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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La dexmedetomidina&#44; un agonista adren&#233;rgico selectivo &#945;2&#44; constituye un intento de mejorar la sedoanalgesia de los pacientes cr&#237;ticos&#44; por sus efectos distintivos en comparaci&#243;n a los planes tradicionales como son&#58; sedaci&#243;n consciente&#44; simpaticolisis y ausencia de depresi&#243;n respiratoria&#46;</p> <span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudiar el efecto de la dexmedetomidina&#44; un nuevo agonista &#945;28&#44; sobre la hemodin&#225;mica intracraneal y sobre los par&#225;metros hemometab&#243;licos cerebrales en un grupo de pacientes con trauma craneoencef&#225;lico grave&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo de los pacientes con lesi&#243;n encef&#225;lica traum&#225;tica grave &#40;Glasgow Coma Scale &#8804; 8&#41; ingresados en un Centro de Tratamiento Intensivo &#40;CTI&#41; que recibieron monitorizaci&#243;n de la presi&#243;n intracraneal &#40;PIC&#41; y monitorizaci&#243;n de saturaci&#243;n de O<span class="elsevierStyleInf">2</span> del bulbo yugular &#40;SjO<span class="elsevierStyleInf">2</span>&#41;&#46; Se realiz&#243; una perfusi&#243;n intravenosa de la droga durante 3 horas&#44; en dosis progresivas &#40;0&#46;2&#44; 0&#46;4 y 0&#46;7<span class="elsevierStyleHsp" style=""></span>ug&#47;kg&#47;h&#41;&#44; previa suspensi&#243;n de otros sedantes y analg&#233;sicos&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron 12 pacientes sin hiperten-si&#243;n intracraneal&#46; No se encontraron diferencias significativas entre los valores de PIC y presi&#243;n arterial media &#40;PAM&#41; tras la infusi&#243;n de la droga en relaci&#243;n con los valores basales&#46; La presi&#243;n de perfusi&#243;n cerebral &#40;PPC&#41; mostr&#243; una tendencia a disminuir durante el estudio &#40;efecto marginal&#44; p&#61;0&#46;058&#41;&#46; Se encontr&#243; un descenso significativo de la frecuencia card&#237;aca &#40;FC&#41; &#40;p&#60;0&#46;0001&#41; en relaci&#243;n a los valores basales&#46; No se hallaron diferencias significativas en los par&#225;metros hemometab&#243;licos cerebrales &#40;SjO<span class="elsevierStyleInf">2</span> y CEO<span class="elsevierStyleInf">2</span>&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusi&#243;n</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A las dosis utilizadas&#44; la dexmede-tomidina fue segura&#44; no asoci&#225;ndose a alteraciones significativas de la hemodin&#225;mica intracraneal ni del metabolismo sangu&#237;neo cerebral en pacientes en la etapa aguda del trauma craneoencef&#225;lico grave &#40;TECG&#41;</p>"
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        "resumen" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Dexmedetomidine&#44; an &#945;2 adrenergic agonist&#44; with distinctive characteristics when compared to traditional plans&#44; namely&#58; conscious sedation&#44; sympatholysis and lack of respiratory depression&#44; represents an attempt to improve the sedoanalgesia of critically ill patients&#46;</p> <span class="elsevierStyleSectionTitle">Objective</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To study dexmedetomidine&#39;s effect on intracranial hemodynamic and hemometabolic parameters in severe head injured patients&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Prospective study on the effect of Dexmedetomidine on twelve severe head injured patients &#40;Glasgow Coma Scale score &#8804; 8&#41; admitted to an intensive care unit&#44; with intracranial pressure &#60; 20<span class="elsevierStyleHsp" style=""></span>mmHg and O<span class="elsevierStyleInf">2</span> saturation monitoring of blood from jugular bulb&#46; The drug was perfused intravenously during 3 hours&#44; in progressive doses &#40;0&#46;2&#44; 0&#46;4 y 0&#46;7<span class="elsevierStyleHsp" style=""></span>ug&#47;kg&#47;h&#41;&#46; All other sedo-analgesia medication had been previously withdrawn&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">No significant differences were found in intracranial pressure&#44; mean arterial pressure and cerebral hemometabolic parameters after infusion of dexmedetomidine in relation to basal values&#46; Cerebral perfusion pressure showed a trend to decrease during the drug infusion &#40;marginal effect&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>&#46;058&#41;&#46; Cardiac frequency decreased significantly after the drug administration&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">At the doses utilized&#44; dexmedetomidine was safe&#44; and it was not associated with significant changes in intracranial hemodynamics&#44; nor in cerebral hemometabolic parameters&#44; in a group of severe head jnjured patients&#46;</p>"
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              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effect of the alpha 2-agonist dexmedetomidine and the N-methyl-D-aspartate antagonist S&#40;&#43;&#41;-ketamine on the expression of apoptosis-regulating proteins after incomplete cerebral ischemia and reperfusion in rats"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Engelhard"
                            1 => "C&#46; Werner"
                            2 => "E&#46; Eberspacher"
                            3 => "M&#46; Bachl"
                            4 => "E&#46; Hildt"
                            5 => "M&#46; Blobner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesth Analg"
                        "fecha" => "2003"
                        "volumen" => "96"
                        "paginaInicial" => "524"
                        "paginaFinal" => "531"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12538207"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "In Vivo Effects of Dexmedetomidine on Laser-Doppler Flow and Pial Arteriolar Diameter"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Ganjoo"
                            1 => "N&#46; Farber"
                            2 => "A&#46; Hudetz"
                            3 => "J&#46;J&#46; Smith"
                            4 => "E&#46; Samso"
                            5 => "J&#46; Kampine"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesthesiology"
                        "fecha" => "1998"
                        "volumen" => "88"
                        "paginaInicial" => "429"
                        "paginaFinal" => "439"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9477064"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hypothermia attenuates tha vasodilator effects of Dexmetomidine on pial vessels in rabbits in vivo"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46; Iida"
                            1 => "M&#46; Iida"
                            2 => "H&#46; Ohata"
                            3 => "K&#46; Nagase"
                            4 => "S&#46; Dohi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesth Analg"
                        "fecha" => "2004"
                        "volumen" => "98"
                        "paginaInicial" => "477"
                        "paginaFinal" => "482"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14742391"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neuroprotection by the alpha2-adrenoceptor agonist&#44; dexmedetomidine&#44; in rat focal cerebral ischemia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Jolkkonen"
                            1 => "K&#46; Puurunen"
                            2 => "J&#46; Koistinaho"
                            3 => "R&#46; Kauppinen"
                            4 => "A&#46; Haapalinna"
                            5 => "L&#46; Nieminen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Pharmacol"
                        "fecha" => "1999 7"
                        "volumen" => "372"
                        "paginaInicial" => "31"
                        "paginaFinal" => "36"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10374712"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "V&#46;S&#46;B&#46; Jorden"
                            1 => "A&#46; Tung"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Dexmedetomidine&#58; Clinical Update Anesth Periop Mesd and Pain"
                        "fecha" => "2002"
                        "volumen" => "21"
                        "paginaInicial" => "265"
                        "paginaFinal" => "274"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical uses of &#945;2 adrenergic agonists"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "T&#46; Kamibayashi"
                            1 => "M&#46; Maze"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesthesiology"
                        "fecha" => "2000"
                        "volumen" => "93"
                        "paginaInicial" => "1345"
                        "paginaFinal" => "1349"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11046225"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Redefining intensive care unit sedation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46; Katsanoulas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Internacional Congress and Symposium Series - Redefining sedation"
                        "fecha" => "1998"
                        "volumen" => "221"
                        "paginaInicial" => "83"
                        "paginaFinal" => "88"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Propofol in the treatment of moderate and severe head injury&#58; a randomized&#44; prospective double-blinded pilot trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;F&#46; Kelly"
                            1 => "D&#46;B&#46; Goodale"
                            2 => "J&#46; Williams"
                            3 => "D&#46;L&#46; Herr"
                            4 => "E&#46;T&#46; Chappel"
                            5 => "M&#46;J&#46; Rosner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1999.90.6.1042"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg&#46;"
                        "fecha" => "1999"
                        "volumen" => "90"
                        "paginaInicial" => "1042"
                        "paginaFinal" => "1052"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10350250"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "APACHE II&#58; A severity of disease classification system"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46;A&#46; Knaus"
                            1 => "E&#46;A&#46; Draper"
                            2 => "D&#46;P&#46; Wagner"
                            3 => "J&#46;E&#46; Zimmerman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "1985"
                        "volumen" => "13"
                        "paginaInicial" => "818"
                        "paginaFinal" => "829"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3928249"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sr et al&#46;&#58; Neuroprotective effects of Dexmedetomidine in the Gerbil hippocampus after transient global ischemia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46; Kuhmonen"
                            1 => "J&#46; Pokorny"
                            2 => "R&#46; Miettinen"
                            3 => "A&#46; Haapalinna"
                            4 => "J&#46; Jolkkonen"
                            5 => "P&#46; Riekkinen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesthesiology"
                        "fecha" => "1997"
                        "volumen" => "87"
                        "paginaInicial" => "371"
                        "paginaFinal" => "377"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9286902"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sedation in the intensive care unit&#58; an overview"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;M&#46; Louvelle"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Can J Hosp Pharm"
                        "fecha" => "1995"
                        "volumen" => "48"
                        "paginaInicial" => "344"
                        "paginaFinal" => "347"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10153866"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neuroprotection by the alpha 2-adrenoreceptor agonist dexmedetomidine in a focal model of cerebral ischemia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46; Maier"
                            1 => "G&#46;K&#46; Steinberg"
                            2 => "G&#46;H&#46; Sun"
                            3 => "G&#46;T&#46; Zhi"
                            4 => "M&#46; Maze"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesthesiology"
                        "fecha" => "1993"
                        "volumen" => "79"
                        "paginaInicial" => "306"
                        "paginaFinal" => "312"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8102042"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A new classification of head injury based on computerized tomography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46;F&#46; Marshall"
                            1 => "S&#46;B&#46; Marshall"
                            2 => "M&#46;R&#46; Klauber"
                            3 => "M&#46; van Berkum Clark"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1991"
                        "volumen" => "75"
                        "numero" => "Suppl"
                        "paginaInicial" => "S14"
                        "paginaFinal" => "S20"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pressure-volume index inhead injury patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46;L&#46; Maset"
                            1 => "A&#46; Maramarou"
                            2 => "J&#46;D&#46; Ward"
                            3 => "S&#46; Choi"
                            4 => "H&#46;A&#46; Lutz"
                            5 => "D&#46; Brooks"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1987.67.6.0832"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Neurosurg"
                        "fecha" => "1987"
                        "volumen" => "67"
                        "paginaInicial" => "832"
                        "paginaFinal" => "840"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3681422"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cardiovascular and parasympathetic effects of dexmedetomidina in healthy subjects"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; Pentittila"
                            1 => "A&#46; Helminen"
                            2 => "M&#46; Anttila"
                            3 => "S&#46; Hinkka"
                            4 => "H&#46; Scheinin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1139/y04-028"
                      "Revista" => array:6 [
                        "tituloSerie" => "Can J Physiol Pharmacol"
                        "fecha" => "2004"
                        "volumen" => "82"
                        "paginaInicial" => "359"
                        "paginaFinal" => "362"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15213737"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dexmedetomidine-induced sedation in volunteers decreases regional and global cerebral blood flow"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;C&#46; Prielipp"
                            1 => "M&#46;H&#46; Wall"
                            2 => "J&#46;R&#46; Tobin"
                            3 => "L&#46; Groban"
                            4 => "M&#46;A&#46; Cannon"
                            5 => "F&#46;H&#46; Fahey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Anesth Analg"
                        "fecha" => "2002"
                        "volumen" => "95"
                        "paginaInicial" => "1052"
                        "paginaFinal" => "1059"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12351293"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "First tier measures in the treatment of intracranial hypertension in the patient with severe craniocerebral trauma&#46; Proposal and justification of a protocol"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Sahuquillo"
                            1 => "A&#46; Biestro"
                            2 => "M&#46;P&#46; Mena"
                            3 => "S&#46; Amoros"
                            4 => "M&#46; Lung"
                            5 => "M&#46;A&#46; Poca"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurocirugia"
                        "fecha" => "2002"
                        "volumen" => "13"
                        "paginaInicial" => "78"
                        "paginaFinal" => "100"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12058608"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Practice parameters for intravenous analgesia and sedation for adult patients in the intensive care unit&#58; an executive summary"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "B&#46;A&#46; Shapiro"
                            1 => "J&#46; Warren"
                            2 => "A&#46;B&#46; Egol"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit Care Med"
                        "fecha" => "1995"
                        "volumen" => "23"
                        "paginaInicial" => "1596"
                        "paginaFinal" => "1600"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7664563"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dexmedetomidine&#58; a real innovation or more of the same&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;P&#46; Shelly"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Editorial Br J Anaesth"
                        "fecha" => "2001"
                        "volumen" => "87"
                        "paginaInicial" => "677"
                        "paginaFinal" => "678"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of Dexmedetomidine on lumbar cerebrospinal fluid pressure in humans"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
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                            4 => "J&#46;C&#46; Eisenach"
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                        "paginaFinal" => "364"
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                          0 => array:2 [
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                        "paginaFinal" => "207"
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                        "paginaInicial" => "566"
                        "paginaFinal" => "577"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8101798"
                            "web" => "Medline"
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