Drowning in Children and Predictive Parameters

Abstract

Background: Drowning is a serious and underestimated public health problem, with the highest morbidity and mortality reported among children. Data regarding pediatric outcomes of drowning are often inadequate, and data collection is poorly standardized among centers. This study aims to provide an overview of a drowning pediatric population in pediatric emergency department, focusing on its main characteristics and management and evaluating prognostic factors.Methods: This is a retrospective multicenter study involving eight Italian Pediatric Emergency Departments. Data about patients between 0 to 16 years of age who drowned between 2006 and 2021 were collected and analyzed according to the Utstein-style guidelines for drowning.Results: One hundred thirty-five patients (60.9% males, median age at the event 5; interquartile range, 3-10) were recruited and only those with known outcome were retained for the analysis (133). Nearly 10% had a preexisting medical conditions with epilepsy being the most common comorbidity. One third were hospitalized in the intensive care unit (ICU) and younger males had a higher rate of ICU admission than female peers. Thirty-five patients (26.3%) were hospitalized in a medical ward while 19 (14.3%) were discharged from the emergency department and 11 (8.3%) were discharged after a brief medical observation less than 24 hours. Six patients died (4.5%). Medium stay in the ED was approximately 40 hours. No difference in terms of ICU admission was found between cardiopulmonary resuscitation performed by bystanders or trained medical personnel ( P = 0.388 vs 0.390). Conclusions:This study offers several perspectives on ED victims who drowned. One of the major finding is that no difference in outcomes was seen in patients who received cardiopulmonary resuscitation performed by bystanders or medical services, highlighting the importance of a prompt intervention.

Transient changes in the ST-T waveform mimicking myocardial infarction in a child with near-drowning: a case report

“…Drowning is a major public health problem, especially in children. 8–10 Papadodima et al. retrospectively analyzed 197 drowning cases by autopsy and through laboratory examinations, and found that 23 patients died because of complications of coronary artery disease.…”

“…Drowning is a major public health problem, especially in children. [8][9][10] Papadodima et al retrospectively analyzed 197 drowning cases by autopsy and through laboratory examinations, and found that 23 patients died because of complications of coronary artery disease. 11 This finding suggests that cardiovascular complications after drowning induce cardiovascular damage, including coronary artery injury.…”