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December 1967

Drowning by Total Immersion: Effects on Pulmonary Surfactant of Distilled Water, Isotonic Saline, and Sea Water

Author Affiliations

Miami, Fla
From the departments of pediatrics and anesthesiology, University of Miami School of Medicine, and Jackson Memorial Hospital, Miami, Fla.

Am J Dis Child. 1967;114(6):612-616. doi:10.1001/archpedi.1967.02090270068005

DEATH by drowning is one of the major causes of childhood mortality. Studies of the mechanisms of drowning have demonstrated that two types of death may occur.1 Asphyxia without fluid aspiration is responsible for less than 10% of drowning deaths, but fluid aspiration occurs in about 80% to 90% of drowning victims.2

The pathophysiological changes which occur during drowning with fluid aspiration depend upon both the composition and volume of fluid aspirated.3-5 The most consistent finding in studies of drowning by aspiration of fluid is acute asphyxia with persistent arterial hypoxemia.3-7 This suggests that alveolar capillary membrane derangement occurs. This study was designed to see the effects of drowning by total immersion in distilled water, distilled water with chlorine, isotonic saline, and sea water on extracts of the alveolar lining layer (pulmonary surfactant).

Methods  Twenty mongrel dogs weighing 16 to 29 kg and in good physical

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