Centro de negocios y convenciones Ibagu? Agr?polis

65 p. Recurso Electr?nicoEl centro de negocios y convenciones Ibagu? agr?polis, localizado en la zona de expansi?n que contempla el plan de ordenamiento territorial (POT) para la capital tolimense, es una propuesta que responde a la demanda de escenarios para la realizaci?n de grandes eventos en la ciudad. Nace de la necesidad de estudiar y entender a Ibagu? desde una perspectiva abierta hacia lo global y cada vez m?s diversa y compleja. El proyecto est? compuesto por una zona de oficinas, un auditorio para presentaciones corporativas, dos pabellones: uno para convenciones con posibilidad de subdividirse a su vez en tres salones de menor capacidad y otro de uso m?ltiple para presentaci?n de maquinaria agr?cola o dem?s exposiciones que requieran una gran superficie; cafeter?a, restaurante y por ?ltimo en relaci?n a la vocaci?n agr?cola de la ciudad cuenta con un ?rea para exposiciones de este ?mbito. Esta propuesta busca consolidar en t?rminos urbanos un sector que tiene grandes oportunidades de transformar f?sico, ambiental, social y econ?micamente la realidad en la que se encuentra y contribuir de esta manera al posicionamiento de Ibagu?, como una ciudad altamente competitiva del pa?s.The business center and conventions Ibagu? Agropolis, located in the expansion zone that contemplates the territorial planning plan (POT) for the capital city of Tolima, is a proposal that responds to the demand of scenarios for the realization of major events in the city. It arises from the need to study and understand, an Ibagu? from an open perspective towards the world and increasingly diverse and complete. The project consists of an office area, an auditorium for corporate presentations, two pavilions: one for conventions with the possibility of subdividing once in three smaller rooms and one of multiple use for presentation of agricultural machinery. A large surface; Cafeteria, restaurant And finally in relation to the agricultural vocation of the city has an area for exhibitions in this area. This proposal seeks to consolidate in urban terms a sector that has great opportunities for physical, environmental, social and economic transformation of the reality in which it is and thus contributes to the positioning of Ibagu?, as a highly competitive city of the country. Key words: Conventions, competitiveness, business, positioning

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference -1·69 [-9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5-8] vs 6 [5-8] cm H2O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52-23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75-0·86]; p<0·0001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status