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Comment published on 10 April 2018, see Int. J. Environ. Res. Public Health 2018, 15(4), 706.

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Int. J. Environ. Res. Public Health 2017, 14(11), 1402; https://doi.org/10.3390/ijerph14111402

Incidence and Consequences of Near-Drowning–Related Pneumonia—A Descriptive Series from Martinique, French West Indies

1
Department of Emergency Medicine, University Hospital of Martinique, Fort-de-France, 97261 Martinique, France
2
Department of Medical and Toxicological Critical Care, Lariboisière Hospital, Paris-Diderot University, INSERM UMR-S 1144, 75013 Paris, France
3
Intensive Care Unit, Hospital Centre of the French Guiana, 97306 Cayenne, France
4
Intensive Care Unit, University Hospital of Martinique, Fort-de-France, 97261 Martinique, France
*
Author to whom correspondence should be addressed.
Received: 22 August 2017 / Revised: 14 November 2017 / Accepted: 15 November 2017 / Published: 17 November 2017
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Abstract

Drowning represents one major cause of accidental death. Near-drowning patients are exposed to aspiration that may result in pneumonia with life-threatening consequences. We designed this descriptive study to investigate the frequency, nature, and consequences of post-drowning pneumonia. One hundred and forty-four near-drowning patients (33 children and 111 adults) admitted during four years to the University Hospital of Martinique, French Indies, were included. Patients presented pre-hospital cardiac arrest (41%) and exhibited acute respiratory failure (54%), cardiovascular failure (27%), and lactic acidosis (75%) on admission. Empirical antibiotics, as decided by the physicians in charge, were administered in 85 patients (59%). Post-drowning early onset bacterial pneumonia was diagnosed as “possible” in 13 patients (9%) and “confirmed” in 22 patients (15%). Tracheal aspiration revealed the presence of polymorphous pharyngeal flora (59%) or one predominant bacteria species (41%) including Enterobacter aerogenes, Enterobacter cloacae, Staphylococcus aureus, Pseudomonas aeruginosa, Aeromonas hydrophilia, and Morganella morgani. Despite adequate supportive care, drowning resulted in 45 fatalities (31%). Early onset bacterial aspiration pneumonia (either possible or confirmed) did not significantly influence the risk of death. In conclusion, near-drowning–related bacterial aspiration pneumonia seems rare and does not influence the mortality rate. There is still a need for practice standardization to improve diagnosis of post-drowning pneumonia and near-drowning patient management. View Full-Text
Keywords: drowning; pneumonia; aspiration; predictive factor; fatality drowning; pneumonia; aspiration; predictive factor; fatality
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).
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Cerland, L.; Mégarbane, B.; Kallel, H.; Brouste, Y.; Mehdaoui, H.; Resiere, D. Incidence and Consequences of Near-Drowning–Related Pneumonia—A Descriptive Series from Martinique, French West Indies. Int. J. Environ. Res. Public Health 2017, 14, 1402.

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