Near-Drowning in Pediatric Respiratory Intensive Care Unit, Siriraj Hospital
Chakraphan Susiva MD*, Thitima Boonrong MD*
Affiliation : *Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
Objectives : To study characteristics, treatment and outcome of near-drowning patients in Pediatric Respira-
tory Care Unit (P-RCU), Siriraj Hospital
Materials and Methods : We retrospectively reviewed hospital records of 31 near-drowning patients admitted
at P-RCU Siriraj Hospital during 1990-2002.
Results : The average age of admitted patients was 4 years (ranged from 6 months to 13 years). Seventy percent
of the patients were under 5 years of age. Male: female ratio was 2.1:1. Sixty-two percents of the patients were
left alone when near-drowning occurred. The sites of occurrence were around their houses in 60% of cases.
Bystander resuscitation was documented in 35%. Common complications were pneumonia (74.2%) and
seizure (58%). Patients with poor outcome were children without spontaneous purposeful movement within
24 hours after submersion. Neurological sequelae was found in 35.5% of the cases and the mortality rate was
25.8% (3 due to severe pneumonia from prolonged intubation and aspiration, 2 due to severe brain hypoxia,
2 due to severe adult respiratory distress syndrome (ARDS) and 1 due to intracerebral hemorrhage)
Conclusion : Due to poor outcome observed in this study, prevention of submersion injury is the most impor-
tant and cost-effective measure. However, if near-drowning happens, effective immediate resuscitation is
crucial for the best outcome.
Keywords : Near-drowning children, RCU, Cardiopulmonary resuscitation
