"Good outcome after drowning with prolonged resuscitation and secondary pediatric acute respiratory distress syndrome requiring extra-corporeal-membrane-oxygenation – A special case in comparison to the single-center local 10-year experience in pediatric drowning”

Drowning is a leading cause of morbidity and mortality in childhood accidents. We report the case of a 13 year old boy who after prolonged resuscitation developed severe secondary ARDS requiring ECMO. Despite the presence of multiple risk factors for poor outcome prognosis he recovered well and was discharged in an age-appropiate neurologic condition. We compare this case to our local 10-year-experience in childhood drowning and similar reports in the literature to identify the special circumstances leading to this unexpected outcome. This analysis reveals no significant differences or specific parameters at the initiation of intensive care treatment that would explain the discrepancy between the presence of multiple risk factors and the positive clinical outcome. Thus, decision-making in pediatric drowning accidents remains uncertain.