Expert consensus on the diagnosis and treatment of critically ill patients with COVID-19 at high altitudes in China

doi:10.3877/cma.j.issn.2096-1537.2022.04.011

Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition) ›› 2022, Vol. 08 ›› Issue (04): 340-346. doi: 10.3877/cma.j.issn.2096-1537.2022.04.011

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• Expert Consensus • Previous Articles Next Articles

Expert consensus on the diagnosis and treatment of critically ill patients with COVID-19 at high altitudes in China

Ling Liu¹, Xuyan Li², Yonghao Xu³, Huiying Zhao⁴, Qiaoxia Luo⁵, Xiaofeng Ou⁶, Lei Song⁷, Yuan Cheng⁸, Juan Zhou⁹, Yiping Zeng¹⁰, Aihua Liu¹¹, Bianbaqiongda¹², Shuo Zhang¹³, Jie Lyu⁴, Xi Wang⁸, Yanyun Lu¹⁴, Baixu Chen⁶, zhen Da¹⁵, Yun Yu¹, Jia Shao¹⁰, Critical Care Respiratory Group, Chinese Society of Critical Care Medicine, Chinese Medical Association, Tibet Medical Association for High Altitude Medicine and Cardiology, Chinese Association of Critical Care Physicians

^1. Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing 210009, China
^2. Beijing Institute of Respiratory Diseases, Department of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
^3. National Center for Respiratory Medicine, Department of Critical Care Medicine, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China
^4. Department of Critical Care Medicine, Peking University People's Hospital, Beijing 100044, China
^5. Department of Pulmonary Division 1, the Third People's Hospital of Tibet Autonomous Region, Lhasa 850000, China
^6. Department of Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
^7. Coronary Heart Disease Center, National Cardiovascular Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
^8. Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing 100034, China
^9. Department of Internal Medicine, Affiliated Hospital of Xizang Minzu University, Xianyang 712082, China
^10. Department of Respiratory and Critical Care Medicine, Hospital of Chengdu Office of People's Goverment of Tibet Autonomous Region, Chengdu 610041, China
^11. Department of Rheumatology and Immunology, Beijing Hospital, Beijing 100730, China
^12. Department of Respiratory and Critical Care, Tibet Autonomous Region People's Hospital, Lhasa 850000, China
^13. Department of Emergency, Peking University First Hospital, Beijing 100034, China
^14. Department of Intensive Care Medicine, the Second People's Hospital of Tibet Autonomous Region, the First Affiliated Hospital of Tibet University, Lhasa 850001, China
^15. Department of Pediatric, Tibet Autonomous Region Women's and Children's Hospital, Lhasa 850000, China

Received:2022-11-12 Online:2022-11-28 Published:2023-02-07

Abstract

Abstract:

Critically ill patients with COVID-19 at high altitudes were difficult to recognize and diagnose, due to hypoxemia associated with high altitudes and various chronic co-morbidities. In order to standardize the diagnostic and treatment practice, the present expert consensus was established by the method of consensus meeting, according to the Diagnostic and Treatment Regimen of COVID-19 (version 9), investigation advances abroad and domestic, and expert opinions, focusing on the common and important issues of diagnosis and treatment practice of critically ill patients with COVID-19 at high altitudes. This consensus will provide a reference for the standardized treatment of critically ill patients with COVID-19 at high altitudes in China.

Key words: High altitudes, COVID-19 pneumonia, Critically ill patient, Expert consensus

Ling Liu, Xuyan Li, Yonghao Xu, Huiying Zhao, Qiaoxia Luo, Xiaofeng Ou, Lei Song, Yuan Cheng, Juan Zhou, Yiping Zeng, Aihua Liu, Bianbaqiongda, Shuo Zhang, Jie Lyu, Xi Wang, Yanyun Lu, Baixu Chen, zhen Da, Yun Yu, Jia Shao, Critical Care Respiratory Group, Chinese Society of Critical Care Medicine, Chinese Medical Association, Tibet Medical Association for High Altitude Medicine and Cardiology, Chinese Association of Critical Care Physicians. Expert consensus on the diagnosis and treatment of critically ill patients with COVID-19 at high altitudes in China[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2022, 08(04): 340-346.

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Figures/Tables 5

References 8

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海拔（m）	健康人群	对应新型冠状病毒肺炎重型
2500~3500	（96±2）~（89±4）	≤90~85
＞3500~4500	（89±4）~（85±4）	≤85~80
＞4500~5000	（85±4）~（81±6）	≤80~75
＞5000	81±6	＜75

海拔（m）	健康人群	对应新型冠状病毒肺炎重型
2500~3500	（96±2）~（89±4）	≤90~85
＞3500~4500	（89±4）~（85±4）	≤85~80
＞4500~5000	（85±4）~（81±6）	≤80~75
＞5000	81±6	＜75

地区	海拔（m）	大气压（mmHg）	PaO₂/FiO₂校正系数	PaO₂/FiO₂（mmHg）
海平面	0	760	1	≤300
拉萨市（城关区）	3650	487	1.56	≤192
日喀则市（桑珠孜区）	3840	472	1.61	≤187
那曲市（色尼区）	4510	441	1.72	≤174
林芝市（巴宜区）	3000	529	1.44	≤209
阿里地区（狮泉河镇）	4300	457	1.66	≤180
山南市（乃东区）	3560	487	1.56	≤192
昌都市（卡若区）	3306	511	1.49	≤202

地区	海拔（m）	大气压（mmHg）	PaO₂/FiO₂校正系数	PaO₂/FiO₂（mmHg）
海平面	0	760	1	≤300
拉萨市（城关区）	3650	487	1.56	≤192
日喀则市（桑珠孜区）	3840	472	1.61	≤187
那曲市（色尼区）	4510	441	1.72	≤174
林芝市（巴宜区）	3000	529	1.44	≤209
阿里地区（狮泉河镇）	4300	457	1.66	≤180
山南市（乃东区）	3560	487	1.56	≤192
昌都市（卡若区）	3306	511	1.49	≤202

年龄	预估分钟通气量（L/min）	不同鼻塞吸氧浓度下经皮氧饱和度（%）
年龄	预估分钟通气量（L/min）	0.2~0.5 L	1.0 L	2.0 L
≤28 d	1.0~1.5	30~60	80~100^*	100^*
1岁	2.0~2.5	27~40	50~60	80~100^*
1~3岁	2.5~3.5	25~35	40~50	65~80^*

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箱内给氧流量（L/min）	箱内预估氧浓度（%）
2	25~30
4	29~35
6	33~41
8	42~52
10	50~80

箱内给氧流量（L/min）	箱内预估氧浓度（%）
2	25~30
4	29~35
6	33~41
8	42~52
10	50~80

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Expert consensus on the diagnosis and treatment of critically ill patients with COVID-19 at high altitudes in China

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