20 July 2023: Review Articles
Understanding Acute Respiratory Distress Syndrome in High-Altitude Environments: A Comprehensive Review of Diagnosis and Treatment
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 4 Differentiation between plateau-related ARDS and HAPE [2,6,15,20,21,24].
| Variable | HAPE | Plateau-related ARDS |
|---|---|---|
| Cause of disease | Exposure to low-pressure hypoxic environments | Double blows from primary causes such as trauma, infection, shock, and secondary hypobaric and hypoxic environmental exposure; it can also develop from HAPE |
| Altitude at onset | More than 3000 m plateau area | >1500 m at any altitude |
| Patient characteristics | Mostly healthy | Most have underlying diseases that can occur at any age |
| Disease characteristics | Diseases occur quickly and cure quickly | Rapid onset, continuous progression, and a long course of the disease, often combined with MODS |
| Pulmonary imaging manifestations | Pulmonary edema performance, lung shadow disappears quickly | Pulmonary edema combined with bilateral lung exudation slowly disappears, the lung shadow disappears slowly, and a “white lung” can be formed |
| Bronchoalveolar lavage fluid | Protein increased; macrophages predominant | The protein was significantly increased, and white blood cells were predominant |
| Response to treatment | The effect of leaving the plateau environment in time and early effective oxygen supply is obvious | Any oxygen therapy method is slow to work and requires mechanical ventilation and other treatment methods |
| Disease course | Short | Long |
| Prognosis | Good, case fatality rate 1–5% | Poor, the fatality rate in cases is 20–70% |
| ARDS – acute respiratory distress syndrome; HAPE – high-altitude pulmonary edema; MODS – multiple organ distress syndrome. | ||