Department of Emergency Medicine, University Hospital of Martinique, Fort-de-France, 97261 Martinique, France.
Department of Medical and Toxicological Critical Care, Lariboisière Hospital, Paris-Diderot University, INSERM UMR-S 1144, 75013 Paris, France.
Int J Environ Res Public Health. 2017 Nov 17;14(11):1402. doi: 10.3390/ijerph14111402.
Drowning represents one major cause of accidental death. Near-drowning patients are exposed to aspiration that may result in pneumonia with life-threatening consequences. We designed this descriptive study to investigate the frequency, nature, and consequences of post-drowning pneumonia. One hundred and forty-four near-drowning patients (33 children and 111 adults) admitted during four years to the University Hospital of Martinique, French Indies, were included. Patients presented pre-hospital cardiac arrest (41%) and exhibited acute respiratory failure (54%), cardiovascular failure (27%), and lactic acidosis (75%) on admission. Empirical antibiotics, as decided by the physicians in charge, were administered in 85 patients (59%). Post-drowning early onset bacterial pneumonia was diagnosed as "possible" in 13 patients (9%) and "confirmed" in 22 patients (15%). Tracheal aspiration revealed the presence of polymorphous pharyngeal flora (59%) or one predominant bacteria species (41%) including , , , , , and . Despite adequate supportive care, drowning resulted in 45 fatalities (31%). Early onset bacterial aspiration pneumonia (either possible or confirmed) did not significantly influence the risk of death. In conclusion, near-drowning-related bacterial aspiration pneumonia seems rare and does not influence the mortality rate. There is still a need for practice standardization to improve diagnosis of post-drowning pneumonia and near-drowning patient management.
溺水是意外死亡的主要原因之一。近溺水患者有发生吸入的风险，可能导致危及生命的肺炎。我们设计了这项描述性研究，以调查溺水后肺炎的频率、性质和后果。在四年期间，有 144 名近溺水患者（33 名儿童和 111 名成人）被收入法属西印度群岛马提尼克岛大学医院。患者入院时表现出院外心脏骤停（41%）和急性呼吸衰竭（54%）、心血管衰竭（27%）和酸中毒（75%）。根据主管医生的决定，对 85 名患者（59%）给予经验性抗生素治疗。在 13 名患者（9%）中诊断出溺水后早期发病的细菌性肺炎为“可能”，在 22 名患者（15%）中诊断出“确诊”。气管抽吸显示存在多形性咽腔菌群（59%）或单一主要细菌物种（41%），包括 、 、 、 、 和 。尽管给予了充分的支持性治疗，溺水仍导致 45 人死亡（31%）。早期发病的细菌性吸入性肺炎（无论是可能还是确诊）并未显著影响死亡风险。总之，与近溺水相关的细菌性吸入性肺炎似乎很少见，并不影响死亡率。仍需要标准化实践，以改善溺水后肺炎和近溺水患者管理的诊断。
