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The Pathophysiology and Treatment of Drowning
Author(s) -
Modell Jerome H.
Publication year - 1968
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1968.tb00739.x
Subject(s) - medicine , hypoxemia , pathophysiology , acidosis , asphyxia , hypoxia (environmental) , near drowning , intensive care medicine , shunt (medical) , perfusion , anesthesia , poison control , surgery , cardiology , emergency medicine , injury prevention , chemistry , organic chemistry , oxygen
SUMMARY The pathophysiological changes which occur in both animals and man during drowning and near‐drowning with aspiration have been reviewed. Although the fluid and electrolyte changes will differ in patients, depending primarily on the quantity and nature of the fluid that was aspirated, the primary disturbance requiring emergency therapy is acute asphyxia with persistent arterial hypoxemia and acidosis. Initially, the hypoxia is due to perfusion of non‐ventilated alveoli. Arterial hypoxemia persists, however, even after a significant intra‐pulmonary shunt can no longer be demonstrated. All efforts should be directed to correct this situation with whatever equipment is most readily available. While the patient is being so treated, his fluid and electrolyte status should be evaluated and cor‐rected accordingly. Other drug therapy should be supplied as indicated. With this physiological approach to therapy the success rate in resuscitating drowning and near‐drowning victims will continue to improve.