Citation

Cerland L, Megarbane B, Kallel H, Brouste Y, Mehdaoui H, Résière D. Int. J. Environ. Res. Public Health 2017; 14(11): e14111402.

Affiliation

Intensive Care Unit, University Hospital of Martinique, Fort-de-France, 97261 Martinique, France. dabor.resiere@chu-martinique.fr.

Copyright

(Copyright © 2017, MDPI: Multidisciplinary Digital Publishing Institute)

DOI

10.3390/ijerph14111402

PMID

29149019

Abstract

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 Enterobacter aerogenes, Enterobacter cloacae, Staphylococcus aureus, Pseudomonas aeruginosa, Aeromonas hydrophilia, and Morganella morgani. 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.

Language: en

Keywords

aspiration; drowning; fatality; pneumonia; predictive factor