The hemodynamic and cardiovascular effects of near-drowning in hypotonic, isotonic, or hypertonic solutions

Drowning and Emergency Department

“…[8,13,15,20] Sıcak havalarda dinlenme, serinleme ve eğlence amaçlı su kenarlarına gitme eğilimi boğulma riskini de beraberinde getirmektedir. Yaz aylarında, özelikle çocuklu ailelerin daha dikkatli olmaları; kanalet, su drenaj alanlarında ve göl kenarlarında tel örgüler gibi koruyucu önlemlerin alınması ile ma- [21][22][23] Bizim çalışmamızda da tatlı/ tuzlu su maruziyetinin kan elektroit düzeylerinde (sodyum ve potasyum) değişiklik yapmadığı sonucuna ulaştık. Boğulma olgularında ortaya çıkan elektrolit düzey değişikliği, suyun kimyasal özelliğinin değil, boğulmanın patofizyolojisinde olan hipoksi veya anoksinin direkt etkisi sonucudur.…”

Sports related to drowning

“…If the person is not rescued, aspiration of water continues and hypoxaemia leads to loss of consciousness and apnoea in the seconds to a few minutes preceding cardiac arrest. As a consequence, hypoxic cardiac arrest generally occurs after a period of bradycardia and pulseless electrical activity, and not by means of ventricular fibrillation [12,13]. The whole drowning process, from submersion or immersion to cardiac arrest, usually occurs within seconds to a few minutes, but in unusual situations, such as rapid hypothermia, this process can last for up to an hour [14].…”

“…Water in the alveoli causes surfactant destruction and wash-out. Salt and fresh water aspiration cause similar pathology [12]. In either situation, the effect of the osmotic gradient on the alveolar-capillary membrane can disrupt the integrity of the membrane, increase its permeability and exacerbate fluid, plasma and electrolyte shifts [12].…”

Immersion deaths and drowning: issues arising in the investigation of bodies recovered from water

“…The mechanism of death in drowning is complicated and involves more than just asphyxia from filling of the airways with fluid, but also hydrostatic and osmotic effects [11], although the clinical significance of the latter has been debated [12]. While the existence of so-called ''dry drowning'' is also argued, it is considered that certain victims may suffer airway obstruction from laryngeal spasm [13].…”