Impact of age, submersion time and water temperature on outcome in near-drowning.
BACKGROUND
Because children have less subcutaneous fat, and a higher surface area to body weight ratio than adults, it has been suggested that children cool more rapidly during submersion, and therefore have a better outcome following near-drowning incidents.


OBJECTIVE
To study the impact of age, submersion time, water temperature and rectal temperature in the emergency room on outcome in near-drowning.


METHODS
This retrospective study included all near-drowning victims admitted to the intensive care units of Helsinki University Central Hospital after successful cardiopulmonary resuscitation between 1985 and 1997.


RESULTS
There were 61 near-drowning victims (age range: 0.5-60 years, median 29 years). Males were in the majority (40), and 26 were children (<16 years). The median water temperature was 17 degrees C (range: 0-33 degrees C). The median submersion time for the 43 survivors (70%) was 10 min (range: 1-38 min). Intact survivors and those with mild neurological disability (n=26, 43%) had a median submersion time of 5 min (range: 1-21 min). In non-survivors the median submersion time was 16 min (range: 2-75 min). Submersion time was the only independent predictor of survival in linear regression analysis (P<0.01). Patient age, water temperature and rectal temperature in the emergency room were not significant predictors of survival.


CONCLUSIONS
Although submersion time is usually an estimate, it is the best prognostic factor after a near drowning incident. Children did not have a better outcome than adults.
Suominen
P
P
Department of Anaesthesia and Intensive Care, Hospital for Children and Adolescents, Helsinki University Central Hospital, Stenbäckinkatu 9, FIN-00029 HUS, Helsinki, Finland. pertti.suominen@hus.fi
Baillie
C
C
Korpela
R
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Rautanen
S
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Ranta
S
S
Olkkola
K T
KT
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001831:Body Temperature; D016887:Cardiopulmonary Resuscitation; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D015701:Near Drowning / Q000628:therapy*; D012189:Retrospective Studies; D013696:Temperature; D013997:Time Factors; D016896:Treatment Outcome; D014867:Water
D014867:Water