Recovery of Acute Pulmonary Edema Following Drowning Due to Seizure: Report of Two Cases

Abstract

J Babol Univ Med Sci; 20(6); Jun 2018; PP: 70-5 Received: Aug 31 2017, Revised: Mar 3 2018, Accepted: May 7 2018. ABSTRACT BACKGROUND AND OBJECTIVE: Drowning is a process of respiratory impairment due to the full immersion under fluids that about one third of patients with drowning experience pulmonary edema. In this article, two patients with acute pulmonary edema after drowning due to seizure who were admitted to the ICU department at Ayatollah Rouhani Hospital in Babol have been presented. CASE REPORT: An 18-year-old man with a history of epilepsy was drowned while swimming in the pool after a seizure. Due to hypoxia, he was treated with supplemental oxygen and NIV for 12 hours. After partial recovery, he was treated with oxygen for three days. The patient on the fourth day was discharged with a good general condition. Second patient: An 36-year old man, with a previous history of brain trauma was drowned while swimming in the sea after a seizure. The patient was intubated due to severe hypoxemia despite administration of oxygen (pao2 = 44mmHg) and low blood pressure (BP = 80 / 50mmHg), and was transferred to ICU at Ayatollah Rouhani Hospital. The patient was treated for mechanical ventilation and positive end expiratory pressure (PEEP) for 12 days. After recovery, he was separated from the ventilator and was discharged on the 14th day. CONCLUSION: In acute pulmonary edema after drowning, administration of oxygen and non-invasive ventilation is recommended. In the absence of response, tracheal intubation and invasive mechanical ventilation are recommended.