PULMONARY

Aspiration of both seawater and freshwater in relatively small quantities can lead to disruptions in the surfactant equilibrium of the lungs. Reduced surfactant leads to atelectasis which can make patients more prone to atelectrauma and subsequent biotrauma (neutrophil migration and subsequent acute respiratory distress syndrome or sepsis).36,38  Osmotic shifts in the alveoli can lead to noncardiogenic pulmonary edema which results in reduced compliance, right to left shunting, and hypoxemia. Evidence-based care for mechanically ventilated patients should be followed. 2