Near drowning pulmonary oedema is considered an aetiological subtype of non cardiogenic pulmonary oedema. It can occur with both salt water and fresh water near-drowning.
Pathology
It is thought to result from the inhalation of either fresh water or sea water resulting in lung damage and a ventilation-perfusion mismatch.
Near drowning can be divided into three stages:
- stage 1: acute laryngospasm that occurs after inhalation of a small amount of water
- stage 2: the victim still usually presents with laryngospasm but may begin to swallow water into the stomach
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stage 3
- 10-15% of patients still present with dry drowning caused by persistence of the associated laryngospasm
- in the remaining 85-90% of patients, the laryngospasm relaxes secondary to hypoxia and large amounts of water are aspirated
Radiographic features
Radiography
Features in stages 2 and 3 on chest radiographs are usually identical to pulmonary oedema from other non-cardiac causes 3.
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