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                        "titulo" => "Cerebral Blood Flow"
                        "paginaInicial" => "37"
                        "paginaFinal" => "58"
                        "serieFecha" => "1987"
                      ]
                    ]
                  ]
                ]
              ]
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            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Modulating cerebral oxygen delivery and extraction in acute traumatic coma"
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                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Cruz"
                            1 => "M&#46;E&#46; Miner"
                          ]
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                    0 => array:1 [
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                        "titulo" => "Neurotrauma&#46; Treatment&#44; Rehabilitation&#44; and Related Issues"
                        "paginaInicial" => "55"
                        "paginaFinal" => "72"
                        "edicion" => "ed 1"
                        "serieFecha" => "1986"
                      ]
                    ]
                  ]
                ]
              ]
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            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Continuous monitoring of cerebral oxygenation in acute brain injury&#58; injection of manitol during hyperventilation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; Cruz"
                            1 => "M&#46;E&#46; Miner"
                            2 => "S&#46;T&#46; Allen"
                            3 => "W&#46;M&#46; Alves"
                            4 => "T&#46;A&#46; Gennarelli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1990.73.5.0725"
                      "Revista" => array:6 [
                        "tituloSerie" => "J&#46; Neurosurg&#46;"
                        "fecha" => "1990"
                        "volumen" => "73"
                        "paginaInicial" => "725"
                        "paginaFinal" => "730"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2120395"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Physiological salt solutions for brain surgery&#58; Studies of local PH and pial vessel reactions to buffered an unbuffered isotonic solutions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "K&#46;A&#46;C&#46; Elliott"
                            1 => "H&#46;H&#46; Jasper"
                          ]
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                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3171/jns.1949.6.2.0140"
                      "Revista" => array:6 [
                        "tituloSerie" => "J&#46; Neurosurg&#46;"
                        "fecha" => "1949"
                        "volumen" => "6"
                        "paginaInicial" => "140"
                        "paginaFinal" => "152"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18124751"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The validity of internal jugular venous blood in studies of cerebral metabolism and blood flow in man"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "E&#46;B&#46; Ferris"
                            1 => "G&#46;L&#46; Engel"
                            2 => "C&#46;D&#46; Stevens"
                            3 => "M&#46; Logan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am&#46; J&#46; Physiol"
                        "fecha" => "1946"
                        "volumen" => "147"
                        "paginaInicial" => "517"
                        "paginaFinal" => "521"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21002946"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ueber die messung des blutquantums in den herzventrikeln"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46; Fick"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Sitz ber Physik-Med Ges Wurzburg"
                        "fecha" => "1870"
                        "volumen" => "2"
                        "paginaInicial" => "16"
                        "paginaFinal" => "28"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cerebral blood flow immediately following brief circulatory stasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46;G&#46; Fischer"
                            1 => "A&#46; Ames III"
                            2 => "A&#46;V&#46; Lorenzo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Stroke"
                        "fecha" => "1979"
                        "volumen" => "10"
                        "paginaInicial" => "423"
                        "paginaFinal" => "427"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/505480"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ueber den Hirnkreislauf"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46; G&#228;rtner"
                            1 => "J&#46; Wagner"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Wein Med&#46; Wochenschr"
                        "fecha" => "1887"
                        "volumen" => "37"
                        "paginaInicial" => "601"
                        "paginaFinal" => "603"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Jugular venous bulb catheterization in infants and children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46;O&#46; Gayle"
                            1 => "T&#46;C&#46; Frewn"
                            2 => "R&#46;F&#46; Armstrong"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit&#46; Care Med&#46;"
                        "fecha" => "1989"
                        "volumen" => "17"
                        "paginaInicial" => "385"
                        "paginaFinal" => "388"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2707008"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A thermoelectric blood flow recorder in the form of a needle"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "F&#46;A&#46; Gibbs"
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Proc&#46; Soc&#46; Exp&#46; Biol&#46; Med&#46;"
                        "fecha" => "1933"
                        "volumen" => "31"
                        "paginaInicial" => "141"
                        "paginaFinal" => "146"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The cross section areas of the vessels that form the torcular and the manner in which flow is distributed to the right and to the left lateral sinus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46;L&#46; Gibbs"
                            1 => "F&#46;A&#46; Gibbs"
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                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Anat&#46; Rec&#46;"
                        "fecha" => "1934"
                        "volumen" => "59"
                        "paginaInicial" => "419"
                        "paginaFinal" => "426"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bilateral internal jugular blood&#46; Comparison of A&#8211;V differences&#44; oxygeendextrose ratios and respiratory quotients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46;L&#46; Gibbs"
                            1 => "W&#46;G&#46; Lennox"
                            2 => "F&#46;A&#46; Gibbs"
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                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Am&#46; J&#46; Psychiatry"
                        "fecha" => "1945"
                        "volumen" => "102"
                        "paginaInicial" => "184"
                        "paginaFinal" => "190"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Arterial and Cerebral Venous blood Arterial-venous differences in man"
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                        0 => array:2 [
                          "etal" => false
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                            2 => "L&#46;F&#46; Nims"
                            3 => "F&#46;A&#46; Gibbs"
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                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J&#46; Biol&#46; Chem&#46;"
                        "fecha" => "1942"
                        "volumen" => "144"
                        "paginaInicial" => "325"
                        "paginaFinal" => "332"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estimation of CBF by cerebral venous oxigen difference"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46; Gilbert"
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J&#46; Neurosurg&#46;"
                        "fecha" => "1989"
                        "volumen" => "71"
                        "paginaInicial" => "790"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2809735"
                            "web" => "Medline"
                          ]
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                ]
              ]
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            22 => array:3 [
              "identificador" => "bib23"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Validation of the jugular bulb catheter for cerebral venous monitoring"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;G&#46; Goetting"
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                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Neurology"
                        "fecha" => "1990"
                        "volumen" => "40"
                        "paginaInicial" => "254"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effect of jugular bulb catheterization on intracranial pressure"
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                    0 => array:1 [
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                        "serieVolumen" => "Vol VII"
                        "serieTitulo" => "Intracranial Presure"
                        "serieFecha" => "1989"
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                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Jugular bulb catheterization&#58; Experience with 123 patients"
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                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Crit&#46; Care Med&#46;"
                        "fecha" => "1990"
                        "volumen" => "18"
                        "paginaInicial" => "1220"
                        "paginaFinal" => "1223"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2225889"
                            "web" => "Medline"
                          ]
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                ]
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            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ischaemic brain damage in fatal non-missile head injuries"
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                          "autores" => array:3 [
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                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J&#46; Neurol&#46; Sci&#46;"
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                        "volumen" => "39"
                        "paginaInicial" => "213"
                        "paginaFinal" => "234"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/739268"
                            "web" => "Medline"
                          ]
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                ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ischaemic brain damage is still common in fatal non-missile head injury"
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J&#46; Neurol&#46; Neurosurg&#46; and Psychiatry"
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                        "paginaInicial" => "346"
                        "paginaFinal" => "350"
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            27 => array:3 [
              "identificador" => "bib28"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Local cerebral blood volume response to carbon dioxide in man"
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                  "host" => array:1 [
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                        "tituloSerie" => "Circ&#46; Res&#46;"
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                        "paginaInicial" => "324"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/668063"
                            "web" => "Medline"
                          ]
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              "identificador" => "bib29"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cellular energy metabolism during hypoxia"
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                            0 => "G&#46; Guti&#233;rrez"
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                      "Revista" => array:6 [
                        "tituloSerie" => "Crit&#46; Care Med&#46;"
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                        "volumen" => "19"
                        "paginaInicial" => "619"
                        "paginaFinal" => "626"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2026024"
                            "web" => "Medline"
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            29 => array:3 [
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                    0 => array:2 [
                      "titulo" => "Hemodynamics of postischemic reperfusion of the brain"
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                        "paginaInicial" => "21"
                        "paginaFinal" => "36"
                        "serieFecha" => "1990"
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                    ]
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                ]
              ]
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            30 => array:3 [
              "identificador" => "bib31"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Retrograde catheterization of the right internal jugular vein for serial measurements of cerebral venous oxygen content"
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                          "etal" => false
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                    0 => array:2 [
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                      "Revista" => array:6 [
                        "tituloSerie" => "J&#46; Cereb&#46; Blood Flow Metab&#46;"
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                        "paginaInicial" => "717"
                        "paginaFinal" => "720"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2777938"
                            "web" => "Medline"
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                    0 => array:2 [
                      "titulo" => "Patolog&#237;a Din&#225;mica"
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              "identificador" => "bib33"
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                    0 => array:2 [
                      "titulo" => "The deterrnination of cerebral blood flow in man by the use of nitrous oxide in low concentrations"
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                          "etal" => false
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                            0 => "S&#46;S&#46; Kety"
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                  "host" => array:1 [
                    0 => array:1 [
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                        "tituloSerie" => "Am&#46; J&#46; Physiol&#46;"
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                        "volumen" => "143"
                        "paginaInicial" => "53"
                        "paginaFinal" => "66"
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                    ]
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            33 => array:3 [
              "identificador" => "bib34"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neuropathological aspects of the brain edema"
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                          "etal" => false
                          "autores" => array:1 [
                            0 => "I&#46; Klatzo"
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                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J&#46; Neuropathol&#46; Exp&#46; Neurol"
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                        "volumen" => "26"
                        "paginaInicial" => "1"
                        "paginaFinal" => "14"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5336776"
                            "web" => "Medline"
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            34 => array:3 [
              "identificador" => "bib35"
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                    0 => array:2 [
                      "titulo" => "Medici&#243;n del lactato&#58; &#191;plasma o sangre&#63;"
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                  "host" => array:1 [
                    0 => array:1 [
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                        "tituloSerie" => "Intensive Care Med&#46;"
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                        "paginaInicial" => "1"
                        "paginaFinal" => "2"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2312903"
                            "web" => "Medline"
                          ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
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                        "titulo" => "Oclusive Cerebrovascular Disease"
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                        "paginaFinal" => "1173"
                        "serieFecha" => "1985"
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                    ]
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                ]
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The etiology of acute brain swelling following experimental head injury"
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                    0 => array:2 [
                      "doi" => "10.3171/jns.1966.24.1.0047"
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                        "tituloSerie" => "J&#46; Neurosurg&#46;"
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                        "paginaInicial" => "47"
                        "paginaFinal" => "56"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5903298"
                            "web" => "Medline"
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            37 => array:3 [
              "identificador" => "bib38"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The luxury-perfusion syndrome and its possible relation to acute metabolic acidosis localised within the brain"
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                    0 => array:1 [
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                        "tituloSerie" => "Lancet"
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                        "volumen" => "2"
                        "paginaInicial" => "1113"
                        "paginaFinal" => "1115"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2877269"
                            "web" => "Medline"
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              "identificador" => "bib39"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
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                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Cerebral Blood Flow&#58; Normal Regulation and Ischemic Thresholds"
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                        "paginaFinal" => "19"
                        "serieFecha" => "1990"
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            39 => array:3 [
              "identificador" => "bib40"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Validity of internal jugular blood for study of cerebral blood flow and metabolism"
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                  "host" => array:1 [
                    0 => array:1 [
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                        "tituloSerie" => "J&#46; Appl&#46; Physiol&#46;"
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                        "paginaInicial" => "313"
                        "paginaFinal" => "320"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/13759303"
                            "web" => "Medline"
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                    0 => array:2 [
                      "titulo" => "Vegetative state after closed-head injury&#46; A Traumatic Coma Data Bank Report"
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                    0 => array:1 [
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                        "tituloSerie" => "Arch&#46; Neurol"
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                        "paginaFinal" => "585"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2039378"
                            "web" => "Medline"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
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              "identificador" => "bib43"
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                    0 => array:2 [
                      "titulo" => "Basic Intracranial Dynamics"
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                        "titulo" => "Problems on Intracranial Pressure in Childhood"
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              "etiqueta" => "44&#46;"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cerebral Blood Flow Variations with Perfusion Pressure and Metabolism"
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                        "serieFecha" => "1990"
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              "identificador" => "bib46"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Safe placemnet of central venous catheter into internal jugular vein"
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                        "paginaFinal" => "432"
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                    0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Technic for obtaining blood from the internal jugular vein and internal carotid artery"
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                        "serieTitulo" => "Methoden der enzymatischen Analyse"
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                        "paginaFinal" => "13"
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                    0 => array:2 [
                      "titulo" => "Cerebral blood flow and metabolism in comatose patients with acute head injury Relationship to intracranial hypertension"
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                          "etal" => false
                          "autores" => array:5 [
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                            1 => "T&#46;W&#46; Langfiit"
                            2 => "J&#46;L&#46; Jaggi"
                            3 => "J&#46; Cruz"
                            4 => "T&#46;A&#46; Gennarelli"
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Neurosurg&#46;"
                        "fecha" => "1984"
                        "volumen" => "61"
                        "paginaInicial" => "241"
                        "paginaFinal" => "253"
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            55 => array:3 [
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                    0 => array:2 [
                      "titulo" => "Cerebral circulation after head injury&#46; Part 1&#58; Cerebral blood flow and its regulation after closed head injury with emphasis on clinical correlations"
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                          "autores" => array:2 [
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                        "volumen" => "41"
                        "paginaInicial" => "531"
                        "paginaFinal" => "541"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4418221"
                            "web" => "Medline"
                          ]
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                      "titulo" => "Cerebral circulation after head injury&#46; Part 2&#58; The effects of traumatic brain edema"
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                          "autores" => array:2 [
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                        "volumen" => "45"
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                        "paginaFinal" => "300"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/948015"
                            "web" => "Medline"
                          ]
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                ]
              ]
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            57 => array:3 [
              "identificador" => "bib58"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Early changes of intracranial pressure&#44; perfusion pressure&#44; and blood flow after acute head injury&#46; Part 1&#58; An experimental study of tha underlying pathophysiology"
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                          "etal" => false
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                            2 => "D&#46; Breiting"
                            3 => "A&#46; Gr&#252;nert"
                            4 => "F&#46;W&#46; Ahnefeld"
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                    0 => array:2 [
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                        "volumen" => "70"
                        "paginaInicial" => "774"
                        "paginaFinal" => "779"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2709117"
                            "web" => "Medline"
                          ]
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                    ]
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                ]
              ]
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            58 => array:3 [
              "identificador" => "bib59"
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                    0 => array:2 [
                      "titulo" => "Enfermedades Cerebrales Multifocales&#44; Difusas y Metab&#243;licas que causan estupor o coma"
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                          "etal" => false
                          "autores" => array:2 [
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                            1 => "J&#46;B&#46; Posner"
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                        "titulo" => "Estupor y Coma"
                        "paginaInicial" => "207"
                        "paginaFinal" => "354"
                        "serieFecha" => "1982"
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              ]
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            59 => array:3 [
              "identificador" => "bib60"
              "etiqueta" => "60&#46;"
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                      "titulo" => "Monitorizaci&#243;n de la hemodin&#225;mica cerebral en los traumatismos craneoencef&#225;licos graves a partir de las diferencias arterio-yugulares de ox&#237;geno"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cambios en el lactato plasm&#225;tico y en sangre total en respuesta a la oclusi&#243;n arterial"
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                            2 => "W&#46; Dunlop"
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Intensive Care Med"
                        "fecha" => "1989"
                        "volumen" => "16"
                        "paginaInicial" => "28"
                        "paginaFinal" => "32"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2312906"
                            "web" => "Medline"
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                    0 => array:2 [
                      "titulo" => "Ischemic cerebral edema"
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                          "autores" => array:2 [
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                        "titulo" => "Protection of the Brain from Ischemia"
                        "paginaInicial" => "67"
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                        "serieFecha" => "1990"
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            62 => array:3 [
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                    0 => array:2 [
                      "titulo" => "Anaerobic metabolism within the brain&#58; Its relationship to brain failure in head-injuried patients"
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                    0 => array:2 [
                      "titulo" => "The predictive value of cerebral anaerobic metabolism with cerebral infarction after head injury"
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                    0 => array:2 [
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                        "paginaFinal" => "368"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3612268"
                            "web" => "Medline"
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                    0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "Catheter replacement of the needle in percutaneous arteriography"
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                      "Revista" => array:6 [
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9685820"
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                    0 => array:2 [
                      "titulo" => "Dynarnic anatomy of the cerebral circulation"
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                          0 => array:2 [
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Vol. 3. Núm. 4.
Páginas 285-298 (enero 1992)
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Vol. 3. Núm. 4.
Páginas 285-298 (enero 1992)
Monitorización de la hemodinámica cerebral en los traumatismos craneoencefálicos graves a partir de las diferencias arterioyugulares de oxígeno. Fundamentos, metodología e indicaciones
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M.A. Poca, J. Sauquillo, A. Chasampi, F. Coello, F. Ramírez, E. Rubio
Servicio de Neurocirugía. Hospital Vall d’Hebron. Barcelona
A. Robles*, C. Triginer*, A. Gamacho*, M.D. Pelegri**
* Unidad de Vigilancia Intensiva de Neurotraumatología. Hospital Vall d’Hebron. Barcelona
** Servicio de Bioquímica. Hospital Vall d’Hebron. Barcelona
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Estudios recientes han demostrado la importancia de las lesiones secundarias en el resultado final de los pacientes afectos de un traumatismo craneoencefálico grave (TCEG). Entre las lesiones secundarias, revisten una especial importancia las lesiones hipóxico-isquémicas cerebrales. La potencial reversibilidad en algunos casos de las lesiones isquémicas, sugiere la necesidad de un diagnóstico precoz y adecuado de las mismas. La monitorización de la hemodinámica y del metabolismo cerebral a partir de las diferencias arteriovenosas de oxígeno y lactatos, permite detectar alteraciones del metabolismo energético celular.

A pesar de que diversos autores preconizan este sistema de monitorización, la literatura que existe al respecto es escasa y controvertida. En este trabajo pretendemos exponer los fundamentos, indicaciones y limitaciones del método, ya que su uso rutinario puede contribuir a la racionalización de las medidas terapéuticas y, en último término, a mejorar el pronóstico de los pacientes con un TCE grave.

Palabras clave:
Traumatismo craneoencefálico
Flujo sanguíneo cerebral
Metabolismo cerebral
Diferencias arteriovenosas de oxígeno
Lactato
Bulbo yugular
Catéter yugular retrogrado
Isquemia
Summary

Recent studies have shown the importance of secondary lesions in the final outcome of patients suffering from severe head injury. Among secondary lesions, hypoxic-ischemic injury is of special importance. Possible reversibility of ischemic damage suggests the need of an early diagnosis of these lesions. Monitorization of hemodynamics and cerebral metabolism by measuring the arteriovenous differences of oxygen and lactates may allow to detect significant alterations in brain metabolism. Some authors have considered this method of monitoring to be controversial. The object of this study is to describe the basic methodology, the indications and the limitations of this method wich may contribute to the rationalitation of therapeutic manouvers and improve the final outcome of severe head injuried patients.

Key words:
Severe head injury
Cerebral blood flow
Cerebral metabolism
Arteriovenous differences of oxygen
Lactate
Jugular bulb
Reverse jugular catheter
Ischemia

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