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Intact Survival Rates in Nearly Drowned, Comatose Children-Reply

ELIEZER NUSSBAUM, MD
Am J Dis Child. 1986;140(6):504-505. doi:10.1001/archpedi.1986.02140200014006.
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In Reply.—The letter by McComb addresses the controversial issue of brain resuscitation. The lack of prospective, well-controlled studies on nearly drowned victims is probably the source of confusion in designing therapeutic modalities for posthypoxic, severely brain-injured children. The difficulties in evaluating previous studies were compounded by the fact that instead of analyzing one variable between two well-matched groups, multiple factors were rather introduced. Unless the two groups of patients from Miller Children's Hospital, Long Beach, Calif,1 and Childrens Hospital of Los Angeles2 were well matched in terms of baseline evaluation and therapeutic approach, one should be cautious in comparing the results. In addition, some investigators believe that hypothermia3,4 may play a major role in "resuscitating" those neurons that were severely insulted by hypoxic event but that are capable of recovery. On the other hand, our experience with children who had either severe brain damage or full

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