Near drowning pulmonary edema

Last revised by Adrià Roset Altadill on 29 Sep 2023

Near drowning pulmonary edema is considered an etiological subtype of non cardiogenic pulmonary edema. It can occur with both salt water and fresh water near-drowning.


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
  • 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


Features in stages 2 and 3 on chest radiographs are usually identical to pulmonary edema from other non-cardiac causes 3.

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