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Constant-positive airway pressure with spontaneous ventilation was successfully used in treatment of a patient who had suffered near-drowning in salt water. The patient was able to maintain adequate respiratory mechanics, although oxygenation without end-expiratory pressure was severely impaired. The rapid improvement in arterial oxygenation obviated the need for mechanical ventilation in this patient. It is suggested that the simplest modality of effective therapy should be used in such patients.