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Drowning pp 545–560Cite as

Pathophysiology of Drowning

Abstract

Several chapters in this book have described in great detail the specific pathophysiological aspects that may occur during drowning. This chapter provides an integral overview of the immediate pathophysiology of drowning, based on selected drowning scenarios. Late complications are not addressed.

Keywords

  • Cardiac Arrest
  • Acute Respiratory Distress Syndrome
  • Cold Shock
  • Breath Holding
  • Brain Cool

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Fig. 85.1
Fig. 85.2

References

  1. Lunetta P, Modell JH, Sajantila A et al (2004) What is the incidence and significance of “dry-lungs” in bodies found in water? Am J Forensic Med Pathol 25:291–301

    CrossRef  PubMed  Google Scholar 

  2. Lunetta P, Levo A, Laitinen PJ et al (2003) Molecular screening of selected long QT syndrome (LQTS) mutations in 165 consecutive bodies found in water. Int J Legal Med 117:115–1173

    CrossRef  PubMed  Google Scholar 

  3. Tester DJ, Madeiros-Domingo A, Will ML et al (2011) Unexplained drowning and the cardiac channelopathies: a molecular autopsy series. Mayo Clin Proc 86:941–947

    CrossRef  PubMed Central  CAS  PubMed  Google Scholar 

  4. Parker MJ (2005) Breathhold and its breakpoint. Exp Physiol. doi:10.1113/expphysiol.2005.031625

  5. Stallinger A, Wenzel V, Oroszy S et al (2001) The effect of different mouth-to-mouth ventilation tidal volumes on gas exchange during simulated rescue breathing. Anesth Anal 93:1265–1269

    CrossRef  CAS  Google Scholar 

  6. Lindholm P, Lundgren CE (2009) The physiology and pathophysiology of human breath-hold diving. J Appl Physiol 106:284–292

    CrossRef  PubMed  Google Scholar 

  7. Hayashi N, Isihara M, Tanaka A et al (1997) Face immersion increases vagal activity as assessed by heart rate variability. Eur J Appl Physiol 76:394–399

    CrossRef  CAS  Google Scholar 

  8. Garbella E, Catapano G, Pratali L et al (2011) Pulmonary edema in healthy subjects in extreme conditions. Pulm Med 2011:275857

    CrossRef  PubMed Central  PubMed  Google Scholar 

  9. Hansel J, Solleder I, Gfroerer W et al (2009) Hypoxia and cardiac arrhythmias in breath-hold divers during voluntary immersed breath-holds. Eur J Appl Physiol 105:673–678

    CrossRef  PubMed  Google Scholar 

  10. Datta A, Tipton MJ (2006) Respiratory responses to cold water immersion: neural pathways, interactions and clinical consequences. J Appl Physiol 100:2057–2064

    CrossRef  PubMed  Google Scholar 

  11. Hochachka PW, Gunga HC, Kirsch K (1998) Our ancestral physiological phenotype: an adaptation for hypoxia tolerance and for endurance performance. Proc Nat Acad Sci 95:1915–1920

    CrossRef  PubMed Central  CAS  PubMed  Google Scholar 

  12. Alboni P, Alboni M, Gianfranchi L (2011) Diving bradycardia: a mechanism of defence against hypoxic damage. J Cardiovasc Med 12:422–427

    CrossRef  Google Scholar 

  13. Kjeld T, Pott FC, Secher NH (2009) Facial immersion in cold water enhances cerebral blood velocity during breath-hold exercises in humans. J Appl Phyiol 106:1243–1248

    CrossRef  CAS  Google Scholar 

  14. Schaller B (2004) Trigeminocardiac reflex. A new phenomenon or a new physiological entity. J Neurol 251:658–665

    CrossRef  CAS  PubMed  Google Scholar 

  15. Sandu N, Sadr-Eshkevari P, Schaller BJ (2011) Usefulness of case reports to improve medical knowledge regarding trigemino-cardiac reflex in skull base surgery. J Med Case Reports 5:149–151

    CrossRef  PubMed Central  Google Scholar 

  16. Lindholm P, Sundblad P, Linnarsson D (1999) Oxygen-conserving effects of apnea in exercising men. J Appl Physiol 87:2122–2127

    CAS  PubMed  Google Scholar 

  17. Foster GE, Sheel AW (2005) The human diving response, its function, and its control. Scand J Med Sci Sports 15:3–12

    CrossRef  CAS  PubMed  Google Scholar 

  18. Andersson J, Schagatay E (1998) Effects of lung volume and involuntary breathing movements on the human diving response. Eur J Appl Physiol 77:19–24

    CrossRef  CAS  Google Scholar 

  19. Conn AW, Miyasaka K, Katayama M et al (1995) A canine study of cold water drowning in fresh versus salt water. Crit Care Med 12:2029–2037

    CrossRef  Google Scholar 

  20. Golden FSC, Tipton MJ, Scott RC (1997) Immersion, near-drowning and drowning. BJA 79:214–225

    CrossRef  CAS  PubMed  Google Scholar 

  21. Tipton JM, Golden FSTC (2011) A proposed decision making guide for the search, rescue and resuscitation (head under) victims based on expert opinion. Resuscitation 82:819–824

    CrossRef  PubMed  Google Scholar 

  22. Shattock MJ, Tipton MJ (2012) ‘Autonomic conflict’: a different way to die during cold water immersion? J Physiol 590:3219–3230. doi:10.1113/jphysiol.2012.229864

  23. Alboni P, Alboni M, Gianfranchi L (2011) Simultaneous occurrence of two independent vagal reflexes: a possible cause of vagal sudden death. Heart 97:623–625. doi:10.2459/JCM.0b013e328344bcdc

    CrossRef  PubMed  Google Scholar 

  24. Backus WW, Ward RR, Vitkun SA et al (1991) Postextubation laryngeal spasm in an unanesthetized patient with Parkinson’s disease. J Clin Anesth 3:314–316

    CrossRef  CAS  PubMed  Google Scholar 

  25. MurrayCalderon P, Connolly MA (1997) Laryngospasm and noncardiogenic pulmonary edema. J Perianesth Nurs 12:89–94

    CrossRef  CAS  Google Scholar 

  26. Szpilman D (1997) Near-drowning and drowning classification: a proposal to stratify mortality based on the analysis of 1,831 cases. Chest 112:660–665

    CrossRef  CAS  PubMed  Google Scholar 

  27. Modell JH (1971) The pathophysiology and treatment of drowning and near-drowning. Charles C Thomas, Springfield

    Google Scholar 

  28. Modell JH, Bellefleur M, Davis JH (1999) Drowning without aspiration: is this an appropriate diagnosis. J Forensic Sci 44:1119–1123

    CAS  PubMed  Google Scholar 

  29. Layon AJ, Modell JH (2009) Drowning: update 2009. Anesthesiology 110:1390–1401

    CrossRef  PubMed  Google Scholar 

  30. Diamond W, MacDonald RD (2011) Submersion and early-onset acute respiratory distress syndrome: a case report. Prehosp Emerg Care 15:288–293

    CrossRef  PubMed  Google Scholar 

  31. van Berkel M, Bierens JJ, Lie RL et al (1996) Pulmonary oedema, pneumonia and mortality in submersion victims; a retrospective study in 125 patients. Intensive Care Med 22:101–107

    CrossRef  PubMed  Google Scholar 

  32. Kapur N, Slater A, McEniery J et al (2009) Therapeutic bronchoscopy in a child with sand aspiration and respiratory failure from near-drowning – a case report and literature review. Pediatr Pulmonol 44:1043–1047

    CrossRef  CAS  PubMed  Google Scholar 

  33. Kibayashi K, Shimada R, Nakao KI (2011) Frequent detection of stomach content in accidental drowning. Med Sci Law 51:161–163

    CrossRef  PubMed  Google Scholar 

  34. Xu X, Tikuisis P, Giesbrecht G (1999) A mathematical model for human brain cooling during cold water near-drowning. J Appl Physiol 86:265–272

    CAS  PubMed  Google Scholar 

  35. Moore EM, Nichol AD, Bernard SA et al (2011) Therapeutic hypothermia: benefits, mechanisms and potential clinical application in neurological, cardiac and kidney injury. Injury 42:843–855

    CrossRef  PubMed  Google Scholar 

  36. Topjian AA, Berg RA, Bierens JJ et al (2012) Brain resuscitation in the drowning victim. Neurocrit Care 17:441–467. doi:10.1007/s12028-012-9747-4

  37. Vaagenes P, Safar P, Moossy J et al (1997) Asphyxiation versus ventricular fibrillation cardiac arrest in dogs. Differences in cerebral resuscitation effects – a preliminary study. Resuscitation 35:41–52

    CrossRef  CAS  PubMed  Google Scholar 

  38. Gilbert M, Busund R, Skagseth A et al (2000) Resuscitation from accidental hypothermia of 13.7 degrees C with circulatory arrest. Lancet 355:375–376

    CrossRef  CAS  PubMed  Google Scholar 

  39. Lund FK, Torgersen JGR, Flaatten HK (2009) Heart rate monitored hypothermia and drowning in a 48-year-old man, survival without sequelae: a case report. Cases J. doi:10.4076/1756-1626-2-6204

  40. Saidel-Odes LR, Almog Y (2003) Near-drowning in the Dead Sea: a retrospective observational analysis of 69 patients. Isr Med Assoc J 5:856–858

    PubMed  Google Scholar 

  41. Brown JAD, Brugger H, Boyed J et al (2012) Accidental hypothermia. NEJM 367:1930–1938

    CrossRef  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Maatschappij tot Redding van Drenkelingen, 114, 1012 LB, Amsterdam, The Netherlands

    Joost Bierens

  2. Department of Forensic Medicine, University of Helsinki, 40, Kytösuontie 11, 00300, Helsinki, Finland

    Philippe Lunetta

  3. Extreme Environment Laboratory, Department of Sport and Exercise Science, University of Portsmouth, Spinnaker Building, Cambridge Road, Portsmouth, P01 2ER, UK

    Mike Tipton

Authors
  1. Joost Bierens
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  2. Philippe Lunetta
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  3. Mike Tipton
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Corresponding author

Correspondence to Joost Bierens .

Editor information

Editors and Affiliations

  1. Maatschappij tot Redding van Drenkelingen, Amsterdam, The Netherlands

    Joost J.L.M. Bierens

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Bierens, J., Lunetta, P., Tipton, M. (2014). Pathophysiology of Drowning. In: Bierens, J. (eds) Drowning. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-04253-9_85

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  • DOI: https://doi.org/10.1007/978-3-642-04253-9_85

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