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60 Males, due to a generally increased likelihood for risk taking, are 4 times more likely to have submersion injuries. Lung density may be higher than normal but normal weights are possible after cardiac arrest reflex or vaso-vagal reflex. Citation needed Most victims of cold-water drowning do not develop hypothermia quickly enough to decrease cerebral metabolism before ischemia and irreversible hypoxia occur. 3, drowning may be complicated by low body temperature, aspiration of vomit, or acute respiratory distress syndrome. 31 Comparatively, aspiration of hypertonic seawater draws liquid from the plasma into the alveoli and similarly causes damage to surfactant by disrupting the alveolar-capillary membrane.

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