Verdrinking en bijna-verdrinking bij kinderen

- Drowning and near-drowning are major causes of death and neurological damage, respectively, in children.

- The pathophysiological substrate consists of hypoxia, ischaemia, respiratory and metabolic acidosis and sometimes, hypothermia.

- Most cases involve aspiration of liquid; this leads to a persistent impairment of the gas exchange. Occurrence of arrhythmias and hypovolaemia is very likely.

- The main objective of treatment of the near-drowned is limiting cerebral damage.

- Treatment consists of resuscitation and stabilization, administration of oxygen with positive end-expiratory pressure, intravenous administration of liquids and central reheating.

- The prognosis depends in the first place on the duration of the submersion, which, however, is often difficult to establish. Submersion for over 5 minutes is prognostically unfavourable.

- In hypothermia due to submersion in icecold water the prognostic factors are less clear - in these cases the treatment should always be continued until the core temperature is ≥ 32°C.