneous emphysema predominantly in the right chest wall&#46; Note the large gas-filled space in the chest wall adjacent to the post-thermal ablation cavity&#44; suggesting communication between the two cavities &#40;C and D asterisk&#41;&#46; There are also signs of centrilobular emphysema predominantly in the upper lobes&#46;</p>"
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    "titulo" => "Diffuse Alveolar Hemorrhage After Orotracheal Extubation Probably Induced by Sevoflurane Inhalation"
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        "titulo" => "Hemorragia alveolar difusa tras extubaci&#243;n orotraqueal probablemente inducida por la inhalaci&#243;n de sevoflurano"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#44; b&#41; Axial and coronal views of thoracic computed tomography performed after admission in intensive care unit&#59; &#40;c&#41; lesion observed in bronchoscopy on day five after admission&#46; &#40;d&#41; Coronal view of thoracic computed tomography performed 15 days after the first tomographic evaluation&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report a case of a 38 years old male&#44; smoker&#44; without previous known pathologies and any assumed toxic habits&#46; Pre-operative tests including coagulation&#44; were normal&#46; He was submitted to supraspinatus raffia through shoulder arthroscopy&#44; under balanced general anesthesia with inhaled Sevoflurane&#46; Orotracheal intubation &#40;OI&#41;&#44; performed with Macintosh laryngoscope&#44; was smooth and easy with a 7&#46;5<span class="elsevierStyleHsp" style=""></span>mm reinforced tube&#46; No trauma or other complications were reported during OI or surgery&#46; Two minutes after extubation&#44; the patient presented laryngospasm&#44; desaturation&#44; and massive hemoptysis&#46; He was immediately reintubated and admitted to Intensive Care Unit&#44; where a first diagnostic bronchofibroscopy was performed&#44; reporting distal massive hemorrhage without any visible focus or trauma in the airways&#46; Thorax Computed Tomography showed diffuse alveolar hemorrhage &#40;DAH&#41; and excluded pulmonary embolism &#40;PE&#41;&#46; After five days with OI&#44; a new bronchofibroscopy showed a lesion in the posterior wall of trachea&#46; An autoimmune screening was performed and excluded vasculitis&#46; Patient was discharged after two weeks and a third bronchofibroscopy was made after one month&#44; displaying good evolution&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">In this case there were several different diagnostic possibilities&#58; Airway trauma&#44; PE&#44; autoimmune diseases&#44; negative pressure pulmonary edema &#40;NPPE&#41; and Sevoflurane induced DAH&#46; The lesion found in the second bronchofibroscopy was not seen in the first exam&#44; which could be related to the use of high pressure endotracheal cuff&#44; during the five days of OI&#46; In the other hand&#44; in the first bronchofibroscopy&#44; the presence of an orotracheal tube may have hindered the observation of tracheal trauma&#46; NPPE after an upper airway obstruction such as laryngospasm is another plausible hipothesys&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> Still&#44; preexisting pulmonary damage from smoking and administration of the irritating inhaled anesthetic Sevoflurane&#44; could lead to DAH&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> There are&#44; in literature&#44; a few case reports<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">1&#44;2</span></a> of hemoptysis related to the association of inhaled Sevoflurane and NPPE after extubation&#44; and this might be another one &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Even though we didn&#8217;t find an unequivocal diagnosis&#44; with this case we wanted to highlight the chance of Sevoflurane induced DAH or NPPE as hypothesis for immediate postoperative hemoptysis&#46;</p></span>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#44; b&#41; Axial and coronal views of thoracic computed tomography performed after admission in intensive care unit&#59; &#40;c&#41; lesion observed in bronchoscopy on day five after admission&#46; &#40;d&#41; Coronal view of thoracic computed tomography performed 15 days after the first tomographic evaluation&#46;</p>"
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                      "titulo" => "Negative pressure pulmonary edema-related diffuse alveolar hemorrhage associated with Sevoflurane and cigarette smoking"
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                          "autores" => array:4 [
                            0 => "D&#46; Hao"
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                            0 => "C&#46;A&#46; Kim"
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                        "tituloSerie" => "Ann Am Thorac Soc"
                        "fecha" => "2014"
                        "volumen" => "11"
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