Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
권호 표지
DOI QR코드

DOI QR Code

The Utility of Non-Invasive Nasal Positive Pressure Ventilation for Acute Respiratory Distress Syndrome in Near Drowning Patients

  • Kim, June Hyeong (Department of Emergency Medicine, Chosun University College of Medicine) ;
  • Sun, Kyung Hoon (Department of Emergency Medicine, Chosun University College of Medicine) ;
  • Park, Yong Jin (Department of Emergency Medicine, Chosun University College of Medicine)
  • Received : 2019.06.07
  • Accepted : 2019.08.06
  • Published : 2019.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: Near drowning refers to immediate survival after asphyxia due to submersion or immersion in water, which is a crucial public safety problem worldwide. Acute lung injury or acute respiratory distress syndrome (ARDS) is a common complication of near drowning. The purpose of this study was to investigate the feasibility and effectiveness of noninvasive nasal positive pressure ventilation (NINPPV). Methods: This retrospective study was conducted at a tertiary emergency department. NINPPV was administered for moderate ARDS caused by submersion or immersion in patients who were older than 18 years, from January 2015 to December 2018. We collected the demographic (age, sex, length of hospital stay, and outcome), laboratory (arterial blood gas, lactate, oxygen saturation, partial pressure of oxygen divided by the fraction of inspired oxygen, complete blood count, blood urea nitrogen, and creatinine), and clinical data (acute lung injury index and ventilator failure) of the patients. A statistical analysis was performed using Statistical Package for the Social Sciences version 20.0 for Windows. Results: NINPPV treatment was provided to 57 patients for near drowning, 45 of whom (78.9%) were successfully treated without complications; in 12 (21.1%), treatment was changed to invasive mechanical ventilation within 48 hours due to ARDS or acute kidney injury. NINPPV treatment was successful in 31 (75.6%) out of 41 sea-water near drowning patients. They were more difficult to treat with NINPPV compared with the fresh-water near drowning patients (p<0.05). Conclusions: NINPPV would be useful and feasible as the initial treatment of moderate ARDS caused by near drowning.

Keywords

References

  1. Moon RE, Long RJ. Drowning and near-drowning. Emerg Med (Fremantle) 2002;14:377-86. https://doi.org/10.1046/j.1442-2026.2002.00379.x
  2. Azzorina R, Camera GL, Messina A, Fioino LS, Chiarenza F, Francesco AD, et al. Pathophysiology, prevention and treatment of drowing syndrome. Acta Medica Mediterranea 2011;27:31-3.
  3. Szpilman D, Bierens JJ, Handley AJ, Orlowski JP. Drowning. N Engl J Med 2012;366:2102-10. https://doi.org/10.1056/NEJMra1013317
  4. Kim JH. New definition of acute respiratory distress syndrome. Korean J Crit Care Med 2013;28:10-6. https://doi.org/10.4266/kjccm.2013.28.1.10
  5. Weiss CH, McSparron JI, Chatterjee RS, Herman D, Fan E, Wilson KC, et al. Summary for clinicians: mechanical ventilation in adult patients with acute respiratory distress syndrome clinical practice guideline. Ann Am Thorac Soc 2017;14:1235-8. https://doi.org/10.1513/AnnalsATS.201704-332CME
  6. Bellani G, Laffey JG, Pham T, Madotto F, Fan E, Brochard L, et al. Noninvasive ventilation of patients with acute respiratory distress syndrome. Insights from the LUNG SAFE study. Am J Respir Crit Care Med 2017;195:67-77. https://doi.org/10.1164/rccm.201606-1306OC
  7. Mosier JM, Hypes C, Joshi R, Whitmore S, Parthasarathy S, Cairns CB. Ventilator strategies and rescue therapies for management of acute respiratory failure in the emergency department. Ann Emerg Med 2015;66:529-41. https://doi.org/10.1016/j.annemergmed.2015.04.030
  8. Gorelik Y, Darawshi S, Yaseen H, Abassi Z, Heyman SN, Khamaisi M. Acute renal failure following near-drowning. Kidney Int Rep 2018;3:833-40. https://doi.org/10.1016/j.ekir.2018.02.007
  9. Fan E, Del Sorbo L, Goligher EC, Hodgson CL, Munshi L, Walkey AJ, et al. An official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine clinical practice guideline: mechanical ventilation in adult patients with acute respiratory distress syndrome. Am J Respir Crit Care Med 2017;195:1253-63. https://doi.org/10.1164/rccm.201703-0548ST
  10. Parke RL, Eccleston ML, McGuinness SP. The effects of flow on airway pressure during nasal high-flow oxygen therapy. Respir Care 2011;56:1151-5. https://doi.org/10.4187/respcare.01106
  11. Ou X, Hua Y, Liu J, Gong C, Zhao W. Effect of high-flow nasal cannula oxygen therapy in adults with acute hypoxemic respiratory failure: a meta-analysis of randomized controlled trials. CMAJ 2017;189:E260-7. https://doi.org/10.1503/cmaj.160570
  12. Cerland L, Megarbane B, Kallel H, Brouste Y, Mehdaoui H, Resiere D. Incidence and consequences of near-drowningrelated pneumonia-A descriptive series from Martinique, French West Indies. Int J Environ Res Public Health 2017;14:E1402. https://doi.org/10.3390/ijerph14111402
  13. Jin F, Li C. Seawater-drowning-induced acute lung injury: from molecular mechanisms to potential treatments. EXP Ther Med 2017;13:2591-8. https://doi.org/10.3892/etm.2017.4302
  14. Kim KI, Lee WY, Kim HS, Jeong JH, Ko HH. Extracorporeal membrane oxygenation in near-drowning patients with cardiac or pulmonary failure. Scand J Trauma Resusc Emerg Med 2014;22:77. https://doi.org/10.1186/s13049-014-0077-8
  15. Stachon P, Kalbhenn J, Walterspacher S, Bode C, Staudacher D. Near-drowning with good outcome after ECMO-therapy and therapeutic hypothermia despite 20 minutes of anoxia and 16 hours of hypoxia. Dtsch Med Wochenschr 2017;142:596-600. https://doi.org/10.1055/s-0043-101530
  16. Weuster M, Haneya A, Panholzer B, Kluter T, van der Brelie M, van Laak U, et al. The use of extracorporeal membrane oxygenation systems in severe accidental hypothermia after drowning: a centre experience. ASAIO J 2016;62:157-62. https://doi.org/10.1097/MAT.0000000000000312
  17. Amir A, Lee YL. A case of acute kidney injury by near-drowning. Malays Fam Physician 2013;8:34-6.
  18. Seong EY, Rhee H, Lee N, Lee SJ, Song SH, Lee DW, et al. A case of severe acute kidney injury by near-drowning. J Korean Med Sci 2012;27:218-20. https://doi.org/10.3346/jkms.2012.27.2.218
  19. Alp A, Akdam H, Meteoglu I, Unsal A, Akar H, Yenicerioglu Y. Acute kidney injury after near drowning: the way from the beach to hemodialysis. Hemodial Int 2016;20:E1-4.

Cited by

  1. Treatment of the lung injury of drowning: a systematic review vol.25, 2019, https://doi.org/10.1186/s13054-021-03687-2