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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].

VariableHAPEPlateau-related ARDS
Cause of diseaseExposure to low-pressure hypoxic environmentsDouble blows from primary causes such as trauma, infection, shock, and secondary hypobaric and hypoxic environmental exposure; it can also develop from HAPE
Altitude at onsetMore than 3000 m plateau area>1500 m at any altitude
Patient characteristicsMostly healthyMost have underlying diseases that can occur at any age
Disease characteristicsDiseases occur quickly and cure quicklyRapid onset, continuous progression, and a long course of the disease, often combined with MODS
Pulmonary imaging manifestationsPulmonary edema performance, lung shadow disappears quicklyPulmonary edema combined with bilateral lung exudation slowly disappears, the lung shadow disappears slowly, and a “white lung” can be formed
Bronchoalveolar lavage fluidProtein increased; macrophages predominantThe protein was significantly increased, and white blood cells were predominant
Response to treatmentThe effect of leaving the plateau environment in time and early effective oxygen supply is obviousAny oxygen therapy method is slow to work and requires mechanical ventilation and other treatment methods
Disease courseShortLong
PrognosisGood, 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.

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750