Secondary drowning in children.

Secondary drowning (and near-drowning) is one of the post-immersion respiratory syndromes. It is defined as deterioration of pulmonary function that follows deficient gas exchange due to loss or inactivation of surfactant. A review of 94 consecutive cases of near-drowning in childhood showed that this syndrome occurred in five (5%) cases. Its onset was usually rapid and characterised by a latent period of one to 48 hours of relative respiratory well-being. It occurred more rapidly after immersion in fresh water. The two children immersed in salt water died of secondary drowning, while the three immersed in fresh water recovered completely. If it is anticipated, recognised, and treated vigorously prognosis of secondary drowning is good in fresh water cases but bad after salt water immersion.