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June Hyeong Kim 1 Article
The Utility of Non-Invasive Nasal Positive Pressure Ventilation for Acute Respiratory Distress Syndrome in Near Drowning Patients
June Hyeong Kim, Kyung Hoon Sun, Yong Jin Park
J Trauma Inj. 2019;32(3):136-142.   Published online September 30, 2019
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AbstractAbstract PDF

Near drowning refers to immediate survival after asphyxia due to submersion or immersion in water, which is a crucial public safety problem worldwide. Acute lung injury or acute respiratory distress syndrome (ARDS) is a common complication of near drowning. The purpose of this study was to investigate the feasibility and effectiveness of noninvasive nasal positive pressure ventilation (NINPPV).


This retrospective study was conducted at a tertiary emergency department. NINPPV was administered for moderate ARDS caused by submersion or immersion in patients who were older than 18 years, from January 2015 to December 2018. We collected the demographic (age, sex, length of hospital stay, and outcome), laboratory (arterial blood gas, lactate, oxygen saturation, partial pressure of oxygen divided by the fraction of inspired oxygen, complete blood count, blood urea nitrogen, and creatinine), and clinical data (acute lung injury index and ventilator failure) of the patients. A statistical analysis was performed using Statistical Package for the Social Sciences version 20.0 for Windows.


NINPPV treatment was provided to 57 patients for near drowning, 45 of whom (78.9%) were successfully treated without complications; in 12 (21.1%), treatment was changed to invasive mechanical ventilation within 48 hours due to ARDS or acute kidney injury. NINPPV treatment was successful in 31 (75.6%) out of 41 sea-water near drowning patients. They were more difficult to treat with NINPPV compared with the fresh-water near drowning patients (p<0.05).


NINPPV would be useful and feasible as the initial treatment of moderate ARDS caused by near drowning.



Citations to this article as recorded by  
  • Early pronation, protective lung ventilation and use of awake-prone-HFNO therapy after extubation in near-fatal drowning
    G. Misseri, P. Pierucci, D. Bellina, M. Ippolito, G. Ingoglia, C. Gregoretti
    Pulmonology.2024; 30(2): 198.     CrossRef
  • Addressing gaps in our understanding of the drowning patient: a protocol for the retrospective development of an Utstein style database and multicentre collaboration
    Ogilvie Thom, Kym Roberts, Peter A Leggat, Susan Devine, Amy E Peden, Richard Charles Franklin
    BMJ Open.2023; 13(2): e068380.     CrossRef
  • Management for the Drowning Patient
    David Szpilman, Paddy J. Morgan
    Chest.2021; 159(4): 1473.     CrossRef
  • Treatment of the lung injury of drowning: a systematic review
    Ogilvie Thom, Kym Roberts, Susan Devine, Peter A. Leggat, Richard C. Franklin
    Critical Care.2021;[Epub]     CrossRef

J Trauma Inj : Journal of Trauma and Injury