Drowning case complicated with a cardiopulmonary arrest and severe ARDS saved with a good neurological outcome by ECMO: A case report

Abstract

Cardiopulmonary arrest (CPA) due to drowning has an extremely high mortality rate, and very few cases have good neurological outcomes. Severe respiratory failure can occur even after resuscitation. A 66 year old woman with a history of refractory epilepsy had a CPA due to drowning. Approximately 20 min after drowning, she was resuscitated and transported to the hospital, and extracorporeal membrane oxygenation (ECMO) was introduced on day two due to continued severe respiratory failure caused by acute respiratory distress syndrome (ARDS). After the introduction of ECMO, her respiratory status gradually improved and ECMO was discontinued on day 12. Approximately 6 months after drowning, she visited our hospital for a follow-up with a cerebral performance category of 1. Since cases of CPA due to drowning with a short drowning time or hypothermia are expected to have good neurological outcomes, the introduction of ECMO should be considered as a treatment for ARDS after resuscitation.