A Comparison of Passive Rewarming Systems Following Cold Water Immersion.

IF 1.4 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Wilderness & Environmental Medicine Pub Date : 2024-12-01 Epub Date: 2024-09-12 DOI:10.1177/10806032241270530
Phillip J Wallace, Matthew L Hodgkinson, Lucas Ramagnano, Ramneek Singh Janjuha, Mariska J Andrade, Stephen S Cheung
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引用次数: 0

Abstract

Introduction: We studied field rewarming using a typical winter sleeping bag versus two heated hypothermia wrap systems in a semi-realistic lab simulation.

Methods: 10 participants (8 M, 2 F) were cooled to 36.1°C core temperature through 10.5-11.5°C water immersion, then performed 60 min of passive rewarming in 0°C air. The rewarming methods tested were: 1) a -9°C rated mummy-style Sleeping Bag; 2) Doctor Down Rescue Wrap; and 3) Thermal Yielding Vascular Airway Capsule (TYVAC) system; the latter two methods included vapor barriers and two heating pads. Rectal and skin temperatures, along with metabolic heat production calculated via indirect calorimetry, were measured throughout rewarming.

Results: One male participant was removed from analysis due to lack of sufficient cooling. Rectal temperature decreased in the remaining participants by ∼1.1-1.2°C to 36.1°C during the initial immersion phase. Over the 60 min of rewarming, rectal temperature changes were Δ0.0 ± 0.6°C in a sleeping bag, Δ+0.2 ± 0.3°C in Doctor Down, and Δ+0.2 ± 0.3°C in TYVAC, with no significant differences across methods. Mean skin temperatures, metabolic heat production, and perceptual measures were also similar across methods with no method×time interactions.

Conclusions: After 60 min of passive rewarming in cold conditions, all three rewarming methods were able to stall continued core cooling to levels at or slightly above post-immersion temperatures. With no differences in any physiological measures, it appears that all three rewarming methods are equally viable options for wilderness responders, and the choice should come down to environmetal conditions, availability, convenience, and ergonomics rather than rewarming efficacy.

冷水浸泡后被动回温系统的比较。
介绍:方法:10 名参与者(8 名男性,2 名女性)通过 10.5-11.5°C 的水浸泡将核心温度降至 36.1°C,然后在 0°C 的空气中进行 60 分钟的被动复温。测试的复温方法有1)额定温度为 -9°C 的木乃伊式睡袋;2)医生羽绒救援包;3)热产血管气道胶囊(TYVAC)系统;后两种方法包括蒸汽屏障和两个加热垫。在整个复温过程中测量直肠和皮肤温度,以及通过间接热量计计算的代谢产热:结果:一名男性参与者因冷却不足而被排除在分析之外。在最初的浸泡阶段,其余参与者的直肠温度下降了 1.1-1.2°C 至 36.1°C。在 60 分钟的复温过程中,睡袋中的直肠温度变化为 Δ0.0 ± 0.6°C,Doctor Down 中为 Δ+0.2 ± 0.3°C,TYVAC 中为 Δ+0.2 ± 0.3°C,各种方法之间没有显著差异。不同方法的平均皮肤温度、代谢产热和知觉测量结果也相似,没有方法×时间的交互作用:结论:在寒冷条件下被动复温 60 分钟后,所有三种复温方法都能使核心冷却持续达到或略高于浸泡后的温度。由于在任何生理指标上都没有差异,因此对于野外救援人员来说,这三种复温方法似乎都是同样可行的选择,选择时应考虑环境条件、可用性、便利性和人体工程学,而不是复温效果。
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来源期刊
Wilderness & Environmental Medicine
Wilderness & Environmental Medicine 医学-公共卫生、环境卫生与职业卫生
CiteScore
2.10
自引率
7.10%
发文量
96
审稿时长
>12 weeks
期刊介绍: Wilderness & Environmental Medicine, the official journal of the Wilderness Medical Society, is the leading journal for physicians practicing medicine in austere environments. This quarterly journal features articles on all aspects of wilderness medicine, including high altitude and climbing, cold- and heat-related phenomena, natural environmental disasters, immersion and near-drowning, diving, and barotrauma, hazardous plants/animals/insects/marine animals, animal attacks, search and rescue, ethical and legal issues, aeromedial transport, survival physiology, medicine in remote environments, travel medicine, operational medicine, and wilderness trauma management. It presents original research and clinical reports from scientists and practitioners around the globe. WEM invites submissions from authors who want to take advantage of our established publication''s unique scope, wide readership, and international recognition in the field of wilderness medicine. Its readership is a diverse group of medical and outdoor professionals who choose WEM as their primary wilderness medical resource.
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