SUBMERSION IN THE NETHERLANDS - PROGNOSTIC INDICATORS AND RESULTS OF RESUSCITATION

被引:32
作者
BIERENS, JJLM
VANDERVELDE, EA
VANBERKEL, M
VANZANTEN, JJ
机构
[1] Intensive and Respiratory Care Unit, Department of Internal Medicine, University Hospital Leiden (AZL), Leiden
[2] Department of Anaesthesiology, University Hospital Leiden (AZL), Leiden
[3] Department of Medical Statistics, State University of Leiden, Leiden
关键词
drowning; near-drowning; resuscitation; submersion;
D O I
10.1016/S0196-0644(05)82604-6
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Study objectives: To analyze prognostic indicators and the outcome of resuscitation in submersion victims (drowning and near drowning). Design: Retrospective study. Setting: Intensive and Respiratory Care Unit. Between January 1, 1979, and December 31, 1985, 87 submersion victims were admitted. The files of 83 victims were available for statistical analysis. There were 66 male victims and 17 female victims; the average age was 31.4 ± 25.8 years. There were ten salt water and 73 fresh water submersions. Measurements and main results: Predictors for better survival potentials were a young age, submersion of less than ten minutes, no signs of aspiration, and a central body temperature of less than 35 C at admission. We did not detect factors that accelerated a decrease in core body temperature at admission and assume that lethal hypoxia had preceded protective hypothermia in our submersion victims. The Orlowski score had a predictive value but at the same time we found nonindependent indicators in this score. Neurologic outcome in our patients, who were not treated according to a brain protection protocol, was not worse than the outcome published by authors who have used such a protocol. Thirty-three percent of the victims with a cardioventilatory arrest (15) and all victims with a ventilatory arrest (11) survived resuscitation and were discharged. Five nonarrest victims died due to late complications. Conclusion: This study shows that no indicator at the rescue site and in the hospital is absolutely reliable with respect to death or survival. © 1990 American College of Emergency Physicians.
引用
收藏
页码:1390 / 1395
页数:6
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