Despite efforts at prevention and availability of life-sustaining technologies in intensive care units (ICUs), near drowning continues to be associated with high mortality and morbidity in both children and adults.

Attempts at providing interventions to improve the outcomes of victims of near drowning date back 400 years when Paracelus, a Swiss physician, demonstrated the importance of ventilating individuals who were nearly drowned by inserting fireplace bellows into the victim's mouth or nostril to inflate the lungs.<sup>59 Varon J., Sternbach G.L. Cardiopulmonary resuscitation: Lessons from the past J Emerg Med 1991 ;  9 : 503-507  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 63 Weinstein M.D., Krieger B.P. Near-drowning: Epidemiology, pathophysiology, and initial treatment J Emerg Med 1996 ;  14 : 461-467  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> In the eighteenth century, Humane Societies were established in England, Scandinavia, and United States with increasing interest in treating victims of near drowning.<sup>59 Varon J., Sternbach G.L. Cardiopulmonary resuscitation: Lessons from the past J Emerg Med 1991 ;  9 : 503-507  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 63 Weinstein M.D., Krieger B.P. Near-drowning: Epidemiology, pathophysiology, and initial treatment J Emerg Med 1996 ;  14 : 461-467  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup> Tilting boards were used not too long ago in this century with the goal of moving the victim's diaphragm by shifting the weight of the abdominal contents.<sup>59 Varon J., Sternbach G.L. Cardiopulmonary resuscitation: Lessons from the past J Emerg Med 1991 ;  9 : 503-507  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti, 63 Weinstein M.D., Krieger B.P. Near-drowning: Epidemiology, pathophysiology, and initial treatment J Emerg Med 1996 ;  14 : 461-467  [cross-ref]

Cliccare qui per andare alla sezione Riferimenti</sup>

With the availability of sophisticated technologies in adult and pediatric ICUs, victims of near drowning are now more likely to survive. However, this improvement in short-term survival of near-drowning victims after an acute submersion episode has also resulted in an increase in major complications, including the development of acute respiratory distress syndrome (ARDS) during the ICU stay and persistent hypoxic-ischemic central nervous system (CNS) injury. Therefore, it is important for the critical care physician to be not only familiar with the acute ICU management of victims of near drowning, but also to understand the pathophysiologic mechanisms of near drowning, including the cellular mechanisms of CNS injury, because many of the advances in optimizing outcomes of near-drowning victims depend on the success of CNS resuscitation.