Citation

Kosiński S, Darocha T, Mendrala K, Pasquier M. Resuscitation 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Elsevier Publishing)

DOI

10.1016/j.resuscitation.2021.02.043

PMID

unavailable

Abstract

We read the excellent review by Bierens et al. with great interest. The authors have made every effort to fill the gaps in the knowledge of drowning. We would like to add some comments, focusing on the specific cases of drowning cardiac arrest patients with hypothermia.
Hypothermia victims may survive with excellent outcome, if properly treated with extracorporeal life support rewarming (ECLSR). Consequently, all victims of drowning in cardiorespiratory arrest who also have significant hypothermia should be evaluated for ECLSR with cardiopulmonary bypass (CPB) or extracorporeal membrane oxygenation (ECMO). However, drowned victims with submersion (where the airways are under the water) have a relatively bad prognosis compared to victims of hypothermic cardiac arrest from cold exposure alone, because of the presence of asphyxia (similarly as it is for avalanche victims with full burial and obstructed airways).

The indication to start ECLSR in a particular patient should be carefully weighted, and based on data that suggest that mechanical cardiorespiratory support in combination with rewarming will increase the chances of survival or quality of life.
The HOPE score...

Language: en