Chest examination reveals diffuse rales. Supplemental oxygen, through nasal prongs or mask, fails to improve the clinical appearance. ARDS is a clinical syndrome for which no specific marker exists. It is associated with primary pulmonary disease, including infectious pneumonia and aspiration of gastric contents, and with systemic processes, such as sepsis. However, it is clear that the syndrome involves a complex host response by a myriad of mediators, which result in injury to the alveolar capillary membrane.
Most drowning victims aspirate at least some water.
Both fresh and saltwater aspiration results in pulmonary edema. If drowning occurs in stagnant or contaminated water the risk of bacterial pneumonia is high. However, neither corticosteroids nor prophylactic antibiotics are beneficial. Endotoxin from gram-negative organisms has been shown to be a potent mediator. Permeability pulmonary edema may complicate severe isolated brain injury.