A retrospective study was conducted to evaluate the outcome of
near-drowning patients admitted to the intensive care unit (ICU) comparing seawater and freshwater
drownings. A chart review was used to identify
near-drowning patients admitted to ICU from 1 April 1989 to 1 May 1996 for biodata, physiological data and outcome. Seventeen
near-drowning patients were admitted to ICU over a period of nearly 7 years. There were 3 deaths (17.6%) and 8 patients (47%) required
cardiopulmonary resuscitation. Freshwater
near-drowning occurred in 8 patients and saltwater
near-drowning occurred in 9 patients. Nearly all (94%) the patients had a PaO2/FiO2 ratio < 300 mm Hg. Pulmonary oedema was present on the chest radiographs of all patients.
Mechanical ventilation was required for 8 patients (47%), and nearly all (94%) received prophylactic
antibiotics. None of the patients developed
pneumonia. Serum
electrolytes and haemoglobin concentration were not grossly abnormal although, those with saltwater
near-drowning had a significantly higher level of haemoglobin,
sodium and
urea compared to those with freshwater
near-drowning. Patients that survived to hospital discharge had full neurological recovery and stayed an average of 4.5 days. We concluded that
near-drowning victims that survive to be admitted to ICU have significant oxygenation defect with nearly half requiring ventilatory support. Mortality is appreciable, but those that survive to hospital discharge had full neurological recovery.