DOES WATER TEMPERATURE AFFECT OUTCOME OF NEARLY DROWNED CHILDREN

The effect of water temperature on the outcome of nearly drowned child ren was studied retrospectively. All patients under 16 years of age, w ho required admission to the paediatric intensive care unit (PICU) or who died despite life support measures between January 1, 1985 and Dec ember 31, 1994 in Southern Finland, were included in the study. The au thors created a Near Drowning Severity Index (NDSI) and an age-adjuste d NDSIage as tools to evaluate the effect of submersion duration and w ater temperature on the outcome of nearly drowned children. The predic tive performance of the NDSI and the NDSIage were compared with the du ration of submersion to predict the outcome. Of the 48 patients 11 wer e female and 37 were male. Their ages ranged from 0.8 to 15 years and the median was 3.7 years. The submersion time ranged from 0.5 to 90 mi n and the median time was 6.3 min. The median temperature of water was 16 degrees C (range 0-37 degrees C). The NDSI had a sensitivity of 93 .9% and specificity of 90.6% in predicting the outcome after submersio n incidents. The inclusion of age (NDSIage) in the formula did not inc rease predictive performance of the NDSI. With a cut-off value of 10 m in, the duration of submersion alone had a sensitivity of 96.6% and sp ecificity of 89.5% in predicting the outcome. In conclusion the effect of a potentially beneficial rapid development of hypothermia by cold water on the outcome of nearly drowned children could not be proved. ( C) 1997 Elsevier Science Ireland Ltd.