<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0016-3813</journal-id>
<journal-title><![CDATA[Gaceta médica de México]]></journal-title>
<abbrev-journal-title><![CDATA[Gac. Méd. Méx]]></abbrev-journal-title>
<issn>0016-3813</issn>
<publisher>
<publisher-name><![CDATA[Academia Nacional de Medicina de México A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0016-38132020000400302</article-id>
<article-id pub-id-type="doi">10.24875/gmm.m20000411</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Mechanical ventilator as a shared resource for the COVID-19 pandemic]]></article-title>
<article-title xml:lang="es"><![CDATA[El ventilador mecánico como recurso divisible ante la pandemia de COVID-19]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vázquez-de Anda]]></surname>
<given-names><![CDATA[Gilberto F.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ruíz-de Chávez]]></surname>
<given-names><![CDATA[Manuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez-Castañeda]]></surname>
<given-names><![CDATA[Ana I.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vázquez-Moreno]]></surname>
<given-names><![CDATA[Pamela]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Dávila-Fernández]]></surname>
<given-names><![CDATA[Juan C.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Delaye-Aguilar]]></surname>
<given-names><![CDATA[Ma. Guadalupe]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Autónoma del Estado de México  ]]></institution>
<addr-line><![CDATA[ State of Mexico]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Academia Nacional de Medicina de México  ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad Autónoma del Estado de México Faculty of Psychology ]]></institution>
<addr-line><![CDATA[ State of Mexico]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Instituto Tecnológico de Estudios Superiores de Monterrey School of Social Sciences and Government ]]></institution>
<addr-line><![CDATA[ Nuevo León]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Zone 1 General Hospital Intensive Care Unit]]></institution>
<addr-line><![CDATA[Oaxaca ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Universidad Autónoma del Estado de México Faculty of Humanities ]]></institution>
<addr-line><![CDATA[ State of Mexico]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2020</year>
</pub-date>
<volume>156</volume>
<numero>4</numero>
<fpage>302</fpage>
<lpage>306</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0016-38132020000400302&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0016-38132020000400302&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0016-38132020000400302&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract COVID-19, the causative agent of which is a new type of coronavirus called SARS-CoV-2, has caused the most severe pandemic in the last 100 years. The condition is mainly respiratory, and up to 5 % of patients develop critical illness, a situation that has put enormous pressure on the health systems of affected countries. A high demand for care has mainly been observed in intensive care units and critical care resources, which is why the need to redistribute resources in critical medicine emerged, with an emphasis on distributive justice, which establishes the provision of care to the largest number of people and saving the largest number of lives. One principle lies in allocating resources to patients with higher life expectancy. Mechanical ventilator has been assumed to be an indivisible asset; however, simultaneous mechanical ventilation to more than one patient with COVID-19 is technically possible. Ventilator sharing is not without risks, but the principles of beneficence, non-maleficence and justice prevail. According to distributive justice, being a divisible resource, mechanical ventilator can be shared; however, we should ask ourselves if this action is ethically correct.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen COVID-19, cuyo agente causal es un nuevo tipo de coronavirus denominado SARS-CoV-2, ha provocado la pandemia más grave en los últimos 100 años. La afección es principalmente respiratoria y hasta 5 % de los pacientes desarrolla enfermedad crítica, lo cual ha producido una enorme presión sobre los sistemas de salud de los países afectados. Principalmente se ha observado alta demanda de atención en las unidades de cuidados intensivos y de recursos de atención vital. De ahí la necesidad de redistribuir los recursos en medicina crítica, con énfasis en la justicia distributiva, la cual establece atender al mayor número de personas y salvar el mayor número de vidas. Un principio estriba en asignar los recursos a pacientes con mayores expectativas de vida. Se ha dado por hecho que el ventilador mecánico es un bien indivisible; sin embargo, técnicamente es posible la ventilación mecánica simultánea a más de un paciente con COVID-19. La acción de compartir el ventilador no está exenta de riesgos, pero prevalecen los principios de beneficencia, no maleficencia y justicia. Conforme la justicia distributiva, al ser un bien divisible, el ventilador mecánico puede ser compartido, sin embargo, cabe preguntarse si esta acción es éticamente correcta.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[COVID-19]]></kwd>
<kwd lng="en"><![CDATA[Pandemic]]></kwd>
<kwd lng="en"><![CDATA[SARS-COV-2]]></kwd>
<kwd lng="en"><![CDATA[Mechanical ventilator]]></kwd>
<kwd lng="en"><![CDATA[Bioethics]]></kwd>
<kwd lng="es"><![CDATA[COVID-19]]></kwd>
<kwd lng="es"><![CDATA[Pandemia]]></kwd>
<kwd lng="es"><![CDATA[SARS-COV-2]]></kwd>
<kwd lng="es"><![CDATA[Ventilación mecánica]]></kwd>
<kwd lng="es"><![CDATA[Bioética]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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