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"doi" => "10.1016/j.medin.2024.01.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210569124000585?idApp=WMIE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357272400047X?idApp=WMIE" "url" => "/21735727/0000004800000009/v1_202409021221/S217357272400047X/v1_202409021221/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Intensive Medicine</span>" "titulo" => "Harlequin syndrome: a picture speaks a thousand words" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "561" "paginaFinal" => "562" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Jorge Martínez-Solano, Nerea Alava-Echevarría, Iago Sousa-Casasnovas" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Jorge" "apellidos" => "Martínez-Solano" "email" => array:1 [ 0 => "jorge92ms@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" => "Nerea" "apellidos" => "Alava-Echevarría" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Iago" "apellidos" => "Sousa-Casasnovas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Cardiology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria (IiSGM), Facultad de Medicina, Universidad Complutense y CIBERCV, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Radiology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Síndrome de arlequín: una imagen vale más que mil palabras" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1319 "Ancho" => 1675 "Tamanyo" => 151416 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 56-year-old man presented with profound shock and unresponsive hypoxemia. Pulmonary embolism was suspected given the extremely dilated right ventricle with septal flattening. It was decided then to start peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) through bedside cannulation. 72<span class="elsevierStyleHsp" style=""></span>h later, the patient was on unfractionated heparin, had recovered from multiorgan failure without neurological impairment and vasopressors had been withdrawn. However, persistent hypoxemia and right ventricle dysfunction challenged ECMO weaning. A computed tomography confirmed the diagnosis (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) and provided evidence of the harlequin syndrome (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) as the two bloodstreams, the native cardiac output and oxygenated ECMO return, meet in the watershed area. Subsequently, the patient underwent a successful transcatheter pulmonary thromboaspiration (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>) and could be weaned from mechanical ventilation and ECMO the following days. He was discharged two weeks later without further complications.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Authors’ contribution</span><p id="par0010" class="elsevierStylePara elsevierViewall">Conception, design and writing the article JMS and ISC. Analysis and image collection NAE.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest</span><p id="par0015" class="elsevierStylePara elsevierViewall">None.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Funding source</span><p id="par0020" class="elsevierStylePara elsevierViewall">None.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Authors’ contribution" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflict of interest" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Funding source" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:3 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1300 "Ancho" => 1675 "Tamanyo" => 112575 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1319 "Ancho" => 1675 "Tamanyo" => 151416 ] ] ] 2 => array:6 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1033 "Ancho" => 1675 "Tamanyo" => 215813 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735727/0000004800000009/v1_202409021221/S2173572724000262/v1_202409021221/en/main.assets" "Apartado" => array:4 [ "identificador" => "64602" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Intensive Medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735727/0000004800000009/v1_202409021221/S2173572724000262/v1_202409021221/en/main.pdf?idApp=WMIE&text.app=https://www.medintensiva.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572724000262?idApp=WMIE" ]