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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">In recent years non-invasive ventilation &#40;NIV&#41; as become a valuable therapeutic option in exacerbations of patients with chronic pulmonary obstructive disease&#46; Although widely used there is a paucity of information on weaning from NIV&#46;</p> <span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We aimed to describe the performance of a weaning protocol based on progressive periods of NIV withdraw&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">During a one year period we performed NIV in 78 patients with acute exacerbation of chronic respiratory failure&#46; Weaning was considered in patients with 24 hours without acidosis and respiratory rate less than 25 cycles per minute&#46; Weaning was performed as following&#58; during the first 24 hours in each 3 hours&#44; one hour without NIV &#40;except during night period&#41;&#44; in the second day in each 3 hours&#44; two hours without NIV &#40;except during night period&#41; and in the third day NIV was used during the night period&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Sixty five patients began the weaning protocol&#46; Mean NIV time was 120&#44;9 hours &#40;17 to 192 hours&#41;&#46; No adverse effects were recorded in patients who began the weaning protocol&#46; All patients completed the weaning protocol with no re-institution of NIV or invasive ventilation during hospitalization&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">We report an excellent weaning success rate of NIV in patients with acute severe exacerbation of CRF&#46; Although our weaning protocol required 72 hours&#44; our results suggest that strategies based on periods with and with-out NIV are effective&#46; Weather similar less time consuming weaning strategies are effective&#44; merits investigation&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introdu&#231;&#227;o</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Nos &#250;ltimos anos&#44; a ventila&#231;&#227;o n&#227;o invasiva &#40;VNI&#41; tornou-se numa op&#231;&#227;o terap&#234;utica v&#225;lida nas exacerba&#231;&#245;es agudas de doentes com doen&#231;a pulmonar cr&#243;nica obstrutiva&#46; No entanto&#44; apesar de muito utilizada&#44; existe muito pouca informa&#231;&#227;o sobre o desmame deste modo ventilat&#243;rio&#46;</p> <span class="elsevierStyleSectionTitle">Objectivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Descrever um protocolo de desmame baseado em per&#237;odos progressivos de descontinua&#231;&#227;o de VNI&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Durante um ano foram admitidos 78 doentes na nossa unidade para in&#237;cio de VNI devido a exacerba&#231;&#245;es agudas de doentes com doen&#231;a pulmonar cr&#243;nica obstrutiva&#46; O desmame de VNI era considerado em doentes que se apresentavam sem acidose e com frequ&#234;ncia respirat&#243;ria inferior a 25 ciclos por minuto&#46; O desmane era realizado da seguinte forma&#58; Durante as primeiras 24 horas&#44; em cada 3 horas de per&#237;odo diurno o doente estava sem VNI durante uma hora &#40;excepto &#224; noite&#41;&#59; no segundo dia&#44; em cada 3 horas o doente estava sem VNI durante 2 horas &#40;excepto &#224; noite&#41;&#44; e no terceiro dia a VNI era utilizada apenas em per&#237;odo nocturno&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Sessenta doentes iniciaram o protocolo de desmame&#46; O tempo m&#233;dio de VNI foi de 120&#46;9 horas &#40;17 a 192 horas&#41;&#46; N&#227;o houve registo de complica&#231;&#245;es nos doentes que iniciaram este protocolo&#46; Todos completaram o protocolo sem necessidade de reinstituir VNI ou ventila&#231;&#227;o invasiva durante o internamento&#46;</p> <span class="elsevierStyleSectionTitle">Conclus&#245;es</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Descrevemos uma taxa excelente de sucesso de desmame de VNI em doentes com exacerba&#231;&#245;es agudas de doentes com insufici&#234;ncia respirat&#243;ria cr&#243;nica&#46; Apesar de este protocolo implicar uma dura&#231;&#227;o de 72 horas&#44; os resultados sugerem que estrat&#233;gias baseadas em per&#237;odos com e sem VNI s&#227;o eficazes&#46; No entanto&#44; estrat&#233;gias menos demoradas merecem investiga&#231;&#227;o&#46;</p>"
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                    0 => array:2 [
                      "titulo" => "Positive pressure respiration and its application to the treatment of acute pulmonary edema"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;L&#46; Barach"
                            1 => "J&#46; Martin"
                            2 => "M&#46; Eckman"
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "1998"
                        "volumen" => "12"
                        "paginaInicial" => "754"
                        "paginaFinal" => "795"
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "titulo" => "Noninvasive ventilation&#46; State of Art"
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                          "autores" => array:2 [
                            0 => "S&#46; Mehta"
                            1 => "N&#46;S&#46; Hill"
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Crit Care Med"
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                        "paginaInicial" => "540"
                        "paginaFinal" => "577"
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "titulo" => "Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary diseases"
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                          "autores" => array:5 [
                            0 => "L&#46; Brochard"
                            1 => "J&#46; Mancebo"
                            2 => "M&#46; Wysocki"
                            3 => "F&#46; Lofaso"
                            4 => "G&#46; Conti"
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                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1995"
                        "volumen" => "333"
                        "paginaInicial" => "817"
                        "paginaFinal" => "822"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7651472"
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                      "titulo" => "Non-invasive positive pressure ventilation to treat respiratory failure resulting from exacerbations of chronic obstructive pulmonary disease&#58; Cochrane systematic review and meta-analysis"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
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                            2 => "M&#46;W&#46; Elliott"
                            3 => "F&#46;S&#46; Ram"
                          ]
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                      ]
                    ]
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                        "tituloSerie" => "BMJ"
                        "fecha" => "2003"
                        "volumen" => "326"
                        "numero" => "7382"
                        "paginaInicial" => "185"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12543832"
                            "web" => "Medline"
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                      "titulo" => "Randomized&#44; prospective trial of non-invasive positive pressure ventilation in acute respiratory failure"
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                          "autores" => array:3 [
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                            2 => "J&#46; Meharg"
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Repir Crit Care Med"
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                        "volumen" => "151"
                        "paginaInicial" => "1799"
                        "paginaFinal" => "1806"
                      ]
                    ]
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                        0 => array:2 [
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                          "autores" => array:3 [
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                            2 => "M&#46;W&#46; Elliot"
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                      ]
                    ]
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                        "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"
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                          "colaboracion" => "British Thoracic Society"
                          "etal" => false
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                        "tituloSerie" => "Thorax"
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                        "paginaFinal" => "211"
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Weaning from non-invasive positive pressure ventilation: Experience with progressive periods of withdraw
Desmame de ventilação não invasiva: Experiência com períodos de descontinuação
C. Damas2, C. Andrade1, J.P. Araújo1, J. Almeida1, P. Bettencourt1
1 Serviço de Medicina Interna do Hospital de São João, Porto
2 Serviço de Pneumologia do Hospital de São João, Porto Unidade I&D Cardiovascular do Porto Faculdade de Medicina da Universidade do Porto
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        "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">In recent years non-invasive ventilation &#40;NIV&#41; as become a valuable therapeutic option in exacerbations of patients with chronic pulmonary obstructive disease&#46; Although widely used there is a paucity of information on weaning from NIV&#46;</p> <span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We aimed to describe the performance of a weaning protocol based on progressive periods of NIV withdraw&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">During a one year period we performed NIV in 78 patients with acute exacerbation of chronic respiratory failure&#46; Weaning was considered in patients with 24 hours without acidosis and respiratory rate less than 25 cycles per minute&#46; Weaning was performed as following&#58; during the first 24 hours in each 3 hours&#44; one hour without NIV &#40;except during night period&#41;&#44; in the second day in each 3 hours&#44; two hours without NIV &#40;except during night period&#41; and in the third day NIV was used during the night period&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Sixty five patients began the weaning protocol&#46; Mean NIV time was 120&#44;9 hours &#40;17 to 192 hours&#41;&#46; No adverse effects were recorded in patients who began the weaning protocol&#46; All patients completed the weaning protocol with no re-institution of NIV or invasive ventilation during hospitalization&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">We report an excellent weaning success rate of NIV in patients with acute severe exacerbation of CRF&#46; Although our weaning protocol required 72 hours&#44; our results suggest that strategies based on periods with and with-out NIV are effective&#46; Weather similar less time consuming weaning strategies are effective&#44; merits investigation&#46;</p>"
      ]
      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introdu&#231;&#227;o</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Nos &#250;ltimos anos&#44; a ventila&#231;&#227;o n&#227;o invasiva &#40;VNI&#41; tornou-se numa op&#231;&#227;o terap&#234;utica v&#225;lida nas exacerba&#231;&#245;es agudas de doentes com doen&#231;a pulmonar cr&#243;nica obstrutiva&#46; No entanto&#44; apesar de muito utilizada&#44; existe muito pouca informa&#231;&#227;o sobre o desmame deste modo ventilat&#243;rio&#46;</p> <span class="elsevierStyleSectionTitle">Objectivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Descrever um protocolo de desmame baseado em per&#237;odos progressivos de descontinua&#231;&#227;o de VNI&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Durante um ano foram admitidos 78 doentes na nossa unidade para in&#237;cio de VNI devido a exacerba&#231;&#245;es agudas de doentes com doen&#231;a pulmonar cr&#243;nica obstrutiva&#46; O desmame de VNI era considerado em doentes que se apresentavam sem acidose e com frequ&#234;ncia respirat&#243;ria inferior a 25 ciclos por minuto&#46; O desmane era realizado da seguinte forma&#58; Durante as primeiras 24 horas&#44; em cada 3 horas de per&#237;odo diurno o doente estava sem VNI durante uma hora &#40;excepto &#224; noite&#41;&#59; no segundo dia&#44; em cada 3 horas o doente estava sem VNI durante 2 horas &#40;excepto &#224; noite&#41;&#44; e no terceiro dia a VNI era utilizada apenas em per&#237;odo nocturno&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Sessenta doentes iniciaram o protocolo de desmame&#46; O tempo m&#233;dio de VNI foi de 120&#46;9 horas &#40;17 a 192 horas&#41;&#46; N&#227;o houve registo de complica&#231;&#245;es nos doentes que iniciaram este protocolo&#46; Todos completaram o protocolo sem necessidade de reinstituir VNI ou ventila&#231;&#227;o invasiva durante o internamento&#46;</p> <span class="elsevierStyleSectionTitle">Conclus&#245;es</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Descrevemos uma taxa excelente de sucesso de desmame de VNI em doentes com exacerba&#231;&#245;es agudas de doentes com insufici&#234;ncia respirat&#243;ria cr&#243;nica&#46; Apesar de este protocolo implicar uma dura&#231;&#227;o de 72 horas&#44; os resultados sugerem que estrat&#233;gias baseadas em per&#237;odos com e sem VNI s&#227;o eficazes&#46; No entanto&#44; estrat&#233;gias menos demoradas merecem investiga&#231;&#227;o&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliography"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:15 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Positive pressure respiration and its application to the treatment of acute pulmonary edema"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;L&#46; Barach"
                            1 => "J&#46; Martin"
                            2 => "M&#46; Eckman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Ann Intern Med"
                        "fecha" => "1998"
                        "volumen" => "12"
                        "paginaInicial" => "754"
                        "paginaFinal" => "795"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Noninvasive ventilation&#46; State of Art"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; Mehta"
                            1 => "N&#46;S&#46; Hill"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Crit Care Med"
                        "fecha" => "2001"
                        "volumen" => "163"
                        "paginaInicial" => "540"
                        "paginaFinal" => "577"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary diseases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:5 [
                            0 => "L&#46; Brochard"
                            1 => "J&#46; Mancebo"
                            2 => "M&#46; Wysocki"
                            3 => "F&#46; Lofaso"
                            4 => "G&#46; Conti"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJM199509283331301"
                      "Revista" => array:6 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "1995"
                        "volumen" => "333"
                        "paginaInicial" => "817"
                        "paginaFinal" => "822"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7651472"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Non-invasive positive pressure ventilation to treat respiratory failure resulting from exacerbations of chronic obstructive pulmonary disease&#58; Cochrane systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;V&#46; Lightowler"
                            1 => "J&#46;A&#46; Wedzicha"
                            2 => "M&#46;W&#46; Elliott"
                            3 => "F&#46;S&#46; Ram"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2003"
                        "volumen" => "326"
                        "numero" => "7382"
                        "paginaInicial" => "185"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12543832"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Randomized&#44; prospective trial of non-invasive positive pressure ventilation in acute respiratory failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "N&#46; Kramer"
                            1 => "T&#46;J&#46; Meyer"
                            2 => "J&#46; Meharg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Repir Crit Care Med"
                        "fecha" => "1995"
                        "volumen" => "151"
                        "paginaInicial" => "1799"
                        "paginaFinal" => "1806"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "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&#58; a multicentre randomised controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46;K&#46; Plant"
                            1 => "J&#46;L&#46; Owen"
                            2 => "M&#46;W&#46; 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"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Non-invasive ventilation in acute respiratory failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "British Thoracic Society"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "2002"
                        "volumen" => "57"
                        "paginaInicial" => "192"
                        "paginaFinal" => "211"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11867822"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Acute applications of non-invasive positive pressure ventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T Liesching"
                            1 => "H Kwok"
                            2 => "S&#46;N&#46; Hill"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2003"
                        "volumen" => "124"
                        "paginaInicial" => "699"
                        "paginaFinal" => "713"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12907562"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Complications of acute respiratory failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46;K&#46; Pingleton"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1164/ajrccm/137.6.1463"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Rev Respir Dis"
                        "fecha" => "1988"
                        "volumen" => "137"
                        "paginaInicial" => "1463"
                        "paginaFinal" => "1493"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3059862"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Noninvasive ventilation for acute respiratory failure&#58; a prospective randomised placebo-controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "F&#46; Thys"
                            1 => "J&#46; Roeseler"
                            2 => "M&#46; Reynaert"
                            3 => "G&#46; Liistro"
                            4 => "D&#46;O&#46; Rodenstein"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2002"
                        "volumen" => "20"
                        "paginaInicial" => "545"
                        "paginaFinal" => "555"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12358327"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Non invasive mechanical ventilation in acute respiratory failure due to chronic obstructive pulmonary disease&#58; correlates for success"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "N&#46; Ambrosino"
                            1 => "K&#46; Foglio"
                            2 => "F&#46; Rubini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Thorax"
                        "fecha" => "1995"
                        "volumen" => "50"
                        "paginaInicial" => "755"
                        "paginaFinal" => "757"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7570410"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Use of a ventilatory support system &#40;BiPAP&#41; for acute respiratory failure in the emergency department"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;M&#46; Poponick"
                            1 => "J&#46;P&#46; Renston"
                            2 => "R&#46;P&#46; Bennett"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1999"
                        "volumen" => "116"
                        "paginaInicial" => "166"
                        "paginaFinal" => "171"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10424521"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A chart of failure risk for non-invasive ventilation inpatients with COPD exacerbation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:5 [
                            0 => "M&#46; Confalonieri"
                            1 => "G&#46; Garuti"
                            2 => "M&#46;S&#46; Cattaruzza"
                            3 => "J&#46;F&#46; Osborn"
                            4 => "M&#46; Antonelli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1183/09031936.05.00085304"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Respir J"
                        "fecha" => "2005"
                        "volumen" => "25"
                        "paginaInicial" => "348"
                        "paginaFinal" => "355"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15684302"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Noninvasive ventilation to treat Hypercapnic coma secondary to respiratory failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:4 [
                            0 => "G&#46;G&#46; Diaz"
                            1 => "A&#46;C&#46; Alcaraz"
                            2 => "J&#46;C&#46; Talavera"
                            3 => "P&#46;J&#46; P&#233;rez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1378/chest.127.3.952"
                      "Revista" => array:6 [
                        "tituloSerie" => "Chest"
                        "fecha" => "2005"
                        "volumen" => "127"
                        "paginaInicial" => "952"
                        "paginaFinal" => "960"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15764781"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of non-invasive positive pressure ventilation with standard medical therapy in hypercapnic acute respiratory failure"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "T&#46; Celikel"
                            1 => "M&#46; Sungur"
                            2 => "B&#46; Ceyhan"
                            3 => "S&#46; Karakurt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Chest"
                        "fecha" => "1998"
                        "volumen" => "114"
                        "paginaInicial" => "1636"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9872200"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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Pulmonology

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