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At least 19 recordsLinked to original sources

PubMed1977

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↗

PubMed1978

Physiological responses to head-out immersion in water at 11 ATA.

Cardiorespiratory, thermal, and renal responses to a 30-min head-out immersion in 15 degree C water were studied at 1-ATA air and 11-ATA helium-oxygne environments in four male subjects wearing dry suits. Cardiorespiratory responses to immersion (reductions in heart rate, expiratory reserve volume, vital capacity, and thoracic impedance; and increases in stroke volume, cardiac output, and inspiratory capacity) were comparable at both pressures. However, thermal responses to immersion (a reduction in mean skin temperature and increases in skin heat flux and suit conductance) were significantly greater at 11 ATA compared to those at 1 ATA. The rate of urinary excretion of norepinephrine increased significantly during and after immersion at 11 ATA but not at 1 ATA. In contrast, the urinary excretion of epinephrine was not altered by pressure or immersion. The immersion diuresis was greater and lasted longer at 11 ATA than at 1 ATA although there was no difference in the endogenous creatinine excretion . This diuresis was accompanied by a significant natriuresis which was more marked at 1 ATA than at 11 ATA. At 1 ATA, the urinary excretion of both aldosterone and antidiuretic hormone (ADH) decreased during immersion. At 11 ATA, the rate of excretion of these hormones before immersion was lower compared to that at 1 ATA and did not change significantly during immersion. These results indicate that immersion in a hyperbaric helium-oxygen environment presents a greater cold stress than at 1-ATA air, and also that immersion diuresis and natriuresis at high pressure may be induced by a factor other than inhibition of aldosterone and ADH.

Adult↗

PubMed1977

Immersion diuresis in dogs.

The mechanism of diuresis during the 1st h of immersion was investigated using anesthetized dogs. Four different experiments were carried out. First, left atrial transmural pressure was measured before, during, and after immersion. The data suggest that, although the left atrium may or may not be stretched depending on the conditions of immersion, the amount of diuresis is independent of the amount of left atrial stretch, and therefore a causal relationship between diuresis and left atrial stretch could not be established. Second, bilateral cervical vagotomy was carried out. Immersion diuresis sometimes occurred despite this vagotomy, suggesting that the left atrial stretch reflex was not participating in those cases. Third, negative-pressure breathing was carried out to simulate the negative transthoracic pressure associated with uncompensated immersion. The average left atrial transmural pressure did not change. A slight hemodilution and a moderate diuresis occurred. There was no correlation between changes in left atrial transmural pressure and changes in urine ouput. Fourth, blood studies were done on splenectomized dogs subjected to immersion. Hemodilution occurred and was most marked in dogs which had had their kidneys removed. The hemodilution is sufficient to explain the early phase of the immersion diuresis. The data suggest that, in anesthetized dogs, hemodilution is the probable initiator of diuresis upon immersion and that, in dogs, left atrial stretch is unrelated to diuresis during immersion or negative-pressure breathing.

Animals↗

PubMed1979

Comparison of physiological effects of head-down tilting and immersion on the human body.

Among the methods simulating weightlessness, effects on the human body, head-down tilting and water immersion are very useful. The purpose of the present investigation was to carry out a comparative study of water balance and water-protein composition of the blood using the above two methods to simulate the physiological effects typical of an acute stage of weightlessness adaptation. The results of the 7-d head-down tilting and immersion experiments allow the following conclusions: More pronounced changes in water balance and water-protein composition of the blood during immersion seem to indicate that immersion produces a greater effect on the human body; The pattern of changes during immersion and tilting suggests that the adaptation period to immersion takes a longer time; These findings give evidence that immersion, compared with head-down tilting, reproduces more closely effects of acute adaptation to simulated weightlessness.

Adaptation, Physiological↗

PubMed1978

Influence of hydrostatic compression of the chest and intrathoracic blood pooling on static lung mechanics during head-out immersion.

The effect of water immersion on static lung volumes and pressure-volume curves was studied in five subjects. A special container allowed measurements during nonimmersion, head-out immersion, and thorax immersion leaving the head, pelvis region, and legs dry. It was thus possible to separate the part played by hydrostatic forces acting on the chest from the part played by intrathoracic blood pooling during immersion. Hydrostatic compression of the chest decreased total lung capacity (TLC) by 0.30 liter and residual volume (RV) by 0.25 liter. Blood redistributed into the thorax during head-out immersion caused a further reduction of TLC of 0.13 liter; RV increased by 0.10 liter, probably because expiration was hampered by air-trapping. Heal-out immersion reduced VC by 0.29 liter compared to nonimmersion, and this effect was wholly attributable to intrathoracic blood pooling. Lung compliance during head-out immersion was 0.11 liter x (cmH2O)-1 smaller than during nonimmersion; this was mainly due to intrathoracic blood pooling. Results support the notion that blood redistribution decreased lung compliance by exerting an erectile effect on the lung tissue.

Adult↗

PubMed1978

Effects on handgrip strength due to arm immersion in a 10 degree C water bath.

Thirteen male and female human subjects participated in an experiment to determine if cold water immersion of the arm increases post-immersion handgrip strength. The test involved immersion of a subject's fore-arm into a 10 degrees C water bath for 30 min once a week in a 3-week series, involving a control test and two immersion experiments. Handgrip strength was measured 20 min before and then once every 20 minutes after the cold bath immersion for 4 h, for a total of 18 readings. Grip strength significantly decreased as a consequence of immersion of the forearm. However, strength recovery to approximately normal values took place within 40 min. No increases in post-immersion strength were observed.

Adult↗

PubMed1979

Influence of immersion to the neck in water on airway closure and distribution of perfusion in man.

We measured closing volume (CV), expiratory reserve volume (ERV) regional distribution of lung volume (Vr) and perfusion in 7 normal subjects in air and during immersion to the neck in water. In four subjects immersion resulted in a CV greater than ERV and the normal perfusion distribution became inverted. In the other subjects, ERV remained larger than CV and perfusion distribution during immersion was uniform, not inverted. In 5 subjects closing volume increased and in 3 of them, the ratio of apical/basal Vr increased significantly during immersion. One subject had nomeasurable CV and in the other it was not measured. The data suggest: (1) that when CV is greater than ERV during immersion there is an inversion of the normal perfusion distribution, caused by hypoxia and/or an increase in mean alveolar pressure in the alveoli beyond the closed airways, and (2) that an increase in pleural pressure gradient during immersion may contribute to the increase in C.V.

Adolescent↗

PubMed1976

Closing volumes in man immersed to the neck in water.

Closing volumes (CV), along with residual volume (RV), vital capacity (VC), along with residual volume (RV), vital capacity (VC), and expiratory reserve volume (ERV) were determined in 10 subjects in the dry and while immersed to the neck in water. Closing volumes during immersion increased 41.3% (P less than 0.001) over dry values while RV decreased 9.35% (P less than 0.001) and VC decreased 9.94% (P less than 0.001). The large decrease of 71.3% (P less than 0.001) in ERV resulted in the impingement of closing capacity (CV + RV) on the tidal volume in 9 out of 10 subjects. We interpret this to mean that airway closure occurs during tidal ventilation in immersed subjects and may result in impaired gas exchange. When tourniquets were applied to all four limbs during immersion closing volumes increased only 32.1%, but increased to 64.3% when they were removed. If engorgement of peribronchial vessels predisposes airways to collapse, a reduction of plasma volume during an extended period of immersion might lessen this possibility. In a series of long term (2.5-h) immersion experiments where moderate reductions (-10 to -7%y in plasma volume were observed, we found, however, no correlative changes in closing volume.

Adult↗

PubMed1977

Diaphragmatic function during immersion.

Diaphragmatic function during immersion to midneck level was studied in upright mongrel dogs, using constant electrophrenic stimulation. Effectiveness of diaphragmatic contraction was analyzed in terms of inspired volume (VT) (with airways open), and change in intrathoracic pressure (Pmus) (with the respiratory system occluded). Hydrostatic compression of the immersed body decreased functional residual capacity (FRC) to 55% base-line value (FRCO), resulting in a 2.8-fold increase in Pmus. In spite of this Pmus increase, VT often decreased during immersion, averaging only 83% VTO (base-line value in air). Hence, immersion was associated with a marked stiffening of the respiratory system. The Pmus increase during immersion persisted after restoration of FRC to FRCO, and was related to diaphragmatic length being greater in water than in air under condition of iso-lung volume. In all, there were three factors affecting diaphragmatic function during immersion: FRC reduction, change in thoracic configuration, and stiffening of the respiratory system.

Animals↗

PubMed1978

Alcohol and respiratory and body temperature changes during tepid water immersion.

Resting subjects were immersed for 30 min in water at 22 and 30 degrees C after drinking alcohol. Total ventilation, end-tidal PCO2, rectal temperature, aural temperature, mean skin temperature, heart rate, and oxygen consumption were recorded during the experiments. Blood samples taken before the immersion period were analyzed by gas-liquid chromatography. The mean blood alcohol levels were 82.50 +/- 9.93 mg.(100 ml)-1 and 100.6 +/- 12.64 mg (100 ml)-1 for the immersions at 22 and 30 degrees C, respectively. There was no significant change in body temperature measured aurally or rectally, mean surface skin temperature, or heart rate at either water temperature tested. Total expired ventilation was significantly attenuated for the last 15 min of the immersion at 22 degrees C, after alcohol consumption as compared to the ventilation change in water at 22 degrees C without ethanol. This response was not consistently significantly altered during immersion in water at 30 degrees C. It is evident that during a 30-min immersion in tepid water with a high blood alcohol level, body heat loss is not affected but some changes in ventilation do occur.

Body Temperature↗

PubMed1978

Contribution of peripheral pooling to the renal response to immersion in the dog.

The present investigation evaluated the renal and hemodynamic responses to head-out water immersion in dogs. Dogs were immersed in the vertical (seated) position in a 34 degrees C bath. Urine flow (V), osmolar clearance (Cosm), free water clearance (CH2O), sodium excretion (UNa+V), potassium excretion (UK+V), GFR, effective renal plasma flow (ERPF), central venous pressure (CVP), and cardiac output (CO) all increased significantly during immersion. This response was unchanged by bilateral cervical vagotomy or by deoxycorticosterone acetate and antidiuretic hormone administration. The control values of these dogs were low and indicated a state of peripheral vascular pooling which was readjusted to normal by the immersion maneuver. The renal and hemodynamic values during the period of immersion were similar to values of a group of dogs which were recumbent in air. Furthermore, when the latter group of dogs were tilted head down 19 degrees, there was no further increase in any of the measured parameters. These data are consistent with the view that water immersion in the upright dog simply redistributes blood volume back to that level seen in the recumbent dog, a position which is more natural for this species.

Animals↗

PubMed1978

Contribution of vagal pathways to the renal responses to head-out immersion in the nonhuman primate.

Studies were carried out to determine the contribution of cardiopulmonary receptors to the renal responses to head-out water immersion in the nonhuman primate. Immersion to the suprasternal notch was associated with significant increases in central venous pressure, urine flow, and sodium excretion. The increased sodium excretion was due primarily to a significant increase in the percent of the filtered sodium excreted. Deoxycorticosterone acetate (DOCA) and antiduretic hormone (ADH) had no substantial effects on these responses. The finding of a vasopressin-resistant hyposthenuria is consistent with the natriuresis of immersion being due, at least in part, to a decrease in sodium reabsorption proximal to the diluting segment, possibly the proximal tubule. Bilateral cervical vagotomy had no substantial influence on the renal responses to immersion, demonstrating that cardiopulmonary receptors whose axons traverse the vagus nerves are not necessary for the homeostatic adjustments to central hypervolemia in the primate. Since the renal and cardiovascular responses of the primate to immersion are essentially the same as those seen in man, it is probable that vagal pathways also are not necessary in man. However, it is possible that sympathetic afferents are involved in the natriuresis observed in the primate during immersion.

Animals↗

PubMed1979

Reduced aldosterone and sodium excretion in endurance-trained athletes before and during immersion.

Aldosterone excretion (AE) and plasma renin activity (PRA) were measured in eight untrained (UT) and eight endurance-trained (TR) male subjects before and during 4 h head-out immersion to study the mechanism of reduced renal sodium excretion in athletes. AE was significantly lower before immersion, and decreased less during immersion, in TR than in UT. Fractional sodium excretion, too, was lower and increased less during immersion in TR than in UT. PRA decreased in the water bath in all subjects (p less than 0.001) with no significant difference between the groups. During immersion, plasma sodium concentration oscillated whereas potassium concentration showed a temporary rise in TR (p less than 0.001). The attenuated response of AE in TR may be due partly to this increase of plasma potassium concentration. The generally reduced aldosterone release in TR might be caused by a training induced adaptation of the adrenals to corticotropin. The lowered renal sodium excretion of TR in spite of the decreased AE suggests an intensified aldosterone effect in these subjects, diminishing the salt loss during exercise.

Adult↗

PubMed1977

Neurological and phychometric studies in children surviving freshwater immersion accidents.

A study of the neurological and intellectual sequelae of childhood near-drowning is reported. Results are from a total population study, without selection, of all freshwater immersion accidents in which consciousness was lost in the water. Such accidents affected 56 children in the city of Brisbane and environs over the period 1971-75. 54 of these children have been re-examined medically and psychometrically. Over 95 per cent of children who survived such accidents were neurologically normal. The median i.q. of survivors was 110 (range 90-137), which is higher than that of the general population. There is a suggestion that visualmotor (performance)) skills are particularly vulnerable to freshwater immersion hypoxia. In 20 per cent of survivors subscale disparities between verbal and performance skills exceeded 15 i.q. points. No correlation between the post-immersion I.Q. and either estimated immersion-time or water temperature was demonstrated in this study. No long-term emotional or personality disorders were encountered. Uncommon gross clinical sequelae of prolonged immersion in fresh water included spastic quadriplegia and gross mental retardation. All children in this study were apparently dead at the moment of rescue; despite this, the prognosis of near-drowning in childhood is excellent

Child↗

PubMed1975

Expiratory reserve volume and vital capacity of the lungs during immersion in water.

The effects of immersion by 5-cm increments on the expiratory reserve volume of the lungs (ERV) and on the vital capacity were studied in the sitting and supine positions. These effects were compared to those produced by continuous negative-pressure breathing when the subjects were in air and were counteracted by positive pressure breathing during immersion. The depth of immersion was also related to definable anatomic landmarks. In the sitting position about one-fourth of the decrease in the ERV was accounted for by the hydrostatic pressure of the water on the abdomen and the remainder by the pressure on the thorax. Immersion to the level of the spinous process of the seventh cervical vertebra was equivalent to 28 cmH2o continuous negative pressure breathing in air. In the supine position, a comparable value was 8 cmH2o. These observations agree well with those of others if differences in the levels of immersion are accounted for.

Abdomen↗

PubMed1977

Alcohol, respiration, skin and body temperature during cold water immersion.

Subjects who had not been exercising, were immersed for 20 min in water at 13 degrees C after ingestion of alcohol. During the immersion period, total ventilation, end-tidal PCO2, rectal temperature, aural temperature, and mean skin temperature were recorded. Control experiments were carried out at the same water temperature. Blood samples (3 ml), taken immediately before the immersion period, were analyzed by gas liquid chromatography. The mean blood alcohol level was 90+/-11.2 mg-(100 ml)-1. There was no significant difference in ventilatory responses, rectal temperatures, aural temperatures, or mean skin temperatures achieved during the two cold water immersions. It would appear that for a 20-min immersion at 13 degrees C, relatively high blood alcohol levels do not affect ventilatory responses or increase body heat losses.

Alcohol Drinking↗

PubMed1979

Fluid shifts during initial phase of immersion diuresis in man.

The object was to study fluid shifts in man during the 1st h of immersion diuresis. Control experiments were done on subjects lying down in air for 4 h with and without vasopressin. During immersion up to the neck, seven of nine subjects had significant diuresis and natriuresis. In the first 20 min of sitting in 33 degress C water, a hemodilution of 2% of blood volume was observed. As diuresis progressed, hemoconcentration began. When vasopressin was given just before immersion to prevent the diuresis, the hemodilution observed was greater and lasted longer. Thus the hematocrit fell by 1.7 U, plasma osmolality by 6.0 mosmol/kg, plasma proteins by 0.33 g/100 ml, and plasma sodium by 5.0 meq/l. We conclude that a hemodilution of about 4% of blood volume occurs during the early plasma of immersion and the degree of hyposmolality observed suggests that the fluid shifted was more hyposmotic than the interstitial fluid alone, possibly because some intracellular water may have shifted into the bloodstream during immersion.

Diuresis↗

PubMed2026

The effect of drysuit diving in warm water on body temperature and post immersion orthostatic hypotension.

INTRODUCTION: Warm-water diving can limit heat dissipation, particularly when performed in fully encapsulating protective gear, leading to substantial thermal and cardiovascular strain that may impair diver safety. Following immersion, removal of hydrostatic support combined with heat-induced vasodilation may reduce central blood volume and increase susceptibility to orthostatic intolerance during egress and recovery. The extent to which this thermal strain impairs post-immersion orthostatic tolerance remains unknown. METHODS: Four randomised, crossover immersion trials were conducted at 28°C, 33°C, 38°C without precooling (38°C), and 38°C with precooling (38°C + Cool), with subjects wearing fully encapsulating dive gear. Subjects walked for up to 60 minutes at approximately 50% of O2max heart rate (HR) or until core temperature (Tc) reached 38.5°C, or they voluntarily stopped. Tc, HR, and perceptual measures were recorded every 10 minutes. Orthostatic tolerance was assessed after immersion via a 70° head-up tilt test. RESULTS: Eight healthy adults completed all aspects of the study. Tc and HR were higher during both 38°C conditions compared with 28°C and 33°C (all P < 0.01) with no differences between 38°C and 38°C + Cool. Sweat loss exceeded 1.2 (SD 0.67) L⋅h-1 in both 38°C conditions compared with ≤ 0.3 (0.32) L⋅h-1 at 28°C and 33°C (P < 0.01). Survival analysis showed orthostatic tolerance decreased with increasing thermal stress (log-rank P = 0.027; trend P = 0.003). Precooling did not reduce peak Tc or HR, nor did it improve tolerance time in 38°C water. CONCLUSIONS: Encapsulated warm-water diving causes heat stress and cardiovascular strain that persists after immersion, impairing orthostatic tolerance. Precooling does not significantly reduce these outcomes.

Humans↗