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Fernández Rodríguez, J. Casado, F. Formiga, Á. González-Franco, J.C. Arévalo, M. Beltrán, J.M. Cerqueiro González, P. Llàcer, L. Manzano, J.L. Morales-Rull, J. Pérez Silvestre, A. Conde-Martel" "autores" => array:12 [ 0 => array:2 [ "nombre" => "J.M." "apellidos" => "Fernández Rodríguez" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Casado" ] 2 => array:2 [ "nombre" => "F." "apellidos" => "Formiga" ] 3 => array:2 [ "nombre" => "Á." "apellidos" => "González-Franco" ] 4 => array:2 [ "nombre" => "J.C." "apellidos" => "Arévalo" ] 5 => array:2 [ "nombre" => "M." "apellidos" => "Beltrán" ] 6 => array:2 [ "nombre" => "J.M." "apellidos" => "Cerqueiro González" ] 7 => array:2 [ "nombre" => "P." "apellidos" => "Llàcer" ] 8 => array:2 [ "nombre" => "L." "apellidos" => "Manzano" ] 9 => array:2 [ "nombre" => "J.L." "apellidos" => "Morales-Rull" ] 10 => array:2 [ "nombre" => "J." "apellidos" => "Pérez Silvestre" ] 11 => array:2 [ "nombre" => "A." 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Torres Macho, G. García de Casasola Sánchez" "autores" => array:2 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "Torres Macho" "email" => array:1 [ 0 => "jtorresmacho@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "G." "apellidos" => "García de Casasola Sánchez" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Universitario Infanta Leonor-Virgen de la Torre, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Universitario Infanta Cristina, Parla, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Grupo de trabajo de Ecografía Clínica, Sociedad Española de Medicina Interna, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Ecografía pulmonar, paradigma de la ecografía clínica" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Among the different fields of point-of-care ultrasound, lung ultrasound is one of those that has developed the most in recent years.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> It bears the unique characteristic of not having been polarised by any specific speciality, being a technique without any “owner” and it can be used by any physician attending to patients with cardiopulmonary problems in diverse clinical scenarios such as the emergency department, hospital wards or out-patient services, without the risk of conflicting with other services (radiology, cardiology).</p><p id="par0010" class="elsevierStylePara elsevierViewall">Lung ultrasound development has made it possible to establish a distinctive ultrasound physical diagnosis that enables the detection of pleural effusion, infiltrates or consolidations (pneumonia, tumours, atelectasis), interstitial involvement (heart failure, pulmonary fibrosis, acute respiratory distress) or pneumothorax with high reliability and often with greater diagnostic accuracy than physical examination and chest X-ray.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Lung ultrasound is essential in different diagnostic protocols like patients with dyspnoea of unknown origin, the best-known being the BLUE protocol, and even for patients with shock or hypotension such as the FALLS protocol.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> To be able to compare lung “insonation” to physical examination, the only remaining issue is the detection of bronchial hyperreactivity, a sign that is still detected only with the stethoscope.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Logically, lung ultrasound should be combined with examination of other areas of the body (multi-organ ultrasound) and the heart and the deep venous system to guide systemic disease diagnosis such as heart failure or venous thromboembolic disease.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Lung ultrasound meets all the fundamental characteristics of point-of-care ultrasound: it can be performed at bedside with portable equipment, repeated as often as needed, it is immediate, and it is free of radiation. In addition, the learning curve to achieve high reliability, especially a high negative predictive value, is relatively short.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">One of the first indications for point-of-care ultrasound, and which itself justifies the presence of an ultrasound machine in any medical department, was to guide invasive techniques. The introduction of ultrasound has led to techniques that were formerly performed blind now being guided or facilitated, thereby reducing the incidence of associated complications. Performing any of these techniques without the aid of an ultrasound machine when available could be considered medical malpractice.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Logically, thoracentesis and pleural biopsy are included in these techniques.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In this issue of <span class="elsevierStyleSmallCaps">Revista Clínica Española</span>, Ramos Hernández et al.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> publish an observational study analysing the accuracy of bedside lung ultrasound in detecting pneumothorax in patients in which an invasive pleural procedure (thoracentesis or biopsy) was performed. While previous similar studies have already shown excellent results, this study poses some novel aspects, of which we can highlight the fact that the same physician performing the invasive pleural technique also performs the bedside ultrasound, that the training period has been limited, and that a quick and simple examination protocol has been applied.</p><p id="par0035" class="elsevierStylePara elsevierViewall">This study shows some limitations including the facts that it was carried out in a single centre and it had a high percentage of false negatives (21%). Therefore, we must be cautious when recommending this examination protocol. Nevertheless, if some of those aspects improve, such as the protocol is carried out by professionals with a greater learning curve or the performance of a more exhaustive ultrasound examination, we could validate an intervention that prevents the use of a chest x-ray to rule out pneumothorax in the majority of patients.</p><p id="par0040" class="elsevierStylePara elsevierViewall">We conclude that the usefulness of lung ultrasound has been confirmed in multiple studies, its widespread use is inevitable and, without a doubt, new indications for its use will be defined given its simplicity and efficacy.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Torres Macho J, García de Casasola Sánchez G. Ecografía pulmonar, paradigma de la ecografía clínica. Rev Clin Esp. 2021;221:281–282.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "International Liaison Committee on Lung Ultrasound (ILC-LUS) for International Consensus Conference on Lung Ultrasound (ICC-LUS). International evidence-based recommendations for point-of-care lung ultrasound" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Volpicelli" 1 => "M. Elbarbary" 2 => "M. Blaivas" 3 => "D.A. Lichtenstein" 4 => "G. Mathis" 5 => "A.W. 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Casas Rojo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rce.2018.02.001" "Revista" => array:6 [ "tituloSerie" => "Rev Clin Esp" "fecha" => "2018" "volumen" => "218" "paginaInicial" => "192" "paginaFinal" => "198" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29519537" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Society of Hospital Medicine Point-of-Care Ultrasound Task Force. Credentialing of hospitalists in ultrasound-guided bedside procedures: a position statement of the society of hospital medicine" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.P. Lucas" 1 => "D.M. Tierney" 2 => "T.P. Jensen" 3 => "R. Dancel" 4 => "J. Cho" 5 => "M. 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Vilariño Pombo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Clin Esp" "fecha" => "2021" "volumen" => "221" "paginaInicial" => "258" "paginaFinal" => "263" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000022100000005/v3_202105110748/S2254887421000370/v3_202105110748/en/main.assets" "Apartado" => array:4 [ "identificador" => "72714" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Editorials" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000022100000005/v3_202105110748/S2254887421000370/v3_202105110748/en/main.pdf?idApp=WRCEE&text.app=https://www.revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887421000370?idApp=WRCEE" ]
