The most important contributory factors to morbidity and mortality from drowning are hypoxemia and acidosis and the multiorgan effects of these processes. CNS damage may occur because of hypoxemia sustained during the drowning episode (primary injury) or may result from arrhythmias, ongoing pulmonary injury, reperfusion injury, or multiorgan dysfunction (secondary injury), particularly with prolonged tissue hypoxia.
For more on the pathophysiology of drowning, read here.
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Cite this: Richard H. Sinert. Fast Five Quiz: What Do You Know About Drowning? - Medscape - Jun 27, 2016.