Abstract
Near-drowning is a subject of ever-increasing importance. Two recent cases are presented that illustrate many of the problems encountered. For a current understanding of the etiologic and pathophysiologic aspects and of the prognosis of near-drowning, an updated review of the literature is provided. The importance in treatment of the recognition of hypothermia, the use of positive end-expiratory pressure and the controversy over the role of corticosteroid therapy are discussed.
Full text
PDF



Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- CRAIG A. B., Jr Underwater swimming and loss of consciousness. JAMA. 1961 Apr 29;176:255–258. doi: 10.1001/jama.1961.03040170001001. [DOI] [PubMed] [Google Scholar]
- Calderwood H. W., Modell J. H., Ruiz B. C. The ineffectiveness of steroid therapy for treatment of fresh-water near-drowning. Anesthesiology. 1975 Dec;43(6):642–650. doi: 10.1097/00000542-197512000-00008. [DOI] [PubMed] [Google Scholar]
- Culpepper R. M. Letter: Bleeding diathesis in fresh water drowning. Ann Intern Med. 1975 Nov;83(5):675–675. doi: 10.7326/0003-4819-83-5-675_1. [DOI] [PubMed] [Google Scholar]
- Davies D. M., Millar E. J., Miller I. A. Accidental hypothermia treated by extracorporeal blood warming. Lancet. 1967 May 13;1(7498):1036–1037. doi: 10.1016/s0140-6736(67)91546-2. [DOI] [PubMed] [Google Scholar]
- Giammona S. T., Modell J. H. Drowning by total immersion. Effects on pulmonary surfactant of distilled water, isotonic saline, and sea water. Am J Dis Child. 1967 Dec;114(6):612–616. doi: 10.1001/archpedi.1967.02090270068005. [DOI] [PubMed] [Google Scholar]
- Hasan S., Avery W. G., Fabian C., Sackner M. A. Near drowning in humans. A report of 36 patients. Chest. 1971 Feb;59(2):191–197. doi: 10.1378/chest.59.2.191. [DOI] [PubMed] [Google Scholar]
- Hunter T. B., Whitehouse W. M. Fresh-water near-drowning: radiological aspects. Radiology. 1974 Jul;112(1):51–56. doi: 10.1148/112.1.51. [DOI] [PubMed] [Google Scholar]
- Kelman G. R., Nunn J. F. Nomograms for correction of blood Po2, Pco2, pH, and base excess for time and temperature. J Appl Physiol. 1966 Sep;21(5):1484–1490. doi: 10.1152/jappl.1966.21.5.1484. [DOI] [PubMed] [Google Scholar]
- Lash R. F., Burdette J. A., Ozdil T. Accidental profound hypothermia and barbiturate intoxication. A report of rapid "core" rewarming by peritoneal dialysis. JAMA. 1967 Jul 24;201(4):269–270. [PubMed] [Google Scholar]
- Martin C. M., Barrett O., Jr Drowning and near-drowning: a review of ten years' experience in a large Army hospital. Mil Med. 1971 May;136(5):439–443. [PubMed] [Google Scholar]
- Miles S. Drowning. Br Med J. 1968 Sep 7;3(5618):597–600. doi: 10.1136/bmj.3.5618.597. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Modell J. H., Calderwood H. W., Ruiz B. C., Downs J. B., Chapman R., Jr Effects of ventilatory patterns on arterial oxygenation after near-drowning in sea water. Anesthesiology. 1974 Apr;40(4):376–384. doi: 10.1097/00000542-197404000-00013. [DOI] [PubMed] [Google Scholar]
- Modell J. H., Graves S. A., Ketover A. Clinical course of 91 consecutive near-drowning victims. Chest. 1976 Aug;70(2):231–238. doi: 10.1378/chest.70.2.231. [DOI] [PubMed] [Google Scholar]
- PATTLE R. E. The lining layer of the lung alveoli. Br Med Bull. 1963 Jan;19:41–44. doi: 10.1093/oxfordjournals.bmb.a070004. [DOI] [PubMed] [Google Scholar]
- Pearn J. Neurological and phychometric studies in children surviving freshwater immersion accidents. Lancet. 1977 Jan 1;1(8001):7–9. doi: 10.1016/s0140-6736(77)91651-8. [DOI] [PubMed] [Google Scholar]
- Rahn H., Reeves R. B., Howell B. J. Hydrogen ion regulation, temperature, and evolution. Am Rev Respir Dis. 1975 Aug;112(2):165–172. doi: 10.1164/arrd.1975.112.2.165. [DOI] [PubMed] [Google Scholar]
- Rivers J. F., Orr G., Lee H. A. Drowning. Its clinical sequelae and management. Br Med J. 1970 Apr 18;2(5702):157–161. doi: 10.1136/bmj.2.5702.157. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rutledge R. R., Flor R. J. The use of mechanical ventilation with positive end-expiratory pressure in the treatment of near-drowning. Anesthesiology. 1973 Feb;38(2):194–196. doi: 10.1097/00000542-197302000-00019. [DOI] [PubMed] [Google Scholar]
- Segarra F., Redding R. A. Modern concepts about drowning. Can Med Assoc J. 1974 May 4;110(9):1057–passim. [PMC free article] [PubMed] [Google Scholar]
- Siebke H., Rod T., Breivik H., Link B. Survival after 40 minutes; submersion without cerebral sequeae. Lancet. 1975 Jun 7;1(7919):1275–1277. doi: 10.1016/s0140-6736(75)92554-4. [DOI] [PubMed] [Google Scholar]
- Sladen A., Zauder H. L. Methylprednisolone therapy for pulmonary edema following near drowning. JAMA. 1971 Mar 15;215(11):1793–1795. [PubMed] [Google Scholar]