Inflammation severity, rather than respiratory failure, is strongly associated with mortality of ARDS patients in high-altitude ICUs
IntroductionIn high-altitude cities located above 2,500 m, 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 protocol...
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Frontiers Media S.A.
2025-01-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2024.1520650/full |
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| author | Daniel Molano-Franco Daniel Molano-Franco Daniel Molano-Franco Daniel Molano-Franco Daniel Molano-Franco Joan Ramon Masclans Enviz Joan Ramon Masclans Enviz Antonio Viruez-Soto Antonio Viruez-Soto Antonio Viruez-Soto Antonio Viruez-Soto Mario Gomez Harvey Rojas Edgar Beltran Victor Nieto Fernanda Aliaga-Raduan Fernanda Aliaga-Raduan Pablo Iturri Christian Arias-Reyes Christian Arias-Reyes Christian Arias-Reyes Jorge Soliz Jorge Soliz |
| author_facet | Daniel Molano-Franco Daniel Molano-Franco Daniel Molano-Franco Daniel Molano-Franco Daniel Molano-Franco Joan Ramon Masclans Enviz Joan Ramon Masclans Enviz Antonio Viruez-Soto Antonio Viruez-Soto Antonio Viruez-Soto Antonio Viruez-Soto Mario Gomez Harvey Rojas Edgar Beltran Victor Nieto Fernanda Aliaga-Raduan Fernanda Aliaga-Raduan Pablo Iturri Christian Arias-Reyes Christian Arias-Reyes Christian Arias-Reyes Jorge Soliz Jorge Soliz |
| author_sort | Daniel Molano-Franco |
| collection | DOAJ |
| description | IntroductionIn high-altitude cities located above 2,500 m, 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 m) and El Alto, Bolivia (4,150 m).MethodsA cohort of seventy ARDS patients, aged 18 and older, was evaluated within 24 h 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 ARDS-related mortality.ResultsOur 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 m or between male and female patients.ConclusionThe 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 large-scale studies are recommended to validate the impact of inflammatory marker monitoring on survival outcomes in high-altitude ICUs. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
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| series | Frontiers in Physiology |
| spelling | doaj-art-c8766b65a1684c3ca1016fd414665d652025-01-15T06:10:34ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2025-01-011510.3389/fphys.2024.15206501520650Inflammation severity, rather than respiratory failure, is strongly associated with mortality of ARDS patients in high-altitude ICUsDaniel Molano-Franco0Daniel Molano-Franco1Daniel Molano-Franco2Daniel Molano-Franco3Daniel Molano-Franco4Joan Ramon Masclans Enviz5Joan Ramon Masclans Enviz6Antonio Viruez-Soto7Antonio Viruez-Soto8Antonio Viruez-Soto9Antonio Viruez-Soto10Mario Gomez11Harvey Rojas12Edgar Beltran13Victor Nieto14Fernanda Aliaga-Raduan15Fernanda Aliaga-Raduan16Pablo Iturri17Christian Arias-Reyes18Christian Arias-Reyes19Christian Arias-Reyes20Jorge Soliz21Jorge Soliz22High Altitude Intensive Care Medicine International Group (GIMIA), La Paz, BoliviaHigh Altitude Intensive Care Medicine International Group (GIMIA), Lima, PeruHigh Altitude Intensive Care Medicine International Group (GIMIA), Bogotá, ColombiaCritical Care Department, Hospital San Jose, Foundation University of Sciencies Health- CIMCA Research Group, Bogota, ColombiaCritical Care Department, Center of Treatment and Investigation of Cancer- CTIC- GRIBOS Research Group, Bogota, ColombiaCritical Care Department, Hospital del Mar Research Institute – (IMIM), Universitat Pompeu Fabra (UPF), Barcelona, SpainDepartment of Medicine and Life Sciencies (MELIS), Universitat Pompeu Fabra (UPF), Barcelona, SpainHigh Altitude Intensive Care Medicine International Group (GIMIA), La Paz, BoliviaHigh Altitude Intensive Care Medicine International Group (GIMIA), Lima, PeruHigh Altitude Intensive Care Medicine International Group (GIMIA), Bogotá, ColombiaCritical Care Department, Hospital Agramont, El Alto, La Paz, BoliviaCritical Care Department, Hospital San Jose, Foundation University of Sciencies Health- CIMCA Research Group, Bogota, ColombiaCritical Care Department, Hospital San Jose, Foundation University of Sciencies Health- CIMCA Research Group, Bogota, ColombiaCritical Care Department, Hospital San Jose, Foundation University of Sciencies Health- CIMCA Research Group, Bogota, ColombiaCritical Care Department, Center of Treatment and Investigation of Cancer- CTIC- GRIBOS Research Group, Bogota, ColombiaCentre de Recherche de l’Institute Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec City, QC, Canada0Bolivian Foundation of Altitude Sciences (BFAS), Brain Research Institute, La Paz, BoliviaCentre de Recherche de l’Institute Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec City, QC, CanadaCentre de Recherche de l’Institute Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec City, QC, Canada0Bolivian Foundation of Altitude Sciences (BFAS), Brain Research Institute, La Paz, Bolivia1Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, WA, United StatesCentre de Recherche de l’Institute Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec City, QC, Canada0Bolivian Foundation of Altitude Sciences (BFAS), Brain Research Institute, La Paz, BoliviaIntroductionIn high-altitude cities located above 2,500 m, 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 m) and El Alto, Bolivia (4,150 m).MethodsA cohort of seventy ARDS patients, aged 18 and older, was evaluated within 24 h 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 ARDS-related mortality.ResultsOur 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 m or between male and female patients.ConclusionThe 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 large-scale studies are recommended to validate the impact of inflammatory marker monitoring on survival outcomes in high-altitude ICUs.https://www.frontiersin.org/articles/10.3389/fphys.2024.1520650/fullARDShigh-altitudemortalityinflammatory markershypobaric hypoxiahigh altitude adaptation |
| spellingShingle | Daniel Molano-Franco Daniel Molano-Franco Daniel Molano-Franco Daniel Molano-Franco Daniel Molano-Franco Joan Ramon Masclans Enviz Joan Ramon Masclans Enviz Antonio Viruez-Soto Antonio Viruez-Soto Antonio Viruez-Soto Antonio Viruez-Soto Mario Gomez Harvey Rojas Edgar Beltran Victor Nieto Fernanda Aliaga-Raduan Fernanda Aliaga-Raduan Pablo Iturri Christian Arias-Reyes Christian Arias-Reyes Christian Arias-Reyes Jorge Soliz Jorge Soliz Inflammation severity, rather than respiratory failure, is strongly associated with mortality of ARDS patients in high-altitude ICUs Frontiers in Physiology ARDS high-altitude mortality inflammatory markers hypobaric hypoxia high altitude adaptation |
| title | Inflammation severity, rather than respiratory failure, is strongly associated with mortality of ARDS patients in high-altitude ICUs |
| title_full | Inflammation severity, rather than respiratory failure, is strongly associated with mortality of ARDS patients in high-altitude ICUs |
| title_fullStr | Inflammation severity, rather than respiratory failure, is strongly associated with mortality of ARDS patients in high-altitude ICUs |
| title_full_unstemmed | Inflammation severity, rather than respiratory failure, is strongly associated with mortality of ARDS patients in high-altitude ICUs |
| title_short | Inflammation severity, rather than respiratory failure, is strongly associated with mortality of ARDS patients in high-altitude ICUs |
| title_sort | inflammation severity rather than respiratory failure is strongly associated with mortality of ards patients in high altitude icus |
| topic | ARDS high-altitude mortality inflammatory markers hypobaric hypoxia high altitude adaptation |
| url | https://www.frontiersin.org/articles/10.3389/fphys.2024.1520650/full |
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