ABSTRACT
OBJECTIVE: To evaluate the occurrence of the adult respiratory distress syndrome (ARDS), and of hypothermia as a predictor of outcome in cases of submersion injury in children. DESIGN: Retrospective analysis. PATIENTS: All drowning cases admitted to the Intensive Care Unit of the Wilhelmina Children's Hospital in Utrecht between January 1986 and January 1993. RESULTS: There were 45 patients, 29 boys and 16 girls, aged 0-13 years. Hypothermia was related to the duration of submersion and did not correlate with a good outcome. Asystole on arrival at the hospital was associated with demise in all but one patient, who was left with severe neurological impairment. ARDS occurred in 27/45 patients (60%), all within 6 h following admission. Of the 45 patients treated, 11 died. Of the 34 survivors, 7 were discharged from the Intensive Care Unit with neurological sequelae (2 with mild, 5 with serious sequelae). CONCLUSION: In our patients with drowning accidents, hypothermia did not appear to provide any protective effect. ARDS, if it occurred, became evident within 6 h after admission.
Subject(s)
Hypothermia/physiopathology , Near Drowning/physiopathology , Pulmonary Edema/physiopathology , Adolescent , Body Temperature , Child , Child, Preschool , Female , Humans , Infant , Male , Near Drowning/mortality , Prognosis , Retrospective Studies , Time FactorsABSTRACT
An infant with an unusual presentation of Infantile Myofibromatosis (IM) is presented. Massive involvement of the pelvic region complicated the delivery and precluded meaningful therapy. The literature is reviewed.
