Prolonged Respiratory Failure With Pulmonary Fibroproliferative Complications Following Severe Drowning-Associated ARDS: A Case Report.

Authors

Katsutoshi Saito, Yoshihiro Miyake, Tomohiro Abe, Hidenobu Ochiai

Published in

The American journal of case reports. Volume 27. Pages e953531. Sep 18, 2026. Epub Sep 18, 2026.

Abstract

BACKGROUND Drowning-associated acute respiratory distress syndrome (ARDS) is generally considered a reversible condition, with most patients requiring only short-term mechanical ventilation. However, prolonged respiratory failure and fibroproliferative changes have rarely been described. We report a case of severe, prolonged ARDS following drowning complicated by recurrent pneumothorax and late-phase lung injury. CASE REPORT A 15-year-old girl developed ARDS following a drowning accident. Oxygenation collapsed shortly (PaO2/FiO2 ratio of 54.4), necessitating advanced ventilation and prone positioning. The clinical course was complicated by mediastinal emphysema and recurrent bilateral pneumothorax, associated with highly organized and cystic changes, requiring multiple chest tube insertions until day 57. Intensive treatment, including steroid pulses and nitric oxide inhalation, gradually improved respiratory function, resulting in the successful discontinuation of mechanical ventilation on day 53. Chest computed tomography on day 81 demonstrated marked improvement and resolution of organizing changes, with only limited residual organization. The patient was discharged home on day 93. CONCLUSIONS This case highlights that drowning-associated ARDS can, in rare cases, follow a prolonged course with fibroproliferative changes and recurrent complications such as pneumothorax. Nevertheless, even prolonged and complicated respiratory failure following drowning-associated ARDS may still demonstrate partial reversibility over time, suggesting the importance of avoiding premature therapeutic nihilism in similar cases.

PMID:
42755119
Bibliographic data and abstract were imported from PubMed on 18 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.