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Nephrol Dial Transplant 2019 Feb 14. Epub 2019 Feb 14.

Department of Medicine D, Rambam Health Care Campus and Ruth & Bruce Rappaport Faculty of Medicine, Technion-IIT, Haifa, Israel.

Concepts regarding hypoxic acute kidney injury (AKI) are derived from widely used warm ischemia-reflow (WIR) models, characterized by extensive proximal tubular injury and associated with profound inflammation. However, there is ample clinical and experimental data indicating that hypoxic AKI may develop without total cessation of renal blood flow, with a different injury pattern that principally affects medullary thick limbs in the outer medulla. This injury pattern likely reflects an imbalance between blood and oxygen supply and oxygen expenditure, principally for tubular transport. Read More

Neuropediatrics 2019 Apr 20;50(2):71-79. Epub 2018 Dec 20.

Clinic for Neuropediatrics and Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schön Klinik, Vogtareuth, Germany.

Among 131 children admitted to our institution for early phase rehabilitation after freshwater near-drowning (ND) between the year 1986 and 2000, 87 were in unresponsive wakefulness syndrome (UWS) for at least 4 weeks after the accidents. An anonymous questionnaire was sent to the families after 0.5 to 15. Read More

Intern Med J 2018 Nov;48(11):1410-1411

Department of Pathology, Chungbuk National University College of Medicine and Chungbuk National University Hospital, Cheongju, Korea.

Resuscitation 2018 Dec 15;133:108-117. Epub 2018 Oct 15.

Department of Emergency Medicine, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA 71103, USA.

Background: Extracorporeal life support (ECLS) describes the use of blood perfusion devices to provide advanced cardiac or respiratory support. Advances in percutaneous vascular cannula insertion, centrifugal pump technologies, and the miniaturization of extracorporeal devices have simplified ECLS. The intention of this discussion is to review the role of ECLS as a potential rescue method for emergency department (ED) clinicians in critical clinical scenarios and to focus on the prerequisites for managing an ECLS program in an ED setting. Read More

Neurophysiol Clin 2019 Feb 12;49(1):41-47. Epub 2018 Oct 12.

Division of pulmonary and critical care, department of pediatrics, faculty of medicine, Chulalongkorn University, Thailand.

Objective: To determine the prognostic value of continuous electroencephalography (EEG) in children undergoing therapeutic hypothermia after cardiac arrest.

Method: We retrospectively reviewed medical records and continuous EEG of all patients undergoing therapeutic hypothermia after cardiac arrest from November 2013 to September 2016. Demographic, clinical data and immediate complications were collected. Read More

Asian J Neurosurg 2018 Jul-Sep;13(3):792-796

Department of Neurosurgery, College of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Republic of Korea.

Herein, we describe a fatal case of central nervous system (CNS) pseudallescheriasis following near-drowning. A 13-year-old boy, who had been successfully resuscitated after near-drowning, presented with a transient episode of mental confusion during a hospital stay after recovering from severe aspiration pneumonia and respiratory failure. A magnetic resonance imaging (MRI) scan of the brain showed a small brain abscess in the left basal ganglia and ventriculitis in the left lateral ventricle. Read More

MSMR 2018 Sep;25(9):15-19

Service members are at risk for unintentional drownings or near drownings during training, occupational activities, and off-duty recreation. During 2013-2017, there were 359 incident accidental drowning episodes (includes drownings and near drownings) for a crude rate of 5.7 cases per 100,000 person-years. Read More

Acta Paediatr 2019 Apr 17;108(4):731-739. Epub 2018 Oct 17.

The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia.

Aim: Our aim was to improve our understanding of the contextual factors contributing to child drowning in rural West Bengal, India.

Methods: This 2017 study used interviews, focus groups and observations and the participants included community leaders, household heads, parents and children aged 7-17 years from three remote villages. They included adults and children who had been directly affected by the loss of family members or friends. Read More

Rev Med Suisse 2018 Sep;14(617):1565-1567

Fondation Urgences Santé (FUS), Rue Dr César-Roux 29, 1005 Lausanne.

Drowning is a significant and neglected public health problem mostly affecting young children. The definition of drowning has recently been modified and the notions of « dry drowning », « secondary drowning » and « near drowning » are no longer accepted or used. However, recent articles in the media describing dry drowning of children have been reported. Read More

Rev Mal Respir 2018 Nov 13;35(9):959-962. Epub 2018 Sep 13.

Service de pneumologie et oncologie thoracique, CHU de Caen, centre régional de compétence des HTAP sévères, 14033 Caen, France.

Introduction: Aeromonas pneumonia associated with near-drowning, though uncommon, is serious and a major morbidity factor for patients.

Clinical Case: A healthy 30-year-old man nearly drowned in a pound. He was admitted to the medical intensive care unit and required intubation and mechanical ventilation. Read More

Wilderness Environ Med 2018 Dec 9;29(4):549-551. Epub 2018 Sep 9.

Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Shizuoka, Japan.

J Pediatr Surg 2018 Jul 11. Epub 2018 Jul 11.

Keck School of Medicine of the University of Southern California; Division of Pediatric Surgery, Children's Hospital Los Angeles. Electronic address:

Background/purpose: Acute Respiratory Distress Syndrome (ARDS) results in significant morbidity and mortality in pediatric trauma victims. The objective of this study was to determine risk factors and outcomes specifically related to pediatric trauma-associated ARDS (PT-ARDS).

Methods: A retrospective cohort (2007-2014) of children ≤18 years old from the American College of Surgeons National Trauma Data Bank (NTDB) was used to analyze incidence, risk factors, and outcomes related to PT-ARDS. Read More

Acta Neurol Belg 2018 Jul 21. Epub 2018 Jul 21.

Department of Internal Medicine II (Cardiology, Pulmonology and Critical Care), Municipal Hospital Landshut, Landshut, Germany.

Kidney Int Rep 2018 Jul 1;3(4):833-840. Epub 2018 Mar 1.

Internal Medicine, Rambam Health Care Campus, Haifa, Israel.

Introduction: Acute kidney injury associated with near-drowning (ND-AKI) has rarely been reported and its incidence among survivors is unknown. A patient with AKI and urine biomarkers indicating tubular injury led us to assess the occurrence and clinical characteristics of ND-AKI and to evaluate possible causative mechanisms.

Methods: We evaluated medical records of patients rescued from near-drowning in the Mediterranean Sea and treated in a tertiary-level medical center during 2000 to 2017. Read More

Clin Neurol Neurosurg 2018 Sep 30;172:96-98. Epub 2018 Jun 30.

Department of Neurology, Paracelsus Medical University, Salzburg, Austria; Karl Landsteiner Institute for Neurorehabilitation and Space Neurology, Vienna, Austria; Neuroscience Institute, Christian-Doppler-Klinik, Paracelsus Medical University, Salzburg, Austria.

Clinical Case: We report on a 19-year old male patient who is recovering from near-drowning. The patient was admitted for re-evaluation in a Minimally Conscious State.

Method: A regular functional Magnetic Resonance Imaging was not possible due to complex motor tics of the patient with sudden flexion and extension movements of arms and legs as well as opisthotonic retroflexion of the head and trunk. Read More

J Crit Care Med (Targu Mures) 2018 Jan 9;4(1):12-16. Epub 2018 Feb 9.

Ondokuz Mayıs University School of Medicine, Division of Pediatric Critical Care, Samsun, Turkey.

Introduction: Brain death is currently defined as the loss of full brain function including the brainstem. The diagnosis and its subsequent management in the pediatric population are still controversial. The aim of this study was to define the demographic characteristics, clinical features and outcomes of patients with brain death and determine the incidence of brain death, donation rates and occurrence of central diabetes insipidus accompanying brain death in children. Read More

MMW Fortschr Med 2018 Jun;160(12):50-51

Schwarzwald-Baar Klinikum, Klinikstr. 11, D-78052, Villingen Schwenningen, Deutschland.

Epilepsia 2018 06 23;59(6):1220-1233. Epub 2018 May 23.

Epilepsy Center, Department of Neurology, NYU School of Medicine, New York, NY, USA.

Objective: To examine the consistency of applying the Nashef et al (2012) criteria to classify sudden unexpected death in epilepsy (SUDEP).

Methods: We reviewed cases from the North American SUDEP Registry (n = 250) and Medical Examiner Offices (n = 1301: 698 Maryland, 457 New York City, 146 San Diego). Two epileptologists with expertise in SUDEP and epilepsy-related mortality independently reviewed medical records, scene investigation, autopsy, and toxicology and assigned a SUDEP class. Read More

Int J Environ Res Public Health 2018 04 15;15(4). Epub 2018 Apr 15.

Critical Care Unit, University Hospital of Martinique, 97200 Martinique, French West Indies.

Int J Environ Res Public Health 2018 04 10;15(4). Epub 2018 Apr 10.

Sociedade Brasileira de Salvamento Aquático, Barra da Tijuca, Rio de
Janeiro RJ 22631-004, Brazil.

We read with great interest the recent paper by Cerland et al. on the frequency, nature, and consequences of post-drowning pneumonia[.. Read More

Arch Dis Child 2018 Aug 23;103(8):784-789. Epub 2018 Mar 23.

Department of Paediatric Surgery, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.

Objective: To investigate long-term neurocognitive outcomes after a near-drowning incident in children who were deemed neurologically intact on discharge from hospital.

Design: A prospective cohort study of near-drowning children.

Setting: 95 drowning and near-drowning admissions, 0-16 years of age, from January 2009 to December 2013, to The Children's Hospital at Westmead, Sydney, NSW, Australia. Read More

Cureus 2017 Dec 26;9(12):e1990. Epub 2017 Dec 26.

Emergency Medicine, Memorial University of Newfoundland.

Newfoundland and Labrador (NL) has one of the highest provincial drowning rates in Canada, largely due to the many rural communities located near bodies of water. Factor in the province's cold climate (average NL's freshwater temperature is below 5.4°C)and the prevalence of winter recreational activities among the population, there exists an inherent risk of ice-related injuries and subsequent hypothermia. Read More

J Pharmacol Exp Ther 2018 May 28;365(2):408-412. Epub 2018 Feb 28.

Service de Pharmacologie-Toxicologie-Centre Régional de Pharmacovigilance, Institut de Biologie en Santé (B.L., M.B., B.D.), MITOVASC, UMR CNRS 6214, Inserm 1083, Université d'Angers (M.B.), Micro- et Nanomédecines Biomimétiques, UMR INSERM 1066-CNRS 6021, Université d'Angers (J.R.), and Laboratoire de Parasitologie-Mycologie, Institut de Biologie en Santé (J.-P.B.), Centre Hospitalier Universitaire, Angers, France; Groupe d'Etude des Interactions Hôte-Pathogène (EA 3142), Université d'Angers, Université de Bretagne Occidentale, Institut de Biologie en Santé, Angers, France (B.L., C.G., P.L., P.V., J.-P.B., B.D.); and Service Commun de l'Animalerie Hospitalo-Universitaire, Université d'Angers, Angers, France (P.L.).

Cerebral infections usually occur in lung transplant recipients as well as in immunocompetent patients in the context of near drowning. Voriconazole is the first-line treatment. The diffusion of voriconazole through the blood-brain barrier in the context of cerebral infection and cyclosporine administration is crucial and remains a matter of debate. Read More

Injury 2018 Mar 13;49(3):543-548. Epub 2018 Feb 13.

Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon; Emergency Medical Services and Prehospital Care Program, American University of Beirut Medical Center, Beirut, Lebanon. Electronic address:

Introduction: Drowning leads to 372,000 deaths annually worldwide and to severe morbidity secondary to asphyxiation or aspiration. Previous studies described submersion injuries mainly in the pediatric population. This study describes characteristics of patients presenting with submersion injuries to United States emergency departments (EDs) and identifies predictors of poor outcomes (death or long term neurologic deficits) after drowning. Read More

Resuscitation 2018 May 13;126:191-196. Epub 2018 Feb 13.

Division of Critical Care Medicine, Nationwide Children's Hospital, Columbus, OH, United States; Department of Paediatrics, The Ohio State University College of Medicine, Columbus, OH, United States.

Aim: To describe the cerebral blood flow velocity pattern and investigate cerebral autoregulation using transcranial Doppler ultrasonography (TCD) following a global hypoxic-ischaemic (HI) event in children.

Methods: This was a prospective, observational study in a quaternary-level paediatric intensive care unit. Intubated children, newborn to 17 years admitted to the PICU following HI injury (asphyxia, drowning, cardiac arrest) were eligible for inclusion. Read More

Children (Basel) 2018 Feb 8;5(2). Epub 2018 Feb 8.

Department of Paediatrics, R. D. Gardi Medical College, Ujjain 456006, India.

Injuries are a major global public health problem. There are very few community-based studies on childhood injury from India. The objective of this cross-sectional, community-based survey was to identify the incidence, type, and risk factors of unintentional childhood injuries. Read More

Pediatr Emerg Care 2018 Feb 5. Epub 2018 Feb 5.

Objective: Drowning is a leading cause of death among infants and toddlers. Unique physiological and behavioral factors contribute to high mortality rates. Drowning incidents predominantly occur during warmer months and holidays. Read More

BMJ Case Rep 2018 Feb 1;2018. Epub 2018 Feb 1.

Department of Nephrology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.

We present a case of a 51-year-old man who went to the emergency department after an almost-drowning episode, presenting with muscular weakness, myalgia and dark urine. Laboratory data showed a severe rhabdomyolysis (creatine kinase 497 510 U/L). Despite aggressive fluid therapy, an oliguric acute kidney injury was established with temporary need of haemodialysis. Read More

Clin Infect Dis 2018 Jan;66(2):314-315

Department of Infectious Disease, Huashan Hospital, Fudan University, Shanghai, China.

Clin Infect Dis 2018 Jan;66(2):312-313

Inj Epidemiol 2017 Dec 8;4(1):32. Epub 2017 Dec 8.

Department of Epidemiology, Columbia University Mailman School of Public Health, DrPH; 622 West 168th St, New York, NY, PH5-505, USA.

Background: The reported prevalence of autism spectrum disorder (ASD) has increased markedly in the past two decades. Recent research indicates that children with ASD are at a substantially increased risk of injury mortality, particularly from unintentional drowning. The purpose of this study was to explore the circumstances of fatal unintentional drowning incidents involving children with ASD under 15 years of age. Read More

Int J Environ Res Public Health 2017 11 17;14(11). Epub 2017 Nov 17.

Intensive Care Unit, University Hospital of Martinique, Fort-de-France, 97261 Martinique, France.

Drowning represents one major cause of accidental death. Near-drowning patients are exposed to aspiration that may result in pneumonia with life-threatening consequences. We designed this descriptive study to investigate the frequency, nature, and consequences of post-drowning pneumonia. Read More

Air Med J 2017 Nov - Dec;36(6):339-340. Epub 2017 Sep 12.

University of South Florida, Tampa, FL.

Pediatr Ann 2017 Oct;46(10):e354-e357

Drowning is a leading cause of death in children and is highly preventable. More than 10 people die of drowning in the United States each day, most of them adults. Rates of drowning are highest in children given their developmental vulnerabilities. Read More

Am J Emerg Med 2018 Mar 4;36(3):446-449. Epub 2017 Sep 4.

Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL, United States.

Ugeskr Laeger 2017 Aug;179(35)

This article summarizes the current knowledge of drowning-induced hyperfibrinolytic disseminated intravascular coagulation. Drowning induces respiratory failure with ensuing cardiac arrest, hypoxaemia and ischaemia. A coagulopathy is induced by ischaemia, acidosis and hypothermia, and clinically the patient develops uncontrolled bleeding due to hyperfibrinolysis. Read More

Acad Emerg Med 2017 12 23;24(12):1491-1500. Epub 2017 Sep 23.

Department of Pediatrics, Baylor College of Medicine, Houston, TX.

Objectives: Pediatric submersion victims often require admission. We wanted to identify a cohort of children at low risk for submersion-related injury who can be safely discharged from the emergency department (ED) after a period of observation.

Methods: This was a single-center retrospective derivation/validation cross-sectional study of children (0-18 years) who presented postsubmersion to a tertiary care, children's hospital ED from 2008 to 2015. Read More

Hum Brain Mapp 2017 10 17;38(10):4832-4833. Epub 2017 Aug 17.

The Brain and Mind Institute, The University of Western Ontario, Canada.

A growing body of evidence has confirmed that, after severe brain injury in adults, motoric and task-dependent factors that are essential for reliable communication, frequently interfere with an accurate assessment of cognitive status. In the current study, resting state functional magnetic resonance imaging (fMRI) in children who have sustained an anoxic brain injury following a near drowning incident suggests a similar pattern; preserved cognition amidst severe motoric impairment that effectively precludes accurate clinical diagnosis at the bedside. Hum Brain Mapp 38:4832-4833, 2017. Read More

Proc Natl Acad Sci U S A 2017 08 31;114(33):E6759-E6766. Epub 2017 Jul 31.

Max Planck Institute for Chemistry, 55128 Mainz, Germany.

The continental shelves are the most biologically dynamic regions of the ocean, and they are extensive worldwide, especially in the western North Pacific. Their area has varied dramatically over the glacial/interglacial cycles of the last million years, but the effects of this variation on ocean biological and chemical processes remain poorly understood. Conversion of nitrate to N by denitrification in sediments accounts for half or more of the removal of biologically available nitrogen ("fixed N") from the ocean. Read More

Ci Ji Yi Xue Za Zhi 2016 Oct-Dec;28(4):180-182. Epub 2016 Sep 15.

Department of Pediatrics, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.

A 1-year-10-month-old boy was admitted to our pediatric intensive care unit due to near drowning with pulmonary edema. A conventional ventilator with 100% oxygen supplementation was used initially, but was shifted to high frequency oscillatory ventilation as his oxygen saturation was around 84-88%. Therapeutic hypothermia was applied due to hypoxic ischemic encephalopathy with severe acidosis. Read More

Br J Nurs 2017 Jul;26(14):790

Consultant paediatrician, Torbay Hospital.

Med Gas Res 2017 Apr-Jun;7(2):144-149. Epub 2017 Jun 30.

Department of Radiology, University of North Dakota School of Medicine, Bismarck, ND, USA.

A 2-year-old girl experienced cardiac arrest after cold water drowning. Magnetic resonance imaging (MRI) showed deep gray matter injury on day 4 and cerebral atrophy with gray and white matter loss on day 32. Patient had no speech, gait, or responsiveness to commands on day 48 at hospital discharge. Read More

Scand J Trauma Resusc Emerg Med 2017 Jul 17;25(1):72. Epub 2017 Jul 17.

Tulane University School of Medicine, Tulane University, 1430 Tulane Ave, 70112, New Orleans, LA, USA.

Background: In 2002, the World Congress on Drowning developed a uniform definition for drowning. The aim of this study is to determine the prevalence of "non-uniform drowning terminology" (NUDT) and "non-uniform drowning definitions" (NUDD) in peer-reviewed scientific literature from 2010 to 2016, and compare these findings with those from our unpublished study performing a similar analysis on literature from 2003 to 2010.

Methods: A systematic review was performed using drowning-specific search terms in Pubmed and Web of Science. Read More

Int J Inj Contr Saf Promot 2018 Mar 13;25(1):78-84. Epub 2017 Jul 13.

a Coaching and Teaching Studies, West Virginia University , Morgantown , WV , USA.

There have been long-standing calls to better educate the public at large on risks of drowning; yet limited evaluation has taken place on current resources in circulation. The purpose of this qualitative research is to develop an understanding of the content in currently circulated drowning prevention resources in the United States. Data points (n = 451) consisting of specific content within 25 different drowning prevention educational resources were analyzed using document analysis methods; a grounded theory approach was employed to allow for categorical development and indexing of the data. Read More

J Surg Res 2017 09 1;217:244-245. Epub 2017 Jul 1.

EPI-Unit, Institute of Public Health, University of Porto, Porto, Portugal; International Drowning Research Alliance.

Resuscitation 2017 Sep 29;118:e3-e4. Epub 2017 Jun 29.

Neurophysiatric Department, Scientific Institute "Eugenio Medea", Bosisio Parini, Lecco, Italy.

J Surg Res 2017 09 27;217:246. Epub 2017 Jun 27.

Division of Pediatric Surgery, Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee; Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, Tennessee. Electronic address:

Am J Emerg Med 2017 Dec 15;35(12):1887-1891. Epub 2017 Jun 15.

REMOSS Research Group, Lifesaving and Motor Skill, Faculty of Education and Sport Sciences, University of Vigo, Pontevedra, Spain; CLINURSID Research Group, Psychiatry, Radiology and Public Health Department, University of Santiago de Compostela, Santiago de Compostela, Spain; Institute of Research of Santiago (IDIS), Spain; Faculty of Educational Sciences, University of Santiago de Compostela, Santiago de Compostela, Spain.

Purpose: The aim of this study is to compare the effectiveness of active recovery in form of running or foam rolling on clearing blood lactate compared to remain sitting after a water rescue.

Method: A quasi experimental cross-over design was used to test the effectiveness of two active recovery methods: foam rolling (FR) and running (RR), compared with passive recovery (PR) on the blood lactate clearance after performing a water rescue. Twelve lifeguards from Marín (Pontevedra) completed the study. Read More