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At least 19 recordsLinked to original sources

Ice-Water Immersion and Cold-Water Immersion Provide Similar Cooling Rates in Runners With Exercise-Induced Hyperthermia.

OBJECTIVE: To assess whether ice-water immersion or cold-water immersion is the more effective treatment for rapidly cooling hyperthermic runners. DESIGN AND SETTING: 17 heat-acclimated highly trained distance runners (age = 28 +/- 2 years, height = 180 +/- 2 cm, weight = 68.5 +/- 2.1 kg, body fat = 11.2 +/- 1.3%, training volume = 89 +/- 10 km/wk) completed a hilly trail run (approximately 19 km and 86 minutes) in the heat (wet-bulb globe temperature = 27 +/- 1 degrees C) at an individually selected "comfortable" pace on 3 occasions 1 week apart. The random, crossover design included (1) distance run, then 12 minutes of ice-water immersion (5.15 +/- 0.20 degrees C), (2) distance run, then 12 minutes of cold-water immersion (14.03 +/- 0.28 degrees C), or (3) distance run, then 12 minutes of mock immersion (no water, air temperature = 28.88 +/- 0.76 degrees C). MEASUREMENTS: Each subject was immersed from the shoulders to the hip joints for 12 minutes in a tub. Three minutes elapsed between the distance run and the start of immersion. Rectal temperature was recorded at the start of immersion, at each minute of immersion, and 3, 6, 10, and 15 minutes postimmersion. No rehydration occurred during any trial. RESULTS: Length of distance run, time to complete distance run, rectal temperature, and percentage of dehydration after distance run were similar (P >.05) among all trials, as was the wet-bulb globe temperature. No differences (P >.05) for cooling rates were found when comparing ice-water immersion, cold-water immersion, and mock immersion at the start of immersion to 4 minutes, 4 to 8 minutes, and the start of immersion to 8 minutes. Ice-water immersion and cold-water immersion cooling rates were similar (P >.05) to each other and greater (P <.05) than mock immersion at 8 to 12 minutes, the start of immersion to 10 minutes, and the start of immersion to every other time point thereafter. Rectal temperatures were similar (P >.05) between ice-water immersion and cold-water immersion at the completion of immersion and 15 minutes postimmersion, but ice-water immersion rectal temperatures were less (P <.05) than cold-water immersion at 6 and 10 minutes postimmersion. CONCLUSIONS: Cooling rates were nearly identical between ice-water immersion and cold-water immersion, while both were 38% more effective in cooling after 12 minutes of immersion than the mock-immersion trial. Given the similarities in cooling rates and rectal temperatures between ice-water immersion and cold-water immersion, either mode of cooling is recommended for treating the hyperthermic individual.

Journal Article↗

An evaluation of hand immersion for rewarming individuals cooled by immersion in cold water.

The hypothesis that hypothermic individuals can be actively rewarmed in the field by immersion of the extremities in hot water was investigated. Three techniques for rewarming subjects with lowered deep body temperatures were compared: a) whole body immersion to the neck in water at 40 degrees C; b) immersion of two hands plus forearms only in water at 42 degrees C; and c) passive rewarming. The suggestion that the fall in deep body temperature resulting from immersion to the neck in water at 15 degrees C could be arrested by immersing both arms in water at 42 degrees C was also investigated. Results indicated that immersion to the neck in hot water was clearly the most effective rewarming technique. No significant difference (p > 0.05) was observed in the deep body temperature response during passive rewarming or during immersion of both hands and forearms in water at 42 degrees C. In the later condition some increase in peripheral blood flow to the hands may have occurred and resulted in a heat input of approximately 12 W, but any benefit from this was negated by an associated significant decrease (p > 0.05) in intrinsic heat production. Immersing the arms in hot water during immersion to the neck in cold water appeared to accelerate rather than decelerate the rate of fall of deep body temperature. We concluded that hand rewarming, although theoretically attractive, is ineffective in practice and could be detrimental in some circumstances, by suppressing intrinsic heat production or precipitating rewarming collapse.

Adult↗

Warming by immersion or exercise affects initial cooling rate during subsequent cold water immersion.

INTRODUCTION: We examined the effect of prior heating, by exercise and warm-water immersion, on core cooling rates in individuals rendered mildly hypothermic by immersion in cold water. METHODS: There were seven male subjects who were randomly assigned to one of three groups: 1) seated rest for 15 min (control); 2) cycling ergometry for 15 min at 70% Vo2 peak (active warming); or 3) immersion in a circulated bath at 40 degrees C to an esophageal temperature (Tes) similar to that at the end of exercise (passive warming). Subjects were then immersed in 7 degrees C water to a Tes of 34.5 degrees C. RESULTS: Initial Tes cooling rates (initial approximately 6 min cooling) differed significantly among the treatment conditions (0.074 +/- 0.045, 0.129 +/- 0.076, and 0.348 +/- 0.117 degrees C x min(-1) for control, active, and passive warming conditions, respectively); however, secondary cooling rates (rates following initial approximately 6 min cooling to the end of immersion) were not different between treatments (average of 0.102 +/- 0.085 degrees C x min(-1)). Overall Tes cooling rates during the full immersion period differed significantly and were 0.067 +/- 0.047, 0.085 +/- 0.045, and 0.209 +/- 0.131 degrees C x min(-1) for control, active, and passive warming, respectively. DISCUSSION: These results suggest that prior warming by both active and, to a greater extent, passive warming, may predispose a person to greater heat loss and to experience a larger decline in core temperature when subsequently exposed to cold water. Thus, functional time and possibly survival time could be reduced when cold water immersion is preceded by whole-body passive warming, and to a lesser degree by active warming.

Adult↗

[Status of human hemodynamics during water immersion in different postures of immersion].

Central and peripheral hemodynamics was investigated in 16 essentially healthy volunteers who performed a routine tilt test or a tilt test in water immersion. Unlike tilt tests carried out before water immersion, the supine to up-right transfer in water did not change cardiac rhythm, cardiac output, leg blood flow or other circulation parameters. The fact that there are no posture-related circulation changes in water immersion suggests that the horizontal and upright positions in water can be viewed as hemodynamically similar.

Adult↗

The danger of fatal misjudgement in hypothermia after immersion. Successful resuscitation following immersion for 25 minutes.

A case is reported of the successful resuscitation of a 6-year-old child after 25 minutes' immersion in water at 4 degrees C. The difficulties of evaluating vital functions at low body temperatures, with the accompanying danger of fatal misjudgment, are pointed out. It is concluded that low body temperatures indicate that a considerably longer resuscitation procedure than normal should be undertaken, particularly in children, and that if the body temperature is above 30 degrees C rewarming ought not to take place before satisfactory oxygenation and an efficient circulation have been established.

Child↗

[Cold water immersion test for diagnosis of vibration diseases. Comparison between water at 5 degrees C and 10 degrees C].

5 degrees C-water 10-minute immersion test, generally used in Japan, is useful to diagnose vibration diseases. But severe pains during the immersion is troublesome. We studied the availability of 10 degrees C-water 10-minute immersion test to reduce the pain during the test. Subjects were forty-nine chainsaw operators, nineteen patients with vibration disease, and twelve controls. The same subject underwent both 5 degrees C and 10 degrees C immersion tests. The following results were obtained. 1) Skin temperatures in the highest score group after the immersion tests both at 5 degrees C and 10 degrees C was lower than that in the control group. Mean skin temperatures for the last five minutes during the immersion and the recovery activity in both the immersion tests showed a similar trend among subjects groups. Skin temperatures in patients under medical treatment (R'group) did not differ from those in the control group. 2) Hyperemia time by nail press test in the R'group and in the high score group after both immersion tests was longer than that in the control group. But this difference between chainsaw operators and the control group after 5 degrees C immersion test was more marked than that after 10 degrees C immersion test. 3) Vibratory sense as well as pain sense in the R'group and in the high score group after both immersion tests were less sharp than those in the control group. 4) Skin temperatures, nail press test, vibratory sense, and pain sense after 5 degrees C immersion test and those after 10 degrees C immersion test showed statistically significant positive correlation. 5) 10 degrees C immersion test is as effective as 5 degrees C immersion test in finding nervous disorders, but 5 degrees C immersion test is more effective than 10 degrees C immersion test in finding circulatory disorders. However patients with Raynaud's phenomena or moderate circulatory disorders can also be found even by 10 degrees C immersion test. 6) Cold water immersion test revealed disorders not only in skin temperature and by nail press test but revealed also disorders in vibratory sense and pain sense, therefore it is desirable that cold water immersion test should be done in the examination of vibration diseases.

Blood Circulation↗

Into hot water head first: distribution of intentional and unintentional immersion burns.

INTRODUCTION: Experience with several, previously unreported, intentional face-first immersion burns led us to evaluate the distribution of inflicted and unintentional immersion scald burns in a hospital series. SETTING: (1) Authors' clinical and legal practices; (2) Burn center at regional Level 1 trauma hospital. SUBJECTS: : (1) Case series of face-first, inflicted immersion burn victims; (2) Consecutive hospitalized scald burn victims younger than 5 years old, 1/3/1996 to 3/25/2000. METHODS: (1) Individual case reports; (2) Retrospective records review. Simple descriptive statistics, Fisher Exact test and t test. RESULTS: (1) Six cases of inflicted head and neck immersion injury are described. Four were tap water and 2 food/drink scalds. (2) 22/195 hospitalized victims had sustained immersion burns, 13 from tap water and 9 from other fluids. Six (46%) tap water immersions and no (0%) other immersions had inflicted injuries (P = 0.05). Two of the tap water immersions and one other source immersion included burning of the head and neck. Of these, one tap water immersion, but no other immersion, was inflicted. In no patients were head and neck injuries the sole or predominant site of scalding. In all, 9 children sustained inflicted scalds. Bilateral lower extremity tap water immersion scalds occurred in 100% (6/6) of abusive and 29% (2/7) of unintentional injuries (P = 0.02). Buttock and perineal injuries occurred in 67% (4/6) inflicted versus 29% (2/7) unintentional tap water immersion scalds (P = 0.28). Other fluids caused bilateral lower extremity immersion burns in 3/9 (33 %) unintentionally injured patients, but no abused children (NS). CONCLUSIONS: Craniofacial immersion injury, although seen by the authors in legal cases, is infrequent. It was present incidentally in one inflicted tap water burn in the consecutive hospital series. This series affirms the predominance of bilateral lower extremity burns in inflicted tap water immersions. Buttock/perineal immersions were more common with abuse than with unintentional injury.

Accidents, Home↗

Cardiovascular responses to cold-water immersions of the forearm and face, and their relationship to apnoea.

Apnoea as well as cold stimulation of the face or the extremities elicits marked cardiovascular reflexes in humans. The purpose of this study was to investigate whether forearm immersion in cold water has any effect on the cardiovascular responses to face immersion and apnoea. We recorded cardiovascular responses to coldwater immersions of the forearm and face in 19 (part I) and 23 subjects (part II). The experimental protocol was divided in two parts, each part containing four tests: I1, forearm immersion during eupnoea; I2, face immersion during eupnoea; I3, forearm and face immersion during eupnoea; I4, face immersion during apnoea; II1, apnoea without immersion; II2, forearm immersion during apnoea; II3, face immersion during apnoea; and II4, forearm and face immersion during apnoea. The water temperature was 9-11 degrees C. Cold-water immersion of either the forearm or face was enough to elicit the most pronounced thermoregulatory vasoconstriction during both eupnoea and apnoea. During eupnoea, heart rate responses to forearm immersion (3% increase) and face immersion (9% decrease) were additive during concurrent stimulation (3% decrease). During apnoea, the heart rate responses were not affected by the forearm immersion. The oxygen-conserving diving response seems to dominate over thermoregulatory responses in the threat of asphyxia. During breathing, however, the diving response serves no purpose and does not set thermoregulatory adjustments aside.

Adult↗

Permanence of the habituation of the initial responses to cold-water immersion in humans.

Sudden immersion in cold water initiates an inspiratory gasp response followed by uncontrollable hyperventilation and tachycardia. It is known that this response, termed the "cold shock" response, can be attenuated following repeated immersion. In the present investigation we examined how long this habituation lasts. Twelve healthy male volunteers participated in the experiment, they were divided into a control (C) group (n = 4), and a habituation (H) group (n = 8). In October, each subject undertook two 3-min head-out seated immersions into stirred water at 10 degrees C wearing swimming trunks. These immersions took place at the same time of day, with 4 days separating the two immersions. In the intervening period, the C group were not exposed to cold water, while the H group undertook six, 3-min head-out immersions in water at 15 degrees C. Two months (December), 4 months (February), 7 months (May) and 14 months (January) after their first immersion, all subjects undertook another 3-min head-out immersion in water at 10 degrees C. The H group showed a reduction in respiratory frequency (47 to 24 breaths x min(-1)), inspiratory minute volume (72.2 to 31.3 1 x min(-1)) and heart rate (128 to 109 beats x min(-1)) during the first 30 s of immersion on day 5 compared to day 1. Seven months later these responses were still significantly reduced compared to day 1. After 14 months, heart rate remained attenuated but respiratory frequency and inspiratory minute volume had returned towards pre-habituation levels. The responses of the C group during the first 30 s of immersion were not altered. Both groups showed an attenuation in the responses during the remaining 150 s of immersion following repeated immersions. It is concluded that repeated immersions in cold water result in a longlasting (7-14 months) reduction in the magnitude of the cold shock response. Less frequent immersions produced a decrease in the duration, but not the magnitude of the response.

Adult↗

Temperature dependence of habituation of the initial responses to cold-water immersion.

The initial responses to cold-water immersion, evoked by stimulation of peripheral cold receptors, include tachycardia, a reflex inspiratory gasp and uncontrollable hyperventilation. When immersed naked, the maximum responses are initiated in water at 10 degrees C, with smaller responses being observed following immersion in water at 15 degrees C. Habituation of the initial responses can be achieved following repeated immersions, but the specificity of this response with regard to water temperature is not known. Thirteen healthy male volunteers were divided into a control (C) group (n = 5) and a habituation (H) group (n = 8). Each subject undertook two 3-min head-out immersions in water at 10 degrees C wearing swimming trunks. These immersions took place at a corresponding time of day with 4 days separating the two immersions. In the intervening period the C group were not exposed to cold water, while the H group undertook another six, 3-min, head-out immersions in water at 15 degrees C. Respiratory rate (fR), inspiratory minute volume (VI) and heart rate (fH) were measured continuously throughout each immersion. Following repeated immersions in water at 15 degrees C, the fR, VI and fH responses of the H group over the first 30 s of immersion were reduced (P < 0.01) from 33.3 breaths x min(-1), 50.5 l x min(-1) and 114 beats x min(-1) respectively, to 19.8 breaths x min(-1) 26.41 x min(-1) and 98 beats x min(-1), respectively. In water at 10 degrees C these responses were reduced (P < 0.01) from 47.3 breaths x min(-1), 67.61 x min(-1) and 128 beats x min(-1) to 24.0 breaths x min(-1), 29.5 l x min(-1) and 109 beats x min(-1), respectively over a corresponding period of immersion. Similar reductions were observed during the last 2.5 min of immersions. The initial responses of the C group were unchanged. It is concluded that habituation of the cold shock response can be achieved by immersion in warmer water than that for which protection is required. This suggests that repeated submaximal stimulation of the cutaneous cold receptors is sufficient to attenuate the responses to more maximal stimulation.

Adaptation, Physiological↗

Factors influencing autonomic nervous function during cold-water immersion test in patients with hand-arm vibration syndrome.

OBJECTIVES: Factors influencing autonomic nervous function in patients with hand-arm vibration syndrome (HAVS) in response to cold-water immersion test with different water temperatures and immersion times were investigated in the summer and winter seasons. METHODS: Fourteen HAVS patients with vibration-induced white finger (VWF) and 14 healthy control subjects individually age-matched to the patients consented in writing and participated in this study. Patients and controls immersed their left hands in water at 10 degrees C for 10 min and at 15 degrees C for 3 min in summer and in winter in a room with temperature maintained at 21+/-1 degrees C. Electrocardiographic (ECG) data were recorded during the test period and the R-R intervals were analyzed with a fast Fourier transformation (FFT) program. Percentage of very low frequency (VLF%; indicator of both sympathetic and parasympathetic nervous function, and function of rennin-angiotensin system), low frequency (LF%; indicator of both sympathetic and parasympathetic nervous function), high frequency (HF%; indicator of parasympathetic nervous function), and LF/HF ratio (indicator of sympathetic nervous function) were calculated. The results by three-way analysis of variance (ANOVA) were reported elsewhere. In the present study, repeated measures ANOVA was used to re-analyze the factors of data measurement time (time factor) and group (group factor), and their interaction for each test method (water at 10 degrees C for 10-min immersion time; water at 15 degrees C for 3-min immersion time) in summer and winter. RESULTS: The HF% of HAVS patients tended to be lower than that of healthy controls throughout the cold-water immersion tests except for during tests involving water at 10 degrees C for 10-min immersion in summer. The group factor for HF% was statistically significant with an exception during the test involving water at 10 degrees C and 10-min immersion time in summer. The time factor for HF% was statistically significant with an exception during the test involving water at 15 degrees C and 3-min immersion time in winter. CONCLUSIONS: The findings of the present study indicated lower cardiac parasympathetic activity in HAVS patients than in healthy controls, especially in winter. The response of the autonomic nervous system to cold stimulation was to some extent more clearly observed during the immersion test with water at 10 degrees C and 10-min immersion time than during the immersion test with water at 15 degrees C and 3-min immersion time. The results revealed by three-way analysis in a previous study were similar to those in the present study with data analysis by repeated measures ANOVA.

Analysis of Variance↗

Distortion of calculated whole-body hematocrit during lower-body immersion in water.

We found a difference between the venous hematocrits of immersed and nonimmersed arms during immersion of the lower body in cold water but not during a comparable exposure to warm water. Fourteen healthy men were exposed to three different experimental conditions: arm immersion, body immersion, and control. The men always sat upright while both upper extremities hung vertically at their sides. During arm immersion, one forearm was completely immersed for 30 min in either cold water (28 degrees C, n = 7) or warm water (38 degrees C, n = 7). This cold-warm water protocol was repeated on separate days for exposure to the remaining conditions of body immersion (immersion of 1 forearm and all tissues below the xiphoid process) and control (no immersion). Blood samples were simultaneously drawn from cannulated veins in both antecubital fossae. Hematocrit difference (Hct diff) was measured by subtracting the nonimmersed forearm's hematocrit (Hct dry) from the immersed forearm's hematocrit (Hct wet). Hct diff was approximately zero when the men were exposed to the control condition and body immersion in warm water. In the remaining conditions, Hct wet dropped below Hct dry (P less than 0.01, 3-way analysis of variance). The decrements of Hct diff showed there were differences between venous hematocrits in immersed and nonimmersed regions of the body, indicating that changes of the whole-body hematocrit cannot be calculated from a large-vessel hematocrit soon after immersing the lower body in cold water.

Adult↗

Whole body cooling by immersion in water at moderate temperatures.

This study investigated the potential use of whole body cooling by water immersion for lowering body temperatures prior to endurance exercise. Rectal temperature (Tre), mean skin temperature (Tsk), oxygen consumption (VO2), and ventilation (VE) were measured in 7 male and 3 female subjects who were immersed in a water bath for up to 60 min. Initial water temperature was 28.8+/-1.5 degrees C and decreased to 23.8+/-1.1 degrees C by the end of immersion. Pre-immersion Tre of 37.34+/-0.36 degrees C was not altered by 60 min water immersion but decreased to 36.64+/-0.34 degrees C at 3 min post immersion (p < 0.01). Tsk decreased from 33.23+/-1.4 degrees C to 26.95+/-1.8 degrees C (p < 0.01) at the end of immersion. Reductions in Tre and Tsk resulted in reduced body heat content (Hc) of approximately 545 kJ (p < 0.01) at the end of immersion. VO2 and VE increased from pre-immersion values of 0.34+/-0.08 L x min(-1) and 6.2+/-1.4 L x min(-1) to 0.54+/-0.09 L x min(-) and 11.5+/-5.4 L x min(-1) at the end of immersion, respectively. Heart rate remained unchanged throughout immersion. These results indicate that whole body immersion in moderately cold water temperatures is an effective cooling maneuver for lowering body temperatures and body Hc in the absence of severe physiological responses generally associated with sudden cold stress.

Analysis of Variance↗