@article{ref1,
title="Near drowning in a pediatric population: epidemiology and prognosis",
journal="Archivos Argentinos de Pediatria",
year="2009",
author="Torres, Silvio F. and Rodriguez, M. and Iolster, Thomas and Siaba Serrate, Alejandro and Cruz Iturrieta, Carmen and Martínez del Valle, Ezequiel and Schnitzler, Eduardo and Roca Rivarola, Manuel",
volume="107",
number="3",
pages="234-240",
abstract="INTRODUCTION: Submersion injury is associated with high morbidity and mortality, being the third leading cause of accidental death among children. OBJECTIVES: To analyze and describe risk factors, prognosis, and survival of victims, admitted to a third level Community Teaching Hospital. Population, material and methods. A retrospective, observational, analytical study. We studied patients admitted to the pediatric critical care unit, between 06/2000 and 01/2008. The following variables were analyzed: age, sex, length of stay, days of mechanical ventilation, Glasgow Coma Scale (GCS) score, apnea, bradycardia; baseline, 24 and 48 h lactacidemia, submersion time, swimming pool watchers of the victims. Stata 8.0 software was used; continuous variables were analyzed using Wilcoxon test; for categorical variables Z test and Chi square test were used, and a logistic regression analysis was performed. RESULTS: 30 near-drowning victims were admitted, median age was 25 months (R = 11-144 months). 41.3% occurred during summer, 60% were under parental supervision. Sibling supervision was associated with an increased risk of near-drowning (RR: 2.1; 95% CI 1.1-3.2). Immersion time was > 10 minutes in 3.4%; 26% had apnea, and the GCS score was < 5 in 19.99%. Lactic acid at admission was > 3 mmol/l in 10 patients. Risk factors like glucose level > or = 300 mg% (OR: 3.325), apnea (OR: 2.752), bradycardia (OR: 4.74), GCS <5 (OR: 3.550) and inmersion time > 10 minutes (OR: 5.12), were associated with poor prognosis. Mortality was 2/30 patients. CONCLUSION: In our population, the presence of apnea, bradycardia, GCS <5, glucose level > or = 300 mg%, submersion time > 10 minutes, and lactic acid > 6 mmol/l at admission and the first 24 h, were associated with a poor prognosis and serious injury.<p /> <p>Language: es</p>",
language="es",
issn="0004-0487",
doi="10.1590/S0325-00752009000300011",
url="http://dx.doi.org/10.1590/S0325-00752009000300011"
}