During near-drowning in fresh water the person may aspirate water into the lungs. This water is hypotonic and can cause osmotic lysis of erythrocytes.
Patient selection: near-drowning in fresh water
Clinical features:
(1) hemoglobinuria
(2) increased free hemoglobin in the plasma or decreased serum haptoglobin
(3) anemia due to the effects of hemodilution and hemolysis
Later there may be:
(4) hyperbilirubinemia
(5) reticulocytosis after several days
Concurrent conditions and complications may include:
(1) DIC
(2) hypoxic tissue damage
(3) pneumonia
(4) acute renal failure
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Specialty: Hematology Oncology
