Mild hypothermia after near drowning in twin toddlers

Abstract

Introduction: We report a case of twin toddlers who both suffered near drowning but with different post-trauma treatment and course, and different neurological outcomes.

Methods and results: Two twin toddlers (a boy and girl, aged 2 years and 3 months) suffered hypothermic near drowning with protracted cardiac arrest and aspiration. The girl was treated with mild hypothermia for 72 hours and developed acute respiratory dysfunction syndrome and sepsis. She recovered without neurological deficit. The boy's treatment was conducted under normothermia without further complications. He developed an apallic syndrome.

Conclusion: Although the twin toddlers experienced the same near drowning accident together, the outcomes with respect to neurological status and postinjury complications were completely different. One of the factors that possibly influenced the different postinjury course might have been prolonged mild hypothermia.

Figure 1

The girl: cranial computed tomography, done 7 hours after admission, showing cerebral oedema.

Figure 2

The girl: computed tomography of the thorax, done shortly after admission to hospital, showing infiltrations in the basal dorsal thorax following aspiration.

Figure 3

The girl: chest X-ray film, done after admission to hospital, showing increasing bilateral infiltrations of the lung, done after admission.