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Prognostic variables in nearly drowned, comatose children.

E Nussbaum

    American Journal of Diseases of Children (1960)
    |October 1, 1985
    PubMed
    Summary

    Prognostic variables like submersion time, intracranial pressure (ICP), and cerebral perfusion pressure (CPP) predict survival in nearly drowned children but not neurological outcome. Further research into neurophysiologic factors is recommended.

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    Area of Science:

    • Pediatric Critical Care Medicine
    • Neurology
    • Emergency Medicine

    Background:

    • Near-drowning incidents in children often result in coma, necessitating accurate prognostic indicators.
    • Predicting survival and neurological outcome in these critically ill children is challenging.

    Purpose of the Study:

    • To evaluate the predictive value of various clinical and physiological variables for survival and neurological outcome in comatose, near-drowned children.

    Main Methods:

    • A cohort of 51 comatose, near-drowned children was studied.
    • Variables assessed included age, submersion time, arterial pH, core temperature, mean intracranial pressure (ICP), and mean cerebral perfusion pressure (CPP) within the first 24 hours.

    Main Results:

    • Estimated submersion time, mean ICP, and mean CPP were significant predictors of survival.
    • These variables, however, could not reliably predict neurological outcome (intact survival vs. brain damage).
    • Age, arterial pH, and core temperature were not useful predictors of outcome.

    Conclusions:

    • Current prognostic variables like submersion time, ICP, and CPP are unreliable for predicting neurological outcomes in near-drowned children.
    • Focus should shift to exploring neurophysiologic and metabolic factors for guiding aggressive cerebral resuscitation strategies.

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