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ORIGINAL RESEARCH article

Front. Physiol.
Sec. Integrative Physiology
Volume 15 - 2024 | doi: 10.3389/fphys.2024.1520650
This article is part of the Research Topic Physiological and Pathological Responses to Hypoxia and High Altitude, Volume III View all 4 articles

Inflammation severity, rather than respiratory failure, is strongly associated with mortality of ARDS patients in high-altitude ICUs

Provisionally accepted
Daniel Molano Daniel Molano 1Joan Ramon Masclans Joan Ramon Masclans 2Antonio Viruez-Soto Antonio Viruez-Soto 3Mario Gomez Mario Gomez 1Harvey Rojas Harvey Rojas 1Edgar Beltran Edgar Beltran 1Victor Nieto Victor Nieto 1Fernanda Aliaga-Raduan Fernanda Aliaga-Raduan 4Pablo Iturri Pablo Iturri 4Christian Arias-Reyes Christian Arias-Reyes 5Jorge Soliz Jorge Soliz 4*
  • 1 Hospital de San José, Bogotá, Cundinamarca, Colombia
  • 2 Hospital del Mar Medical Research Institute (IMIM), Barcelona, Catalonia, Spain
  • 3 Critical Care Department, Hospital Agramon, La Paz, Bolivia
  • 4 Laval University, Quebec, Canada
  • 5 Seattle Children's Hospital, Seattle, Washington, United States

The final, formatted version of the article will be published soon.

    In high-altitude cities located above 2,500 meters, hospitals face a concerning mortality rate of over 50% among intensive care unit (ICU) patients with acute respiratory distress syndrome (ARDS). This elevated mortality rate is largely due to the absence of altitude-specific medical protocols that consider the unique physiological adaptations of high-altitude residents to hypoxic conditions. This study addresses this critical gap by analyzing demographic, clinical, sex-specific, and preclinical data from ICUs in Bogotá, Colombia (2,650 meters) and El Alto, Bolivia (4,150 meters). A cohort of seventy ARDS patients, aged 18 and older, was evaluated within 24 hours of ICU admission. Data collected included demographic information (age, sex), clinical characteristics (primary pathology, weight, height), vital signs, respiratory variables, cardiorespiratory parameters, blood count results, inflammatory markers, severity assessment scores, and comorbidities. Advanced statistical analyses, such as multivariate logistic regression and principal component analysis, were utilized to identify key clinical predictors of ARDSrelated mortality.Our findings indicate that in high-altitude ICUs, monitoring inflammatory markers may be more beneficial for improving ARDS survival rates than emphasizing respiratory failure markers. Unexpectedly, we found no significant differences in clinical outcomes between altitudes of 2,650 and 4,150 meters or between male and female patients.The study concludes that, in high-altitude settings, ARDS patient survival in ICUs is more closely associated with managing inflammatory responses than with focusing solely on respiratory parameters. Further largescale studies are recommended to validate the impact of inflammatory marker monitoring on survival outcomes in high-altitude ICUs.

    Keywords: ARDS, high-altitude, Mortality, Inflammatory markers, hypobaric hypoxia, adaptation, ICU

    Received: 31 Oct 2024; Accepted: 23 Dec 2024.

    Copyright: © 2024 Molano, Masclans, Viruez-Soto, Gomez, Rojas, Beltran, Nieto, Aliaga-Raduan, Iturri, Arias-Reyes and Soliz. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jorge Soliz, Laval University, Quebec, Canada

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