Electrolytes and blood

Significant electrolyte abnormalities are uncommon unless large volumes are aspirated or the water aspirated contains high concentrations of dissolved salts as is the case in the Dead Sea, the Great Salt Lake, mineral pools, or spas. Similarly, hemolysis and rhabdomyolysis have been reported but are rare. Hemoglobinuria, myoglobinuria, and albuminuria are more likely to be due to ischemia than a direct result of absorbed water and electrolytes. Hemodilution and hemoconcentration occur with freshwater and saltwater aspiration respectively. Disseminated intravascular coagulation complicating freshwater near-drowning has been reported, but it is rare and the pathophysiological mechanism is not clear.

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