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Treatment of the lung injury of drowning: a systematic review.
- Source :
-
Critical care (London, England) [Crit Care] 2021 Jul 19; Vol. 25 (1), pp. 253. Date of Electronic Publication: 2021 Jul 19. - Publication Year :
- 2021
-
Abstract
- Background: Drowning is a cause of significant global mortality. The mechanism of injury involves inhalation of water, lung injury and hypoxia. This systematic review addressed the following question: In drowning patients with lung injury, what is the evidence from primary studies regarding treatment strategies and subsequent patient outcomes?<br />Methods: The search strategy utilised PRISMA guidelines. Databases searched were MEDLINE, EMBASE, CINAHL, Web of Science and SCOPUS. There were no restrictions on publication date or age of participants. Quality of evidence was evaluated using GRADE methodology.<br />Results: Forty-one papers were included. The quality of evidence was very low. Seventeen papers addressed the lung injury of drowning in their research question and 24 had less specific research questions, however included relevant outcome data. There were 21 studies regarding extra-corporeal life support, 14 papers covering the theme of ventilation strategies, 14 addressed antibiotic use, seven papers addressed steroid use and five studies investigating diuretic use. There were no clinical trials. One retrospective comparison of therapeutic strategies was found. There was insufficient evidence to make recommendations as to best practice when supplemental oxygen alone is insufficient. Mechanical ventilation is associated with barotrauma in drowning patients, but the evidence predates the practice of lung protective ventilation. There was insufficient evidence to make recommendations regarding adjuvant therapies.<br />Conclusions: Treating the lung injury of drowning has a limited evidentiary basis. There is an urgent need for comparative studies of therapeutic strategies in drowning.<br /> (© 2021. The Author(s).)
- Subjects :
- Anti-Bacterial Agents standards
Anti-Bacterial Agents therapeutic use
Barotrauma etiology
Barotrauma therapy
Extracorporeal Membrane Oxygenation methods
Extracorporeal Membrane Oxygenation standards
Humans
Lung Injury therapy
Respiration, Artificial methods
Respiration, Artificial standards
Drowning physiopathology
Lung Injury etiology
Treatment Outcome
Subjects
Details
- Language :
- English
- ISSN :
- 1466-609X
- Volume :
- 25
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Critical care (London, England)
- Publication Type :
- Academic Journal
- Accession number :
- 34281609
- Full Text :
- https://doi.org/10.1186/s13054-021-03687-2