Effects of tonicities of saline solutions on pulmonary injury in drowning

Orlowski, James P.; Abulleil, Medhat M.; Phillips, Jacquelyn M.

doi:10.1097/00003246-198702000-00009

Cited by 40 publications

(13 citation statements)

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“…The term near drowning is confusing and imprecise and should be abandoned; in spite of this, it is still in use [5,6]. Alterations in gas exchange, hypoxemia and deteriorated pulmonary compliance are the physiopathological mechanisms described in the initial stages in drowning patients [7][8][9]. In the case discussed here hypoxemia was significant, in spite of FiO 2 of 1 and low compliance at the time of admission.…”

Section: Discussionmentioning

confidence: 88%

Sea drowning: a case report and review of the literature

Estella

Fontaiña

2015

Monaldi Arch Chest Dis

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400,000 incidents of sea drowning take place every year. We report the case of a woman, 34 years old, attended on the beach by external hospital emergency services after suffering immersion in seawater resulting in drowning due to acute respiratory failure. She was admitted to the critical care unit and an emergency fiberoptic bronchoscopy was performed, extracting a large quantity of sand and algae. The respiratory function improved and FiO2 requirements were gradually reduced following the procedure. After 8 days of mechanical ventilation the patient was extubated, with good clinical tolerance and was transferred to a ward.

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Section: Discussionmentioning

confidence: 88%

Sea drowning: a case report and review of the literature

Estella

Fontaiña

2015

Monaldi Arch Chest Dis

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“…However, retrospective [2]. Animal studies reveal that direct injury to the alveoli is the most severe in fresh water solution, with hypertonic and isotonic saline solutions causing less damage [3]. Regardless of medium, the disruption of the P(A-a)O2 gradient and the resulting pulmonary shunting results in the hypoxemia, hypercarbia, and acidosis.…”

Section: Discussionmentioning

confidence: 99%

Is There a Clinical Difference between Salt Water and Fresh Water Drowning?

Quang¹,

Kennedy²,

Blair³

2017

Open J Trauma

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Introduction: Salt water near-drowning events are not uncommon in coastal regions. The difference in tonicity between salt and fresh water in near-drowning events leads many to believe there should be differences in the approach to managing the patient. We present a case of near-drowning in salt water and a thorough review of the literature in managing these patients.Case Presentation: A sixteen year old male presented to our level 1 trauma center approximately 30 minutes after a near-drowning in salt water. The patient began to develop hypoxemia associated with profound pulmonary edema that was not responsive to elevated inspired oxygen levels and high levels of positive end-expiratory pressure (PEEP). Conclusion:Despite the alterations in the alveolar interface that are dependent on the tonicity of the fl uid, the ultimate treatment of drowning injuries remains consistent regardless of the tonicity of the water. Aggressive therapy, tailored to the individual patient, can improve pulmonary shunting. Patients with hypoxemia requiring intubation should be ventilated with (PEEP) as animal studies have shown rapid improvements in PaO2 with PEEP values in the range of 5-15.

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“…O órgão alvo de maior comprometimento é o pulmão. A aspiração de água promove insuficiência respiratória e conseqüentes alterações na troca gasosa alvéolo-capilar e distúrbios no equilíbrio ácido-básico 12,25,26,31 . As alterações fisiopatológicas que ocorrem dependem da composição e da quantidade de líquido aspirado.…”

Section: Fisiopatologiaunclassified

“…Estimase que existam 8.000 casos de morte por ano só nos EUA (53% em piscinas) 7 , onde 50.000 novas piscinas são construídas por ano, somando-se a 2,2 milhões de piscinas residenciais e 2,3 milhões não residenciais 11 . Nas áreas quen-tes do EUA, Austrália e África do Sul, 70 a 90% dos óbitos por afogamento ocorrem em piscinas de uso familiar 12 . No Brasil, onde o número de piscinas domésticas é infinitamente menor, o afogamento em água doce ocorre mais em rios, lagos e represas, perfazendo a metade dos casos fatais 13 .…”

Section: Introductionunclassified

Afogamento

Szpilman¹

2000

Rev Bras Med Esporte

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Effects of tonicities of saline solutions on pulmonary injury in drowning

Cited by 40 publications

References 0 publications

Sea drowning: a case report and review of the literature

Sea drowning: a case report and review of the literature

Is There a Clinical Difference between Salt Water and Fresh Water Drowning?

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