title: [Drowning in pediatric patients].
abstract: OBJECTIVE
  Immersion accidents are still an important cause of morbidity and mortality in children. We performed a retrospective study to identify the prognostic factors associated with outcome in children who experience near-drowning, which could serve to guide decision-making. Our data were compared with other published data.
  
  
  METHODS
  The medical records of children treated for near-drowning in our hospital from January 1995 to April 2003 were reviewed. The data analyzed referred to the patient, the accident, the patient's clinical status in the emergency unit, the unit to which the patient was admitted, and outcome.
  
  
  RESULTS
  Sixty-two patients were included. Of these, outcome was bad in 12 (death in seven and irreversible sequelae in five). Statistically significant predictors of bad prognosis were age > or = 4 years, female sex, immersion time > or = 5 min, cyanosis in the emergency room, cardiac arrest, apnea or severe distress, hypothermia (core temperature < 35 degrees C), metabolic acidosis (pH < or = 7.10) and neurologic damage (Glasgow coma Scale score 3; Conn C; nonreactive and mydriatic pupils) on arrival at the hospital.
  
  
  CONCLUSIONS
  Outcome is closely related to the patient's clinical status on arrival at the hospital. Although data that can serve as a guide to the final outcome of the nearly-drowned patient are available, early models to predict the final clinical results of each case, which could be used to guide initial resuscitation and subsequent treatment, are lacking.
authors.affiliation: Servicio de Pediatría, Hospital Materno-Infantil, Hospital Regional Universitario Carlos Haya, Málaga, Spain. javicanario@eresmas.com
authors.forename: J
authors.initials: J
authors.lastname: Blasco Alonso
authors.forename: D
authors.initials: D
authors.lastname: Moreno Pérez
authors.forename: G
authors.initials: G
authors.lastname: Milano Manso
authors.forename: C
authors.initials: C
authors.lastname: Calvo Macías
authors.forename: A
authors.initials: A
authors.lastname: Jurado Ortiz
mesh_terms: D002675:Child, Preschool; D004332:Drowning / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D015701:Near Drowning / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies