Kaukinen L
Ann Chir Gynaecol. 1984;73(1):34-9.
The clinical course and outcome of 49 consecutive near-drowned patients is presented. All the immersions occurred in fresh water. 37 patients (76%) survived. All 28 patients who were conscious upon admission to hospital recovered fully. However, 13 of these developed pulmonary infiltrates on chest X-ray, three of them with severe respiratory distress syndrome (ARDS) requiring respirator treatment. On entering the emergency station 16 patients had cardiac arrest. 15 of these were successfully resuscitated, of whom, however, 11 died later, most from hypoxic brain damage. Among unconscious patients, the non-survivors had on arrival an average lower rectal temperature than the survivors. The following factors during intensive care correlated with bad prognosis: low PaO2/FiO2, low serum protein concentration and disturbances in renal function. Furthermore, the findings of this study suggest that although a specific near-drowned patient has on admission most abnormal laboratory values, these do not predict his fate, but effective treatment has to be given.
本文介绍了49例连续溺水患者的临床病程及转归。所有溺水均发生在淡水中。37例患者（76%）存活。入院时神志清醒的28例患者均完全康复。然而，其中13例胸部X线出现肺部浸润，3例发生严重呼吸窘迫综合征（ARDS），需要呼吸机治疗。16例患者进入急救站时发生心脏骤停。其中15例成功复苏，但其中11例后来死亡，多数死于缺氧性脑损伤。在昏迷患者中，非存活者入院时直肠温度平均低于存活者。重症监护期间的以下因素与预后不良相关：低氧合指数（PaO2/FiO2）、低血清蛋白浓度和肾功能紊乱。此外，本研究结果表明，尽管某一溺水患者入院时多数实验室值异常，但这些并不能预测其预后，而必须给予有效的治疗。
