The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Cáceres ciudad cultural Impressionniste

Convocatoria Proyectos de innovación de Extremadura 2018/2019Se presenta un proyecto surgido a iniciativa del IES El Brocense de Cáceres y llevado a cabo entre varios centros extremeños que tiene como eje temático el Impresionismo. Se trabajó esta corriente artística en distintas materias del currículo y se expusieron los resultados en una exposición en la Plaza Mayor de Cáceres y en la biblioteca del centro. Los principales objetivos del proyecto fueron: consolidar el trabajo multidisciplinar y cooperativo entre el profesorado y el alumnado de los centros participantes; crear una conciencia social sobre la importancia del francés en la cultura general y en la formación de la civilización europea; acercar la educación a los ciudadanos; promover el uso de las TIC y de las lenguas extranjeras (francés, inglés y portugués); mejorar el espíritu emprendedor, creativo y colaborativo de los alumnos; mejorar la sociedad respetando el medio ambiente, el ser humano y su naturaleza e incentivar la pedagogía activa y eficaz que desarrolle las competencias clave o profesionalesExtremaduraES