Abstract
Background Acute respiratory distress syndrome（ARDS） is a common respiratory critical illness. The high altitude hypoxic environment has a great influence on its occurrence and development. Now we lack clear diagnostic definition of high altitude acute respiratory distress syndrome.To verify the application value of Berlin Definition plateau criteria of Acute Respiratory Distress Syndrome in Xining , Qinghai ( 2261m).Methods Retrospective analysis of the clinical data of ARDS patients admitted to the Department of Critical Care Medicine of the Affiliated Hospital of Qinghai University from January 2018 to December 2018. The severity was divided according to the Berlin definition, the plateau standard, and the Zhang standard, and the differences of three standards were compared.Results In this study, 512 patients with mechanical ventilation were selected. 229 patients who met the criteria of Berlin Definition plateau criteria , including 107 patients with mild ARDS (46.72%), 84 moderate patients (36.68%) and 38 severe ARDS patients (16.59%). Among 253 meet Berlin definition patients , 49(19.77%) were mild,148(58.50%) were moderate,and 56 (22.13%) were severe ARDS. There are 204 patients that meet Zhang criteria, among the 204 enrolled patients, 87(42.65%) were ALI and 117(57.35%) were ARDS. The AUROC of the Berlin Definition, the Plateau criteria and Zhang criteria were 0.6675 (95% CI 0.5866-0.7484), 0.6216 (95%CI 0.5317-0.7116) and 0.6050 (95% CI 0.5084-0.7016).Conclusion For Xining, Qinghai, the Berlin Definition Plateau oxygenation index correction criteria can distinguish the severity of ARDS , but it needs to be enlarged and confirmed by multicenter clinical studies.
The Berlin definition of acute respiratory distress syndrome: should patients receiving high-flow nasal oxygen be included?
