Understanding Acute Respiratory Distress Syndrome in High-Altitude Environments: A Comprehensive Review of Diagnosis and Treatment

20 July 2023: Review Articles

Litao Guo ^1ABEF* , Jingjing Sun ^1CEF* , Zongzhao He ^2BF* , Qindong Shi ^1AEF* , Siqing Ma ^2ADFG**

DOI: 10.12659/MSM.939935

Med Sci Monit 2023; 29:e939935

Table 2 The Berlin definition of acute respiratory distress syndrome [1].

Timing	Within 1 week of a known clinical insult or new or worsening respiratory symptoms
Chest imaging^a	Bilateral opacities not fully explained by effusions, lobar/lung collapse, or nodules
Origin of edema	Respiratory failure not fully explained by cardiac failure or fluid overload. Need objective assessment (eg, echocardiography) to exclude hydrostatic edema if no risk factor present
Oxygenation^b
Mild	200 mmHg^c
Moderate	100 mmHg^c
Severe	PaO/FiO ≤100 mmHg with PEEP ≥5 cmHO^c
CPAP – continuous positive airway pressure; FiO – fraction of inspired oxygen; PaO – partial pressure of arterial oxygen; PEEP – positive end-expiratory pressure. ^a Chest radiograph or computed tomography scan; ^b If altitude is higher than 1000 m, the correction factor should be calculated as follows: (PaO/FiO×[barometric pressure/760]); ^c This may be delivered noninvasively in the mild acute respiratory distress syndrome group.