14 research outputs found
The financing arrangements for the regional (autonomous) governments for the period 1997-2001
Get PDFIncluye bibliografí
El sistema de financiación autonómica vigente para el período 1997-2001
Get PDFLa descentralizacion fiscal es uno de los rasgos distintivos de la actuacion del sector publico español en las ultimas decadas. El proceso de descentralizacion ha consistido, basicamente, en un traspaso gradual de las competencias de gestion de determinados servicios desde el Estado a las CCAA, y en el desarrollo del sistema de financiacion de estas competencias. Este trabajo se centra en este ultimo aspecto, y describe el actual sistema de financiacion de las CCAA, de regimen comun y de regimen foral. Adicionalmente, se analiza la informacion disponible sobre los recursos de las CCAA. (lgm) (ad
The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients
Get PDFBackground: 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
