HEMATOLOGIC, ENDOCRINE, AND RENAL

Drowning victims requiring the ICU are critically ill and can be prone to the same hematologic, metabolic, and renal pathologies as other ICU patients. There is no evidence that there is clinically significant hemolysis or electrolyte shifts in drowning patients. Rates of renal failure secondary to decreased perfusion during resuscitative efforts or subsequent decreased cardiac output are similar to other cardiac arrest patients.

- No role for routine use of bicarbonate in patients with metabolic acidosis.10
- Maintain euglycemia (140-180mg/dl).25
- Renal failure in the majority of drowning patients is uncommon; however, when present, it may be secondary to decreased perfusion, myoglobinuria or hemoglobinuria.10