Çakmakcı Selin, Ergan Begüm, Cömert Bilgin, Gökmen Ali Necati
Department of Pulmonary Diseases, Dokuz Eylül University School of Medicine, İzmir, Turkey.
Department of Chest Diseases, Dokuz Eylül University, İzmir, Turkey.
Turk Thorac J. 2021 Nov;22(6):477-481. doi: 10.5152/TurkThoracJ.2021.21086.
Drowning is a process of submersion and can lead to respiratory failure. Annually, there are an estimated 320 000 deaths worldwide due to drowning, in addition to nonfatal drowning events. There are limited data for respiratory failure due to drowning and its prognosis in Turkey. The aim of this study was to identify the therapeutic modalities used for acute respiratory failure (ARF) due to drowning, and its prognosis in hospitalized patients.
All adult drowning cases (according to the International Classification of Disease (ICD) diagnosis code) who were admitted to either the emergency department (ED) or the intensive care units (ICU), or the pulmonology inpatient clinics between 2008 and 2018 were included in the study. Data for demographic characteristics, radiologic evaluations, respiratory support and mechanical ventilation, hospital stay duration, and hospital mortality were retrospectively collected from hospital records.
A total of 117 patients (47 females, 70 males, mean age: 57.3 years) were included in the study. The drowning accidents most commonly occurred in summer (86.3%). Of them, 31 victims (26.4%) were admitted to ICU due to severe respiratory failure. The mean pH was 7.32, and PaO2 was 69.13 mmHg in the arterial blood gas at admission. Invasive and noninvasive mechanical ventilation were performed in 24.7% and 25.6% of the patients respectively. The PaO2/FiO2 of 106 patients (who had accessible FiO2 values) were >300 in 12 (11%), 201-300 in 32 (30%), 101-200 in 49 (46%), and <100 in 13 (12%) patients. Bilateral opacities were observed in 85.4% of the patients. Cardiopulmonary resuscitation was performed in 8 (6.8%) patients. The hospital mortality rate was 6%.
The present study results show that with appropriate therapeutic and support strategies, respiratory failure due to drowning can be treated successfully.
溺水是一种淹没过程，可导致呼吸衰竭。全球每年估计有32万人死于溺水，此外还有非致命性溺水事件。在土耳其，关于溺水所致呼吸衰竭及其预后的数据有限。本研究的目的是确定用于治疗溺水所致急性呼吸衰竭（ARF）的治疗方式及其在住院患者中的预后。
纳入2008年至2018年间入住急诊科（ED）、重症监护病房（ICU）或肺病住院门诊的所有成年溺水病例（根据国际疾病分类（ICD）诊断代码）。从医院记录中回顾性收集人口统计学特征、放射学评估、呼吸支持和机械通气、住院时间和医院死亡率的数据。
本研究共纳入117例患者（47例女性，70例男性，平均年龄：57.3岁）。溺水事故最常发生在夏季（86.3%）。其中，31名受害者（26.4%）因严重呼吸衰竭入住ICU。入院时动脉血气分析平均pH值为7.32，PaO2为69.13 mmHg。分别有24.7%和25.6%的患者接受了有创和无创机械通气。106例患者（有可用FiO2值）的PaO2/FiO2中，12例（11%）>300，32例（30%）为201 - 300，49例（46%）为101 - 200，13例（12%）<100。85.4%的患者观察到双侧混浊。8例（6.8%）患者进行了心肺复苏。医院死亡率为6%。
本研究结果表明，通过适当的治疗和支持策略，溺水所致呼吸衰竭可得到成功治疗。
