<?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>2448-8909</journal-id>
<journal-title><![CDATA[Medicina crítica (Colegio Mexicano de Medicina Crítica)]]></journal-title>
<abbrev-journal-title><![CDATA[Med. crít. (Col. Mex. Med. Crít.)]]></abbrev-journal-title>
<issn>2448-8909</issn>
<publisher>
<publisher-name><![CDATA[Colegio Mexicano de Medicina Crítica A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2448-89092018000200008</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Diagnóstico ecográfico de la insuficiencia respiratoria postoperatoria aguda tras timectomía]]></article-title>
<article-title xml:lang="en"><![CDATA[Role of ecography in diagnostic of postoperative acute respiratory failure after timectomy]]></article-title>
<article-title xml:lang="pt"><![CDATA[Diagnóstico ultrassonográfico da insuficiência respiratória aguda pós-operatória após timectomia]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Catalá Ripoll]]></surname>
<given-names><![CDATA[José Vicente]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Carrió Font]]></surname>
<given-names><![CDATA[Marta]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cuesta Montero]]></surname>
<given-names><![CDATA[Pablo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Torres Valiño]]></surname>
<given-names><![CDATA[Carlota]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Simón Polo]]></surname>
<given-names><![CDATA[Elena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Monsalve Naharro]]></surname>
<given-names><![CDATA[José Ángel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital General de Albacete Servicio de Anestesiología, Reanimación y Terapéutica del dolor ]]></institution>
<addr-line><![CDATA[Albacete ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital de Denia Servicio de Anestesiología y Unidad de Cuidados Intensivos ]]></institution>
<addr-line><![CDATA[Alicante ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital de Cieza Servicio de Anestesiología, Reanimación y Terapéutica del dolor ]]></institution>
<addr-line><![CDATA[Murcia ]]></addr-line>
<country>Spain</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2018</year>
</pub-date>
<volume>32</volume>
<numero>2</numero>
<fpage>108</fpage>
<lpage>110</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2448-89092018000200008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2448-89092018000200008&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2448-89092018000200008&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: La miastenia gravis es una enfermedad autoinmune que puede alterar las capacidades físicas de los pacientes. La timectomía es una de las opciones terapéuticas. Su postoperatorio puede ser complicado por la propia enfermedad o por lesiones intraoperatorias de estructuras nerviosas. Presentamos a una mujer de 66 años intervenida de timectomía por timoma que causa miastenia gravis. Durante la intervención se reseca el nervio frénico izquierdo. En el postoperatorio inmediato presenta insuficiencia respiratoria aguda, por lo que se realiza ecografía pulmonar anodina y ecografía diafragmática que muestra fracción de acortamiento de 10% en el lado derecho y ausencia de contractilidad en el lado izquierdo. La paciente precisó ventilación mecánica no invasiva durante seis días y traqueotomía para avanzar en el destete respiratorio, siendo dada de alta a planta finalmente en respiración espontánea con cánula fenestrada por traqueotomía. La ecografía diafragmática supone una técnica diagnóstica disponible a la cabecera del paciente, útil en situaciones urgentes gracias a su rápida realización y a que complementa la valoración clínica en el diagnóstico de la insuficiencia respiratoria aguda postquirúrgica.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: Myasthenia gravis is an autoimmune disease that can alter the physical abilities of patients. Thymectomy is one of the therapeutic options. The postoperatory may be complicated by the disease itself or by intraoperative lesions of nerve structures. Case of 66-year-old woman with myasthenia gravis undergoing thymectomy. The left phrenic nerve was resected. In the immediate postoperative period, the patient presented acute respiratory failure. A lung ultrasound is performed, being anodyne. The diaphragmatic ultrasound proved a 10% of thickening fraction on the right side and absence of contractility on the left side. The patient required non-invasive mechanical ventilation for six days, tracheotomy was performed to succeed the respiratory weaning. The patient was transferred to ward in spontaneous ventilation. The diaphragmatic ultrasound is a useful and portable diagnostic technique, mainly in urgent situations due to the rapidity of its implementation. It complements the clinical assessment in the diagnosis of acute postoperative respiratory failure.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo: A miastenia gravis é uma doença auto-imune que pode alterar as capacidades físicas dos pacientes. A timectomia é uma das opções de tratamento. O pós-operatório pode ser complicado pela própria doença ou por lesões intra-operatória de estruturas nervosas. Apresentamos uma mulher de 66 anos submetida a timectomia por timoma que causa miastenia gravis. Durante a cirurgia, o nervo frênico esquerdo é ressecado. No pós-operatório imediato, a paciente apresentou insuficiência respiratória aguda, de modo que foram realizadas uma ultrassonografia pulmonar anódino e ecografia diafragmática, mostrando uma fração de encurtamento de 10% no lado direito e ausência de contratilidade no lado esquerdo. A paciente requeriu de ventilação mecânica não invasiva por 6 dias e a realização de uma traqueotomia para avançar no desmame respiratório, sendo dada de alta da UTI respirando espontâneamente com uma cânula de traqueostomia fenestrada. O ultrassom diafragmático é uma técnica de diagnóstico disponível à beira do leito, útil em situações urgentes devido à rapidez do seu desempenho e que complementa a avaliação clínica no diagnóstico de insuficiência respiratória aguda pós-operatória.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Diafragma]]></kwd>
<kwd lng="es"><![CDATA[miastenia gravis]]></kwd>
<kwd lng="es"><![CDATA[ecografía]]></kwd>
<kwd lng="es"><![CDATA[timectomía]]></kwd>
<kwd lng="en"><![CDATA[Diaphragm]]></kwd>
<kwd lng="en"><![CDATA[myasthenia gravis]]></kwd>
<kwd lng="en"><![CDATA[ultrasonography]]></kwd>
<kwd lng="en"><![CDATA[thymectomy]]></kwd>
<kwd lng="pt"><![CDATA[Diafragma]]></kwd>
<kwd lng="pt"><![CDATA[miastenia gravis]]></kwd>
<kwd lng="pt"><![CDATA[ultrassom]]></kwd>
<kwd lng="pt"><![CDATA[timectomia]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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