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Effects of dehydration on the vasopressin response to immersion.

Nine healthy volunteers underwent three experimental procedures in random order. The protocols were 4 h of thermal dehydration followed by 2 h of head-out water immersion, 4 h of thermal dehydration followed by 2 h of chair rest, and 6 h of rest in the supine position. Four hours of heat exposure (50 degrees C) resulted in a body weight loss of approximately 3.5%. Plasma osmolality rose by approximately 5 mosmol/kg, mean arterial pressure (MAP) decreased from 85 to 78 mmHg, and body temperature increased from 36.8 to 38.6 degrees C. As a consequence of the combined action of hypertonicity, hypovolemia, hypotension, and hyperthermia, plasma arginine vasopressin (AVP) increased from 2.1 to 8.1 pg/ml after 4 h thermal dehydration. Changes in body weight, plasma osmolality, body temperature, and MAP were similar after either a subsequent 2 h of water immersion or 2 h of chair rest. However, during chair rest plasma AVP remained elevated (8.4 pg/ml), whereas during immersion plasma AVP decreased from 8.1 to 4.7 pg/ml. This was probably due to the central hypervolemia induced by immersion. Our results support the hypothesis that central hypervolemia rather than hypotonicity is the primary stimulus for AVP suppression during water immersion in dehydrated subjects. During the early immersion period hypoosmolality might contribute to the AVP suppression.

Adult↗

Fluid conservation in athletes: responses to water intake, supine posture, and immersion.

The roles of antidiuretic hormone (ADH) and aldosterone in the elicited diuretic responses of trained and untrained men to seated, supine, and head-out water immersed conditions were studied. Volunteers were comprised of groups of six untrained individuals, six trained swimmers, and six trained runners. Each subject underwent three protocols, six hours in a seated position, supine position, or immersion (35 degrees C water). The last two protocols were preceded and followed by 1 h of seated position. After 10 h of fasting, 0.5% body wt of water was drunk. One hour later the trained groups had higher urine osmolalities (P less than 0.05) and urinary excretion rates of ADH (P less than 0.05) and lower urine flow rates (P less than 0.05) than untrained subjects. Throughout the sitting protocol, urinary ADH was also higher in both trained groups (P less than 0.05). Both supine posture and immersion resulted in significant decreases in urinary ADH in the untrained subjects (P less than 0.05) but no changes wer noted in swimmers and only during the second hour of immersion in the runners (P less than 0.05). The natriuresis and kaliuresis were greater during immersion than in the supine position but plasma renin activity, measured only in trained groups, and plasma aldosterone, measured in the untrained group, were decreased similarly with both protocols. The increases in urinary sodium excretion and urine flow rate were lower in trained than untrained subjects during the supine and immersion protocols (P less than 0.05). The data are compatible with an increased osmotic but decreased volume sensitivity of ADH control in trained men.

Adult↗

Effect of water immersion on cardiopulmonary physiology at high gravity (+Gz).

We compared the cardiopulmonary physiology of eight subjects exposed to 1, 2, and 3 Gz during immersion (35 degrees C) to the heart level with control dry rides. Immersion should almost cancel the effects of gravity on systemic circulation and should leave the lung alone to gravitational influence. During steady-state breathing we measured ventilation, O2 consumption (VO2), CO2 production, end-tidal PCO2 (PACO2), and heart frequency (fH). Using CO2 rebreathing techniques, we measured cardiac output, functional residual capacity, equivalent lung tissue volume, and mixed venous O2 content, and we calculated arterial PCO2 (PaCO2). As Gz increased, ventilation, fH, and VO2 rose markedly, and PACO2 and PaCO2 decreased greatly in dry ride, but during immersion these variables changed very little in the same direction. Functional residual capacity was lower during immersion and decreased in both the dry and immersed states as Gz increased, probably reflecting closure effects. Cardiac output decreased as Gz increased in dry rides and was elevated and unaffected by Gz during immersion. We conclude that most of the changes we observed during acceleration are due to the effect on the systemic circulation, rather than to the effect on the lung itself.

Adult↗

Adjustments in oxygen transport during head-out immersion in water at different temperatures.

Respiratory gas exchange was investigated in human subjects immersed up to the shoulders in water at different temperatures (Tw = 25, 34, and 40 degrees C). Cardiac output (Qc) and pulmonary tissue volume (Vti) were measured by a rebreathing technique with the inert gas Freon 22, and O2 consumption (VO2) was determined by the closed-circuit technique. Arterial blood gases (PaO2, PaCO2) were analyzed by a micromethod, and alveolar gas (PAO2) was analyzed during quiet breathing with a mass spectrometer. The findings were as follows. 1) Immersion in a cold bath had no significant effect on Qc compared with the value measured at Tw = 34 degrees C, whereas immersion in a hot bath led to a considerable increase in Qc. Vti was not affected by immersion at any of the temperatures tested. 2) A large rise in metabolic rate VO2 was only observed at Tw = 25 degrees C (P less than 0.001). 3) Arterial blood gases were not significantly affected by immersion, whatever the water temperature. 4) O2 transport during immersion is affected by two main factors: hydrostatic pressure and temperature. Above neutral temperature, O2 transport is improved because of the marked increase in Qc resulting from the combined actions of hydrostatic counter pressure and body heating. Below neutral temperature, O2 transport is altered; an increase in O2 extraction of the tissue is even calculated.

Anesthesia, Closed-Circuit↗

Vasopressin inhibits diuresis induced by water immersion in humans.

We tested the hypothesis that 1-desamino-8-D-arginine vasopressin (DDAVP), a V2-receptor agonist, could inhibit the diuresis induced by water immersion in humans. Water and electrolyte excretion, plasma atrial natriuretic factor concentration, and plasma aldosterone concentration were measured initially and after 3 h of water immersion in 13 healthy sodium-replete men given either placebo or 20 micrograms of intranasal DDAVP. Guanosine 3',5'-cyclic monophosphate and urea excretion and urine osmolality were also determined. DDAVP inhibited the diuresis induced by water immersion in men: 758 +/- 168 (SE) ml/3 h in the placebo group vs. 159 +/- 28 ml/3 h in the DDAVP group (P less than 0.05). After 3 h of water immersion, plasma atrial natriuretic factor concentrations were increased from 11 +/- 2 to 20 +/- 4 pg/ml in the placebo group and from 14 +/- 2 to 33 +/- 4 pg/ml in the DDAVP group (P less than 0.05). Plasma aldosterone concentrations were decreased from 98 +/- 18 to 45 +/- 6 pg/ml in the placebo group (P less than 0.05) and from 54 +/- 17 to 25 +/- 5 pg/ml in the DDAVP group (P less than 0.05). Despite these changes in aldosterone and atrial natriuretic factor concentrations, which should increase sodium excretion, DDAVP decreased the natriuresis induced by water immersion in humans: 56 +/- 8 meq Na+/3 h in the placebo group vs. 36 +/- 6 meq Na+/3 h in the DDAVP group (P less than 0.05). DDAVP may be used to prevent the diuresis associated with central redistribution of blood volumes that occur during water immersion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Cardiovascular responses to apneic facial immersion during altered cardiac filling.

The hypothesis that reduced cardiac filling, as a result of lower body negative pressure (LBNP) and postexercise hypotension (PEH), would attenuate the reflex changes to heart rate (HR), skin blood flow (SkBF), and mean arterial pressure (MAP) normally induced by facial immersion was tested. The purpose of this study was to investigate the cardiovascular control mechanisms associated with apneic facial immersion during different cardiovascular challenges. Six subjects randomly performed 30-s apneic facial immersions in 6.0 +/- 1.2 degrees C water under the following conditions: 1) -20 mmHg LBNP, 2) +40 mmHg lower body positive pressure (LBPP), 3) during a period of PEH, and 4) normal resting (control). Measurements included SkBF at one acral (distal phalanx of the thumb) and one nonacral region of skin (ventral forearm), HR, and MAP. Facial immersion reduced HR and SkBF at both sites and increased MAP under all conditions (P < 0.05). Reduced cardiac filling during LBNP and PEH significantly attenuated the absolute HR nadir observed during the control immersion (P < 0.05). The LBPP condition did not result in a lower HR nadir than control but did result in a nadir significantly lower than that of the LBNP and PEH conditions (P < 0.05). No differences were observed in either SkBF or MAP between conditions; however, the magnitude of SkBF reduction was greater at the acral site than at the nonacral site for all conditions (P < 0.05). These results suggest that the cardiac parasympathetic response during facial immersion can be attenuated when cardiac filling is compromised.

Adult↗

Prolonged water immersion. Effects on blood pressure maturation in normotensive rats.

The purpose of this experiment was to study the impact of simulated microgravity and of chronic removal of hydrostatic pressure gradients on blood pressure maturation and body growth in rats. A special device was developed in our laboratory to transfer prolonged "dry" water immersion (a technique that has been used for training astronauts under hypogravic conditions) to six Sprague-Dawley test rats (immersion-G group). The time course of heart rate, systolic blood pressure, urinary output, and body weight was monitored from weaning to maturity and then compared with those responses from six sex- and age-matched Sprague-Dawley rats grown in a gravity environment (group G). A downward shift in systolic blood pressure and body weight maturation curves was observed in immersion-G rats from the age of 60 days. Cessation of dry water immersion produced a gradual, significant rise in systolic blood pressure but not in body weight to control values. No marked changes in heart rate and urinary output between G and immersion-G rats were noticed throughout the investigation. Our results provide indirect evidence that an interference in the natural history of blood pressure maturation was introduced by immersion, which dissociated the effects of body weight increase during growth from the effects of ageing per se. It is concluded that the physiological increase in systolic blood pressure during growth is partly gravity-dependent.

Animals↗

Augmentation of bethanechol-stimulated gastric secretion by lowering body temperature in water-immersed rats.

The present study was designed to elucidate influences of hypothermia on gastric secretory response to secretagogues (bethanechol, histamine and tetragastrin) in rats exposed to restraint plus water immersion (36 and 25 degrees C) stress. In vagotomized rats provided with a pH microelectrode, decrease in intragastric pH by bethanechol (75 micrograms/kg, i.p.) was markedly produced under the water-immersion at 25 degrees C and the extent of the pH decrease was significantly greater than that observed under the water-immersion at 36 degrees C. However, intragastric pH decrease by histamine (1 mg/kg, i.v.) or tetragastrin (60 micrograms/kg/20 min, i.v.) was not affected by varying water temperatures. Using a technique of pyloric ligation, gastric acid and pepsin responses to bethanechol were measured at doses of 50-100 micrograms/kg in vagotomized rats and also at doses of 0.5-1.0 mg/kg in vagally intact rats. Stimulation of acid and pepsin secretion by bethanechol was provoked only under the water-immersion at 25 degrees C. As compared with the values obtained under the water-immersion at 36 degrees C, a significant augmentation of bethanechol-stimulated secretion was seen for acid and pepsin output in vagotomized rats and seen for acid output in vagally intact rats under the water-immersion at 25 degrees C. These results suggest that hypothermia may operate some mechanism for increasing the secretory responsiveness of the stomach to cholinomimetics.

Animals↗

Screening of children with arrhythmias for arrhythmia development during diving and swimming--face immersion as a substitute for diving and exercise stress testing as a substitute for swimming.

We compared face immersion and exercise stress testing by diving and swimming as screening methods for arrhythmias induced by immersion in water. The subjects were 64 children with various arrhythmias who were tested using 5 methods: diving, swimming, face immersion in 25 degrees C water, face immersion in 6 degrees C water, and a treadmill exercise test. Significant arrhythmias occurred during diving or swimming in 51 children, with 44 developing arrhythmias while diving. Both tachyarrhythmias and bradyarrhythmias were seen during diving, but 17 children who also showed significant arrhythmias while swimming mostly had tachyarrhythmias. A comparison with the incidence of arrhythmias produced by diving showed that face immersion in cold water had a sensitivity of 88.6%, a specificity of 85.0%, a predictive value of 92.9%, and an accuracy of 87.5%. Arrhythmias were alleviated in 12.5%, unchanged in 79.7%, and aggravated in 7.8% of the subjects. Face immersion thus appeared to be a useful and adequate screening substitute for diving. Exercise testing was also compared with swimming (sensitivity, 52.9%; specificity, 100%; predictive value, 100%; and accuracy, 87.5%). Arrhythmias were alleviated in 12.5% and unchanged in 87.5% of patients. Although exercise testing produced many false-negatives, all of the severe arrhythmias were reproduced.

Adolescent↗

[A 4 degrees C-1 min method of cold water immersion test for peripheral circulatory function in fingers].

To assess the validity of a new simplified cold water immersion test (4 degrees C-1 min method) for peripheral circulatory function, comparison was made with the conventional method (10 degrees C-10 min method). These two different methods of cold immersion test were applied to 23 patients with vibration disease and 24 healthy men. Observation was made on finger skin temperature by a thermistor and complaints in the hand by a 5-step self-reported scale method every minute during the test. The patterns of recovery of skin temperature after cold immersion in each group were similar in both methods. Pain in the hand in the 4 degrees C-1 min method was less than that in the 10 degrees C-10 min method. The recovery rate at 5 min in the patients with Raynaud's phenomenon was lower than that in those without Raynaud's phenomenon in the 4 degrees C-1 min method (p < 0.01). However, no significant differences were noted in 10 degrees C-10 min method. The results suggest that the new method is feasible in detecting the response of vasodilation after immersion. In the recovery rate at 5 min after immersion, near values of the sensitivity and specificity were observed between 50% cut-off values in the 4 degrees C-1 min method and 30% value in the 10 degrees C-10 min method. Thus, the 4 degrees C-1 min method is considered to be more useful to evaluate the physiological response after cold immersion than the 10 degrees C-10 min method.

Adult↗

Does capsaicin affect the thermal sensation of males during immersion in 18 degrees C and 22 degrees C?

Animals respond to acute local or systemic administration of capsaicin with strong nociceptive reactions. The present investigation examined the thermal sensation in males who were given capsaicin (CAP, 2 mg x kg(-1) body weight) vs a placebo (PL, a maltodextrin capsule) before immersion in cold water. Seven Caucasian males ages 20-28 years were immersed in 18 degrees C and 22 degrees C twice (PL vs CAP) for 120 minutes. The following were examined: metabolism (VO2; L x min(-1)), rectal temperature (Tre; degrees C), and thermal sensation (TS). For VO2 there were no significant differences between treatments (PL vs CAP) when the variables were pooled jointly over the two immersion temperatures (18 degrees C and 22 degrees C) and across time. However, for Tre there were significant differences detected across time (p = 0.01) when Tre was pooled jointly across two treatments and two immersion temperatures. Postanalysis of variance revealed specific significant differences between 5 minutes (mean +/- SE; 37.2 +/- 0.07) and 120 minutes (36.0 +/- 0.09). For TS, there was a trend (p = 0.0699) which demonstrated differences between immersion temperatures only when TS was pooled jointly over the two treatments and across time, whereby TS was lower in 18 degrees C (6.2 +/- 0.5) than in 22 degrees C (3.7 +/- 0.6). From these data it appears that although Tre differed across time and temperature, respectively, a CAP feeding did not affect differentially the TS and metabolic response of males during acute cold water immersion.

Adult↗

[Changes in transcutaneous tcPO2 during water immersion and its effects on the human body].

Changes in transcutaneous PO2(tcPO2) during water immersions with O2 and N2 bubbling are presented. Three healthy male volunteers underwent water immersions for 30 min. Water temperature was controlled to 36.5 degrees C to minimize any thermal stress. Minute ventilation (Ve), oxygen consumption (VO2), heart rate (HR), respiratory rate (RR), and body temperature (Tb) were continuously monitored throughout exposure. In addition, tcPO2 electrode was mounted on the volar side of the right forearm in the middle part of immersion and tcPO2 and tcPCO2 were then monitored in the water. Blood flow of the right forearm was also measured following tcPO2/tcPCO2 measurements The tcPO2 values during water immersions with O2 bubbling were higher than those with N2 bubbling for given blood flow. Although end-tidal PO2 remained unchanged for any occasion, Ve, VO2, HR, RR during water immersions with O2 bubbling were significantly decreased compared to those with N2 bubbling. Results suggest that cutaneous respiration facilitated by hydration may contribute higher tcPO2 values during water immersions with O2 bubbling and may be somewhat related to systemic changes.

Adult↗

Physiological response to water immersion: a method for sport recovery?

Recovery from exercise can be an important factor in performance during repeated bouts of exercise. In a tournament situation, where athletes may compete numerous times over a few days, enhancing recovery may provide a competitive advantage. One method that is gaining popularity as a means to enhance post-game or post-training recovery is immersion in water. Much of the literature on the ability of water immersion as a means to improve athletic recovery appears to be based on anecdotal information, with limited research on actual performance change. Water immersion may cause physiological changes within the body that could improve recovery from exercise. These physiological changes include intracellular-intravascular fluid shifts, reduction of muscle oedema and increased cardiac output (without increasing energy expenditure), which increases blood flow and possible nutrient and waste transportation through the body. Also, there may be a psychological benefit to athletes with a reduced cessation of fatigue during immersion. Water temperature alters the physiological response to immersion and cool to thermoneutral temperatures may provide the best range for recovery. Further performance-orientated research is required to determine whether water immersion is beneficial to athletes.

Athletic Injuries↗

Effect of prolonged water immersion on equine hoof epidermis in vitro.

OBJECTIVE: To evaluate the effect of prolonged water exposure on tissue mass and solutes of outer and inner layers of the stratum medium, sole, frog, and the stratum medium (SMZA) zona alba layer of horses' hooves. SPECIMEN POPULATION: 10 hooves from 10 horses without foot abnormalities. PROCEDURES: Hoof wall tissue specimens were obtained and immersed for 10 days in distilled deionized water. Serial changes in mass were recorded during the immersion period. Subsequently, osmolarity and Na+, K, Cl-, and protein concentrations of the immersion solution were quantified. RESULTS: Fully cornified outer hoof wall, sole, and frog epidermal structures increased in mass, whereas the SMZA lost mass when immersed in water. All hoof structures had a variable loss of crystalloids during immersion, but none of the specimens lost proteins. The frog epidermis was distinct in that total solute lost during immersion could not be ascribed to N+, K+, and Cl-. CONCLUSIONS AND CLINICAL RELEVANCE: Data support a 2-compartment model for the fully cornified outer stratum medium, frog, and sole that permits the exchange of crystalloids, but not proteins, across the cell membrane and infers that topical agents containing proteins cannot benefit the hoof. The unique osmotic behavior of the SMZA relative to other hoof structures suggests the hypothesis that it is composed of transitional epithelial cells. The solutes lost from frog epithelium are interpreted to reflect its unique lipid composition.

Animals↗

Electrical and contractile parameters of muscle in man: effects of 7-day "dry" water immersion.

HYPOTHESIS: The purpose of this experiment was to test the hypothesis that the changes in single muscle twitch tension (Pt) in a cosmonaut following exposure to long-duration microgravity may have been due to the sarcoplasmic reticulum, while the decrease in maximal voluntary contraction (MVC) relative to the electrically evoked maximal tetanic tension (Po) may reflect a reduction in control neural drive resulting from the voluntary muscle inactivity. METHODS: The effects of 7-d "dry" water immersion were investigated in six subjects. Changes of contraction properties were studied in the triceps surae muscle. RESULTS: After immersion, the MVC was reduced by 33.8% (p < 0.01), and the Po was reduced by 8.2% (p > 0.05). The difference between Po and MVC expressed as a percentage of Po and referred to as force deficiency, has also been calculated. The force deficiency increased by a mean of 44.1% (p < 0.01) after immersion. The decrease in Po was associated with increased maximal rate of tension development (7.2%). The twitch time-to-peak was not significantly changed, and half-relaxation time was decreased by 5.3%. However, the Pt was not significantly changed and the Pt/Po ratio was decreased by 8.7% (p < 0.01) after immersion. The muscle surface action potential presented an increase of its duration (18.8%) and a decrease of the amplitude and the total area (14.6% and 2.8%; p < 0.05-0.01, respectively). CONCLUSION: The comparison of the electrical and mechanical alterations recorded during voluntary contractions, and in contractions evoked by electrical stimulation of the motor nerve, suggests that immersion not only modifies the peripheral processes associated with contraction, but also changes central and/or neural command of the contraction. At peripheral sites, it is proposed that the intracellular processes of contraction play the role in a contractile impairment recorded during immersion.

Action Potentials↗

Immersion of distal arms and legs in warm water (AVA rewarming) effectively rewarms mildly hypothermic humans.

INTRODUCTION: Active rewarming of hypothermic victims for field use, and where transport to medical facilities is impossible, might be the only way to restore deep body temperature. In active rewarming in warm water, there has been a controversy concerning whether arms and legs should be immersed in the water or left out. Further, it has been suggested in the Royal Danish Navy treatment regime, that immersion of hands, forearms, feet, and lower legs alone might accomplish rapid rates of rewarming (AVA rewarming). METHODS: On three occasions, six subjects (one female) were cooled in 8 degrees C water, to an esophageal temperature of 34.3+/-0.8 (+/-SD) degrees C. After cooling the subjects were warmed by shivering heat production alone, or by immersing the distal extremities (hands, forearms, feet and lower legs) in either 42 degrees C or 45 degrees C water. RESULTS: The post cooling afterdrop in esophageal temperature was decreased by both 42 degrees C and 45 degrees C water immersion (0.4+/-0.2 degrees C) compared with the shivering alone procedure (0.6+/-0.4 degrees C; p < 0.05). The subsequent rate of rewarming was significantly greater with 45 degrees C water immersion (9.9+/-3.2 degrees C x h(-1)) than both 42 degrees C water immersion (6.1+/-1.2 degrees C x h(-1)) and shivering alone (3.4+/-1.5 degrees C x h(-1); p < 0.05). CONCLUSION: The extremity rewarming procedure was experienced by the subjects as the most comfortable as the rapid rise in deep body temperature shortened the period of shivering. During the extremity rewarming procedures the rectal temperature lagged considerably behind the esophageal and aural canal (via indwelling thermocouple) temperatures. Thus large gradients may still exist between body compartments even though the heart is warmed.

Adult↗

Continuous monitoring of change in hemodilution during water immersion in humans: effect of water temperature.

BACKGROUND: The present study was designed to examine whether water temperature during head-out immersion (HOI) modifies hemodilution dynamics. METHODS: We made continuous measurements of blood density (rho(b)) during HOI at 3 different water temperatures; the lower critical (32 degrees C), neutral (34.5 degrees C), and upper critical (36 degrees C) temperatures in 6 healthy male volunteers. Blood was withdrawn continuously from the antecubital vein for measurement of rho(b) during 60 min of water immersion with a 10-min control period before the immersion. The density was measured with the mechanical oscillator technique. Hematocrit (Hct), plasma density (rho(p)), and osmolality were measured at 5-min intervals. Erythrocyte density (rho(e)) was calculated from rho(b), rho(p) and Hct. Cardiac output and BP were measured to calculate total peripheral resistance. RESULTS: Hct, rho(b), and rho(p) decreased rapidly in the first 20-25 min of immersion and were maintained at a reduced level during immersion. Plasma volume calculated from rho(p) and Hct increased with the rho(b) reduction. These immersion-induced changes were independent of these water temperatures. Plasma osmolality and rho(e) remained constant throughout the experimental period in the three temperature conditions, indicating that the increase in plasma volume and hence hemodilution was induced by an isotonic fluid shift from extravascular space. The total peripheral resistance increased inversely in proportion to the water temperature during HOI. CONCLUSION: In the present condition, water temperature did not modify the net transcapillary fluid transfer during HOI in the presence of the temperature dependent increase in vascular tone.

Adult↗

[Jacuzzi-immersion for obstetric analgesia].

The effect of immersion in a jacuzzi in relieving labor pains, and on cervical dilatation was examined in 40 parturients. They were immersed in the jacuzzi during labor for an average of 25.5 minutes. Labor pains decreased during immersion by 2.59 degrees (scale of 0-10) compared with an average increase in labor pains of 0.25 degrees in 40 control women who were not immersed (p < 0.01). The cervical opening increased during immersion by an average of 1.5 cm in the test group, compared with 0.3 cm in the controls (p < 0.01). Immersion in a jacuzzi during labor is apparently associated with analgesia and accelerated cervical dilatation.

Analgesia, Obstetrical↗