Drowning incidents involve two million people each year, mostly children and young adults, and lead to 400,000 deaths worldwide. Acute respiratory distress syndrome (ARDS) is the leading cause of death in the patients that are successfully rescued. Whereas the literature on the use of cardiac bypass for rewarming hypothermic patients in cardiac arrest (CA) after drowning is abundant, evidence on the use of extra corporeal membrane oxygenation (ECMO) for the treatment of ARDS secondary to water aspiration is scarce. We report the case of a patient who was rescued in CA after a drowning attempt and presented with a refractory ARDS after return of spontaneous circulation, successfully treated with ECMO.
Layon AJ, Modell JH. Drowning: Update 2009. Anesthesiology 2009; 110:1390-401.
Salomez F, Vincent J-L. Drowning: a review of epidemiology, pathophysiology, treatment and prevention. Resuscitation 2004; 63:261-8.
Fanelli V, Vlachou A, Ghannadian S, Simonetti U, Slutsky AS, Zhang H. Acute respiratory distress syndrome: new definition, current and future therapeutic options. J Thorac Dis 2013; 5:326-34.
Briel M, Meade M, Mercat A, Brower RG, Talmor D, Walter SD, et al. Higher vs lower positive end-expiratory pressure in patients with acute lung injury and acute respiratory distress syndrome: systematic review and meta-analysis. JAMA 2010; 303:865-73.
Diamond W, MacDonald RD. Submersion and early-onset acute respiratory distress syndrome: a case report. Prehospital Emerg Care. 2011; 15:288-93.
Walsh BK, Daigle B, DiBlasi RM, Restrepo RD; American Association for Respiratory Care. Clinical Practice Guideline. Surfactant replacement therapy: 2013. Respir Care 2013; 58:367-75.
Peek GJ, Mugford M, Tiruvoipati R, Wilson A, Allen E, Thalanany MM, et al. Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trial. Lancet 2009; 374:1351-63.
Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med 2013; 39:165-228.
Coskun KO, Popov AF, Schmitto JD, Hinz J, Kriebel T, Schoendube FA, et al. Extracorporeal circulation for rewarming in drowning and near-drowning pediatric patients. Artif Organs 2010; 34:1026-30.
Wang CH, Chou CC, Ko WJ, Lee YC. Rescue a drowning patient by prolonged extracorporeal membrane oxygenation support for 117 days. Am J Emerg Med 2010; 28:750.e5-7.
Beurtheret S, Mordant P, Paoletti X, Marijon E, Celermajer DS, Léger P, et al. Emergency circulatory support in refractory cardiogenic shock patients in remote institutions: a pilot study (the cardiac-RESCUE program). Eur Heart J 2013; 34:112-20.