Severe Metabolic Acidosis and Pulmonary Edema: A Near-Drowning Case

• Main Authors: Yasemin Çoban, Mehmet Davutoğlu
• Format: Article
• Language: English
• Published: Galenos Yayinevi 2018-03-01
• Series: Journal of Pediatric Research
• Subjects: Near-drowning; child; pulmonary edema
• Online Access: http://jpedres.org/archives/archive-detail/article-preview/severe-metabolic-acidosis-and-pulmonary-edema-a-ne/16908

Drowning is defined as a situation which results in the death of the patient within the first 24 hours, while “near-drowning” refers to all conditions of submersion which does not cause death but brings about morbidity and damaging effects. A twenty-five-month-old boy was found immobile in a bathtub filled with water. The patient was transported to the intensive care unit from the emergency department where he vas ventilated with a bag-mask, then intubated, and diagnosed with respiratory insufficiency, and his respiration was supported by mechanical ventilator. Physical examination of the patient showed that he was hypothermic, not breathing spontaneously, his heart rate was 120/min., blood pressure 100/80 mmHg, he was unconscious, and Glasgow Coma scale was 5. The first blood analysis results were mmol/L. The pulmonary edema regressed, cardiopulmonary hemodynamic returned to normal. Then, at the 48th hour he was weaned from mechanical ventilator support. The patient was discharged from the hospital in good health, without negative cognitive and motor symptoms on the 10th day. The present case report aimed to highlight the importance of basic and advanced life support in cases of near-drowning which happens frequently among children, and to discuss the management of pulmonary edema and other complications.