Extracorporeal life support (ECLS) for refractory XXXX after drowning: An 11-year experience.

@entity1 @entity146 @entity972 @entity1167 @entity2332
AIM: Neuroprotective effects of @entity2332 may explain surprisingly high survival rates reported after drowning in cold water despite prolonged submersion. We described a cohort of refractory hypothermic @entity1167 ( @entity1167 ) due to drowning treated by extracorporeal life support (ECLS) and aimed to identify criteria associated with 24-h survival. METHODS: Eleven-year period (2002-2012) retrospective study in the surgical intensive care unit (ICU) of a tertiary hospital (European Hospital Georges Pompidou, Paris, France). All consecutive hypothermic @entity1 admitted for refractory @entity1167 after drowning in the Seine River were included. @entity1 with core temperature below 30  C and submersion duration of less than 1h were potentially eligible for ECLS resuscitation. RESULTS: Forty-three @entity1 were admitted directly to the ICU during the study period. ECLS was initiated in 20 @entity1 (47%). Among these 20 @entity1 , only four (9%) survived more than 24h. A first hospital core temperature  <=26  C and a @entity972 serum level between 4.2 and 6mM at hospital admission have a sensitivity of 100% [95%CI: 28-100%] and a specificity of 100% [95%CI: 71-100%] to discriminate @entity1 who survived more than 24h. Overall survival at ICU discharge and at 6-months was 5% [95%CI: 1-16%] (two @entity1 ). CONCLUSIONS: Despite @entity1 @entity2332 and @entity146 resuscitation with ECLS, the observed survival rate is low in the present cohort. Like existing algorithms for ECLS management in avalanche victims, we recommend to use first core temperature and @entity972 serum level to indicate ECLS for refractory @entity1167 due to drowning.
