Bierens Joost J L M, Knape Johannes T A, Gelissen Harry P M M
Department of Anesthesiology, VU University Medical Center, Amsterdam, the Netherlands.
Curr Opin Crit Care. 2002 Dec;8(6):578-86. doi: 10.1097/00075198-200212000-00016.
Recent epidemiologic data have shown that the burden of drowning is much greater than expected. Prevention and timely rescue are the most effective means of reducing the number of persons at risk. Early bystander cardiopulmonary resuscitation is the most important factor for survival after submersion. Cerebral damage is a serious threat when the hypoxic period is too long. In most situations, low body temperature is an indication of the severity of the drowning incident. Sometimes hypothermia that occurs during the submersion period can be brain protective. There is also new evidence to support the strategy of inducing mild hypothermia for a period of 12 to 24 hours in comatose drowning victims. In immersed patients, hypothermia should be treated. The most appropriate technique will depend on the available means in the hospital and the condition of the patient. Treatment of pulmonary complications depends on the lung injury that occurred during aspiration and the bacteria involved in aspiration. Understanding the pathophysiology of drowning may help us to understand lung injuries and ischemic brain injuries.
近期流行病学数据显示,溺水负担远超预期。预防和及时救援是减少溺水风险人数的最有效手段。早期旁观者心肺复苏是溺水后存活的最重要因素。缺氧时间过长时,脑损伤是严重威胁。在大多数情况下,体温过低表明溺水事件的严重程度。有时,溺水期间出现的体温过低对大脑有保护作用。也有新证据支持对昏迷溺水受害者诱导轻度低温12至24小时的策略。对于浸泡在水中的患者,应治疗体温过低。最合适的技术将取决于医院可用的手段和患者的病情。肺部并发症的治疗取决于吸入过程中发生的肺损伤以及吸入涉及的细菌。了解溺水的病理生理学可能有助于我们理解肺损伤和缺血性脑损伤。