Subject(s)
Brain Death , Pediatrics/history , Brain Death/diagnosis , Brain Death/legislation & jurisprudence , Child , Critical Care/history , Cultural Characteristics , Ethics, Medical , Female , History, 20th Century , History, Ancient , History, Medieval , Humans , Male , Religion and Medicine , Sociology, Medical , Tissue and Organ ProcurementABSTRACT
The incidence, epidemiology, and pathophysiology of drowning and near-drowning are presented. Particular attention is paid to the neurologic and pulmonary pathophysiology indicators for monitoring and laboratory tests. Special attention to transportation of patients is given, and treatment in the field, emergency department, and pediatric intensive care unit is delineated.
Subject(s)
Critical Care/methods , Drowning , Near Drowning , Pediatrics/methods , Adolescent , Age Factors , Cardiopulmonary Resuscitation/methods , Child , Child, Preschool , Drowning/epidemiology , Drowning/physiopathology , Female , Humans , Incidence , Infant , Infant, Newborn , Intensive Care Units, Pediatric/statistics & numerical data , Male , Near Drowning/epidemiology , Near Drowning/physiopathology , Near Drowning/therapy , Outcome Assessment, Health Care , Oxygen Inhalation Therapy/methods , Respiration, Artificial/methods , Risk Factors , Sex Factors , Terminology as Topic , Transportation of Patients/methodsABSTRACT
Since the effects of prostaglandin synthetase inhibitors on the developing human fetal pulmonary vasculature are unknown, we studied the lungs of two infants, one whose mother took salicylates and the other whose mother took indomethacin during pregnancy. Lungs were fixed by perfusion and fifth generation (resistance) vessels identified. The infant with chronic exposure to aspirin had premature constriction of the ductus arteriosus, tricuspid insufficiency, increased pulmonary arterial medial width/external diameter ratio due to increased smooth muscle, and a decreased number of pulmonary vessels/cm2 lung tissue. The infant with short-term exposure to indomethacin had hypoxemia, increased pulmonary arterial m/d ratio due to increased smooth muscle, and a normal number of pulmonary vessels/cm2 lung tissue. These abnormalities may be due to the effects of prostaglandin synthetase inhibitor drugs on the ductus arteriosus and/or the pulmonary vessels of the human fetus.
