Survival after 40 minutes; submersion without cerebral sequeae.
Cardiopulmonary resuscitation and rewarming were successful in a 5-year-old boy who had been submerged for 40 minutes in ice-cold fresh water. Severe metabolic acidosis  was corrected by intravenous infusion of sodium bicarbonate solution before spontaneous circulation could be re-established. Fulminant pulmonary oedema developed after re-establishment of spontaneous circulation. This was efficiently reversed by positive-end-expiratory-pressure ventilation. During 2 days of treatment of a respiratory the patient gradually regained consciousness; the endotracheal tube was then removed and the patient immediately started talking intelligently. The patient went through a period of slow cerebration and motor dysfunction but recovered rapidly, and on examination 13 months after the accident all findings were normal.
D000138:Acidosis / Q000097:blood / Q000188:drug therapy / Q000209:etiology; D001639:Bicarbonates / Q000627:therapeutic use; D001831:Body Temperature; D002245:Carbon Dioxide / Q000097:blood; D002675:Child, Preschool; D003080:Cold Temperature; D004332:Drowning; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007008:Hypokalemia / Q000209:etiology; D007101:Immersion; D008297:Male; D010100:Oxygen / Q000097:blood; D011175:Positive-Pressure Respiration; D011654:Pulmonary Edema / Q000209:etiology; D012151:Resuscitation; D013997:Time Factors
D001639:Bicarbonates; D002245:Carbon Dioxide; D010100:Oxygen