Evidencias paleosísmicas y geomorfológicas de actividad tectónica reciente de la Falla de Pozohondo (Cordillera Bética, SE de España)

Instrumental and historical seismicity in the Albacete province (External Prebetic Zone) has been scarcely recorded. However, major strike-slip faults showing NW-SE trending provide geomorphologic and paleoseismic evidence of recent tectonic activity (Late Pleistocene to Present). Moreover, these faults are consistently well oriented under the present stress tensor and therefore, they can trigger earthquakes of magnitude greater than M6, according to the lengths of surface ruptures and active segments recognized in fieldwork. Present landscape nearby the village of Hellin (SE of Albacete) is determined by the recent activity of the Pozohondo Fault (FPH), a NW-SE right-lateral fault with 90 km in length. In this study, we have calculated the Late Quaternary tectonic sliprate of the FPH from geomorphological, sedimentological, archaeoseimological, and paleoseismological approaches. All of these data suggest that the FPH runs with a minimum slip-rate of 0.1 mm/yr during the last 100 kyrs (Upper Pleistocene-Holocene). In addition, we have recognized the last two major paleoearthquakes associated to this fault. Magnitudes of these paleoearthquakes were gretarer than M6 and their recurrence intervals ranged from 6600 to 8600 yrs for the seismic cycle of FPH. The last earthquake was dated between the 1st and 6th centuries, though two earthquakes could be interpreted in this wide time interval, one at the FPH and other from a far field source. Results obtained here, suggest an increasing of the tectonic activity of the Pozohondo Fault during the last 10,000 yrs.A pesar de la escasa sismicidad instrumental e histórica en el Prebético Externo, que comprende la provincia de Albacete, existen tres grandes fallas con evidencias de actividad reciente y cuya orientación es compatible con el campo de esfuerzos activo. Estas fallas consisten en desgarres dextrorsos de orientación NO-SE cuya longitud de traza sobrepasa los 50 km. Este trabajo se centra en el análisis del segmento Tobarra-Cordovilla de la Falla de Pozohondo (FPH) (90 km de longitud), mediante estudios paleosísmicos, geomorfológicos, sedimentológicos e incluso arqueosísmicos. De todos estos análisis es posible afirmar que dicha falla (FPH) presenta una tasa de actividad cuaternaria superior a 0,1 mm/año durante los últimos 100 ka (Pleistoceno Superior-Holoceno). Además, se han descrito los últimos dos paleoterremotos asociados a este segmento con una tasa de recurrencia para magnitudes superior a M6 de 6600-8600 años, habiendo tenido lugar el último evento entre los siglos I y VI. Sin embargo, los datos no permiten fijar de forma más precisa dicho evento, e incluso es posible que hayan tenido lugar dos eventos diferenciados durante este periodo, uno relacionado con la FPH y el otro de origen de campo lejano. En cualquier caso, se evidencia un suave incremento en la actividad tectónica en la zona durante los últimos 10.000 años

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

International audienceBackground: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society