Brain Resuscitation in the Drowning Victim Alexis A. TopjianRobert A. BergJoost J. L. M. BierensChristine M. Branche • Robert S. ClarkHans FribergCornelia W. E. Hoedemaekers • Michael HolzerLaurence M. KatzJohannes T. A. Knape •

Drowning is a leading cause of accidental death. Survivors may sustain severe neurologic morbidity. There is negligible research specific to brain injury in drowning making current clinical management non-specific to this disorder. This review represents an evidence- based consensus effort to provide recommendations for management and investigation of the drowning victim. Epidemiology, brain-oriented prehospital and intensive care, therapeutic hypothermia, neuroimaging/monitoring, biomarkers, and neuroresuscitative pharmacology are addressed. When cardiac arrest is present, chest compres- sions with rescue breathing are recommended due to the asphyxial insult. In the comatose patient with restoration of spontaneous circulation, hypoxemia and hyperoxemia should be avoided, hyperthermia treated, and induced hypothermia (32-34 � C) considered. Arterial hypotension/