A second postcooling afterdrop: more evidence for a convective mechanism

1992 ◽  
Vol 73 (4) ◽  
pp. 1253-1258 ◽  
Author(s):  
G. G. Giesbrecht ◽  
G. K. Bristow

An attempt was made to demonstrate the importance of increased perfusion of cold tissue in core temperature afterdrop. Five male subjects were cooled twice in water (8 degrees C) for 53–80 min. They were then rewarmed by one of two methods (shivering thermogenesis or treadmill exercise) for another 40–65 min, after which they entered a warm bath (40 degrees C). Esophageal temperature (Tes) as well as thigh and calf muscle temperatures at three depths (1.5, 3.0, and 4.5 cm) were measured. Cold water immersion was terminated at Tes varying between 33.0 and 34.5 degrees C. For each subject this temperature was similar in both trials. The initial core temperature afterdrop was 58% greater during exercise (mean +/- SE, 0.65 +/- 0.10 degrees C) than shivering (0.41 +/- 0.06 degrees C) (P < 0.005). Within the first 5 min after subjects entered the warm bath the initial rate of rewarming (previously established during shivering or exercise, approximately 0.07 degrees C/min) decreased. The attenuation was 0.088 +/- 0.03 degrees C/min (P < 0.025) after shivering and 0.062 +/- 0.022 degrees C/min (P < 0.025) after exercise. In 4 of 10 trials (2 after shivering and 2 after exercise) a second afterdrop occurred during this period. We suggest that increased perfusion of cold tissue is one probable mechanism responsible for attenuation or reversal of the initial rewarming rate. These results have important implications for treatment of hypothermia victims, even when treatment commences long after removal from cold water.

1995 ◽  
Vol 78 (6) ◽  
pp. 2301-2308 ◽  
Author(s):  
S. S. Cheung ◽  
I. B. Mekjavic

The present study investigated whether nitrous oxide (N2O) attenuates shivering thermogenesis during cold water immersion in a dose-dependent manner. Seven male subjects were immersed to the neck for 60 min in 20 degrees C water on five separate occasions while breathing either air (AIR) or a normoxic mixture of 10, 15, 20, or 25% N2O balanced with N2. All N2O concentrations investigated caused a significant (P < 0.02) reduction in shivering thermogenesis compared with AIR. Despite similar heat flux from the skin, the relative changes in esophageal temperature from resting preimmersion levels were significantly greater (P < 0.05) during the N2O trials compared with AIR, with no significant difference among the N2O conditions. A dose-dependent trend in the perception of thermal comfort was observed for the N2O conditions. It is concluded that shivering thermogenesis, and thus thermal balance, is affected to the same degree for the range of inspired N2O concentrations investigated, with no discernable dose-dependent effect.


1988 ◽  
Vol 65 (6) ◽  
pp. 2709-2713 ◽  
Author(s):  
K. D. Mittleman ◽  
I. B. Mekjavic

Recent studies using inanimate and animal models suggest that the afterdrop observed upon rewarming from hypothermia is based entirely on physical laws of heat flow without involvement of the returning cooled blood from the limbs. During the investigation of thermoregulatory responses to cold water immersion (15 degrees C), blood flow to the limbs (minimized by the effects of hydrostatic pressure and vasoconstriction) was occluded in 17 male subjects (age, 29.0 +/- 3.3 yr). Comparisons of rectal (Tre) and esophageal temperature (Tes) responses were made during the 5 min before occlusion, during the 10-min occlusion period, and for 5 min immediately after the release of the cuffs (postocclusion). In the preocclusion phase, Tre and Tes showed similar cooling rates. The occlusion of blood flow to the extremities significantly arrested the cooling of Tes (P less than 0.05) with little effect on Tre. Upon release of the pressure cuffs, the returning extremity blood flow resulted in an increased rate of cooling, that was three times greater at the esophageal site (-0:149 +/- 0.052 vs. -0.050 +/- 0.026 degrees C.min-1). These results suggest that the cooled peripheral circulation, minimized during cold water immersion, may dramatically affect esophageal temperature and the complete neglect of the circulatory component to the afterdrop phenomenon is not warranted.


1989 ◽  
Vol 67 (6) ◽  
pp. 2466-2472 ◽  
Author(s):  
L. Martineau ◽  
I. Jacobs

The purpose of this study was to investigate whether a reduced availability of plasma free fatty acids (FFA) would impair human temperature regulation during cold exposure. Seven seminude male subjects were immersed on two occasions in 18 degrees C water for 90 min or until their rectal temperature (Tre) decreased to 35.5 degrees C. The immersion occurred after 2 h of intermittent oral ingestion of either nicotinic acid (NIC) or a placebo (PLAC). Plasma FFA levels immediately before the immersion were significantly lower in NIC (87 +/- 15 mumol/l) than in PLAC (655 +/- 116 mumol/l, P less than 0.05). Although FFA levels increased by 73% in NIC during the immersion (P less than 0.05), they remained significantly lower than in PLAC (151 +/- 19 vs. 716 +/- 74 mumol/l, P less than 0.05) throughout the immersion. Muscle glycogen concentrations in the vastus lateralis decreased after cold water immersion in both trials (P less than 0.05), but the rate of glycogen utilization was similar, averaging 1.00 +/- 0.27 mmol glucose unit.kg dry muscle-1.min-1). Plasma glucose levels were significantly reduced after immersion in both trials (P less than 0.05), this decrease being greater in NIC (1.3 +/- 0.2 mmol/l) than in PLAC (0.7 +/- 0.1 mmol/l, P less than 0.05). O2 uptake increased to 3.8 +/- 0.3 times preimmersion values in both trials (P less than 0.05). Mean respiratory exchange ratio (RER) immediately before the immersion was greater in NIC (0.87 +/- 0.02) than in PLAC (0.77 +/- 0.01, P less than 0.05). Cold exposure increased RER in PLAC but not in NIC.(ABSTRACT TRUNCATED AT 250 WORDS)


2016 ◽  
Vol 41 (11) ◽  
pp. 1163-1170 ◽  
Author(s):  
Avina McCarthy ◽  
James Mulligan ◽  
Mikel Egaña

A brief cold water immersion between 2 continuous high-intensity exercise bouts improves the performance of the latter compared with passive recovery in the heat. We investigated if this effect is apparent in normothermic conditions (∼19 °C), employing an intermittent high-intensity exercise designed to reflect the work performed at the high-intensity domain in team sports. Fifteen young active men completed 2 exhaustive cycling protocols (Ex1 and Ex2: 12 min at 85% ventilatory threshold (VT) and then an intermittent exercise alternating 30-s at 40% peak power (Ppeak) and 30 s at 90% Ppeak to exhaustion) separated by 15 min of (i) passive rest, (ii) 5-min cold-water immersion at 8 °C, and (iii) 10-min cold-water immersion at 8 °C. Core temperature, heart rate, rates of perceived exertion, and oxygen uptake kinetics were not different during Ex1 among conditions. Time to failure during the intermittent exercise was significantly (P < 0.05) longer during Ex2 following the 5- and 10-min cold-water immersions (7.2 ± 3.5 min and 7.3 ± 3.3 min, respectively) compared with passive rest (5.8 ± 3.1 min). Core temperature, heart rate, and rates of perceived exertion were significantly (P < 0.05) lower during most periods of Ex2 after both cold-water immersions compared with passive rest. The time constant of phase II oxygen uptake response during the 85% VT bout of Ex2 was not different among the 3 conditions. A postexercise, 5- to 10-min cold-water immersion increases subsequent intermittent high-intensity exercise compared with passive rest in normothermia due, at least in part, to reductions in core temperature, circulatory strain, and effort perception.


1988 ◽  
Vol 65 (5) ◽  
pp. 2046-2050 ◽  
Author(s):  
L. Martineau ◽  
I. Jacobs

The purpose of the present study was to clarify the importance of skeletal muscle glycogen as a fuel for shivering thermogenesis in humans during cold-water immersion. Fourteen seminude subjects were immersed to the shoulders in 18 degrees C water for 90 min or until rectal temperature (Tre) decreased to 35.5 degrees C. Biopsies from the vastus lateralis muscle and venous blood samples were obtained before and immediately after the immersion. Metabolic rate increased during the immersion to 3.5 +/- 0.3 (SE) times resting values, whereas Tre decreased by 0.9 degrees C to approximately 35.8 degrees C at the end of the immersion. Intramuscular glycogen concentration in the vastus lateralis decreased from 410 +/- 15 to 332 +/- 18 mmol glucose/kg dry muscle, with each subject showing a decrease (P less than 0.001). Plasma volume decreased (P less than 0.001) markedly during the immersion (-24 +/- 1%). After correcting for this decrease, blood lactate and plasma glycerol levels increased by 60 (P less than 0.05) and 38% (P less than 0.01), respectively, whereas plasma glucose levels were reduced by 20% after the immersion (P less than 0.001). The mean expiratory exchange ratio showed a biphasic pattern, increasing initially during the first 30 min of the immersion from 0.80 +/- 0.06 to 0.85 +/- 0.05 (P less than 0.01) and decreasing thereafter toward basal values. The results demonstrate clearly that intramuscular glycogen reserves are used as a metabolic substrate to fuel intensive thermogenic shivering activity of human skeletal muscle.


2016 ◽  
Vol 51 (6) ◽  
pp. 500-501 ◽  
Author(s):  
Emma A. Nye ◽  
Jessica R. Edler ◽  
Lindsey E. Eberman ◽  
Kenneth E. Games

Reference: Zhang Y, Davis JK, Casa DJ, Bishop PA. Optimizing cold water immersion for exercise-induced hyperthermia: a meta-analysis. Med Sci Sports Exerc. 2015;47(11):2464−2472. Clinical Questions: Do optimal procedures exist for implementing cold-water immersion (CWI) that yields high cooling rates for hyperthermic individuals? Data Sources: One reviewer performed a literature search using PubMed and Web of Science. Search phrases were cold water immersion, forearm immersion, ice bath, ice water immersion, immersion, AND cooling. Study Selection: Studies were included based on the following criteria: (1) English language, (2) full-length articles published in peer-reviewed journals, (3) healthy adults subjected to exercise-induced hyperthermia, and (4) reporting of core temperature as 1 outcome measure. A total of 19 studies were analyzed. Data Extraction: Pre-immersion core temperature, immersion water temperature, ambient temperature, immersion duration, and immersion level were coded a priori for extraction. Data originally reported in graphical form were digitally converted to numeric values. Mean differences comparing the cooling rates of CWI with passive recovery, standard deviation of change from baseline core temperature, and within-subjects r were extracted. Two independent reviewers used the Physiotherapy Evidence Database (PEDro) scale to assess the risk of bias. Main Results: Cold-water immersion increased the cooling rate by 0.03°C/min (95% confidence interval [CI] = 0.03, 0.04°C/min) compared with passive recovery. Cooling rates were more effective when the pre-immersion core temperature was ≥38.6°C (P = .023), immersion water temperature was ≤10°C (P = .036), ambient temperature was ≥20°C (P = .013), or immersion duration was ≤10 minutes (P &lt; .001). Cooling rates for torso and limb immersion (mean difference = 0.04°C/min, 95% CI = 0.03, 0.06°C/min) were higher (P = .028) than those for forearm and hand immersion (mean difference = 0.01°C/min, 95% CI = −0.01, 0.04°C/min). Conclusions: Hyperthermic individuals were cooled twice as fast by CWI as by passive recovery. Therefore, the former method is the preferred choice when treating patients with exertional heat stroke. Water temperature should be &lt;10°C, with the torso and limbs immersed. Insufficient published evidence supports CWI of the forearms and hands.


2018 ◽  
Vol 13 (7) ◽  
pp. 917-925 ◽  
Author(s):  
Jessica M. Stephens ◽  
Ken Sharpe ◽  
Christopher Gore ◽  
Joanna Miller ◽  
Gary J. Slater ◽  
...  

Purpose: To examine the effect of postexercise cold-water immersion (CWI) protocols, compared with control (CON), on the magnitude and time course of core temperature (Tc) responses. Methods: Pooled-data analyses were used to examine the Tc responses of 157 subjects from previous postexercise CWI trials in the authors’ laboratories. CWI protocols varied with different combinations of temperature, duration, immersion depth, and mode (continuous vs intermittent). Tc was examined as a double difference (ΔΔTc), calculated as the change in Tc in CWI condition minus the corresponding change in CON. The effect of CWI on ΔΔTc was assessed using separate linear mixed models across 2 time components (component 1, immersion; component 2, postintervention). Results: Intermittent CWI resulted in a mean decrease in ΔΔTc that was 0.25°C (0.10°C) (estimate [SE]) greater than continuous CWI during the immersion component (P = .02). There was a significant effect of CWI temperature during the immersion component (P = .05), where reductions in water temperature of 1°C resulted in decreases in ΔΔTc of 0.03°C (0.01°C). Similarly, the effect of CWI duration was significant during the immersion component (P = .01), where every 1 min of immersion resulted in a decrease in ΔΔTc of 0.02°C (0.01°C). The peak difference in Tc between the CWI and CON interventions during the postimmersion component occurred at 60 min postintervention. Conclusions: Variations in CWI mode, duration, and temperature may have a significant effect on the extent of change in Tc. Careful consideration should be given to determine the optimal amount of core cooling before deciding which combination of protocol factors to prescribe.


2019 ◽  
Vol 126 (6) ◽  
pp. 1598-1606 ◽  
Author(s):  
Kyle Gordon ◽  
Denis P. Blondin ◽  
Brian J. Friesen ◽  
Hans Christian Tingelstad ◽  
Glen P. Kenny ◽  
...  

Daily compensable cold exposure in humans reduces shivering by ~20% without changing total heat production, partly by increasing brown adipose tissue thermogenic capacity and activity. Although acclimation and acclimatization studies have long suggested that daily reductions in core temperature are essential to elicit significant metabolic changes in response to repeated cold exposure, this has never directly been demonstrated. The aim of the present study is to determine whether daily cold-water immersion, resulting in a significant fall in core temperature, can further reduce shivering intensity during mild acute cold exposure. Seven men underwent 1 h of daily cold-water immersion (14°C) for seven consecutive days. Immediately before and following the acclimation protocol, participants underwent a mild cold exposure using a novel skin temperature clamping cold exposure protocol to elicit the same thermogenic rate between trials. Metabolic heat production, shivering intensity, muscle recruitment pattern, and thermal sensation were measured throughout these experimental sessions. Uncompensable cold acclimation reduced total shivering intensity by 36% ( P = 0.003), without affecting whole body heat production, double what was previously shown from a 4-wk mild acclimation. This implies that nonshivering thermogenesis increased to supplement the reduction in the thermogenic contribution of shivering. As fuel selection did not change following the 7-day cold acclimation, we suggest that the nonshivering mechanism recruited must rely on a similar fuel mixture to produce this heat. The more significant reductions in shivering intensity compared with a longer mild cold acclimation suggest important differential metabolic responses, resulting from an uncompensable compared with compensable cold acclimation. NEW & NOTEWORTHY Several decades of research have been dedicated to reducing the presence of shivering during cold exposure. The present study aims to determine whether as little as seven consecutive days of cold-water immersion is sufficient to reduce shivering and increase nonshivering thermogenesis. We provide evidence that whole body nonshivering thermogenesis can be increased to offset a reduction in shivering activity to maintain endogenous heat production. This demonstrates that short, but intense cold stimulation can elicit rapid metabolic changes in humans, thereby improving our comfort and ability to perform various motor tasks in the cold. Further research is required to determine the nonshivering processes that are upregulated within this short time period.


2017 ◽  
Vol 52 (4) ◽  
pp. 332-338 ◽  
Author(s):  
Kevin C. Miller ◽  
Lexie E. Hughes ◽  
Blaine C. Long ◽  
William M. Adams ◽  
Douglas J. Casa

Context:  No evidence-based recommendation exists regarding how far clinicians should insert a rectal thermistor to obtain the most valid estimate of core temperature. Knowing the validity of temperatures at different rectal depths has implications for exertional heat-stroke (EHS) management. Objective:  To determine whether rectal temperature (Trec) taken at 4 cm, 10 cm, or 15 cm from the anal sphincter provides the most valid estimate of core temperature (as determined by esophageal temperature [Teso]) during similar stressors an athlete with EHS may experience. Design:  Cross-sectional study. Setting:  Laboratory. Patients or Other Participants:  Seventeen individuals (14 men, 3 women: age = 23 ± 2 years, mass = 79.7 ± 12.4 kg, height = 177.8 ± 9.8 cm, body fat = 9.4% ± 4.1%, body surface area = 1.97 ± 0.19 m2). Intervention(s):  Rectal temperatures taken at 4 cm, 10 cm, and 15 cm from the anal sphincter were compared with Teso during a 10-minute rest period; exercise until the participant's Teso reached 39.5°C; cold-water immersion (∼10°C) until all temperatures were ≤38°C; and a 30-minute postimmersion recovery period. The Teso and Trec were compared every minute during rest and recovery. Because exercise and cooling times varied, we compared temperatures at 10% intervals of total exercise and cooling durations for these periods. Main Outcome Measure(s):  The Teso and Trec were used to calculate bias (ie, the difference in temperatures between sites). Results:  Rectal depth affected bias (F2,24 = 6.8, P = .008). Bias at 4 cm (0.85°C ± 0.78°C) was higher than at 15 cm (0.65°C ± 0.68°C, P &lt; .05) but not higher than at 10 cm (0.75°C ± 0.76°C, P &gt; .05). Bias varied over time (F2,34 = 79.5, P &lt; .001). Bias during rest (0.42°C ± 0.27°C), exercise (0.23°C ± 0.53°C), and recovery (0.65°C ± 0.35°C) was less than during cooling (1.72°C ± 0.65°C, P &lt; .05). Bias during exercise was less than during postimmersion recovery (0.65°C ± 0.35°C, P &lt; .05). Conclusions:  When EHS is suspected, clinicians should insert the flexible rectal thermistor to 15 cm (6 in) because it is the most valid depth. The low level of bias during exercise suggests Trec is valid for diagnosing hyperthermia. Rectal temperature is a better indicator of pelvic organ temperature during cold-water immersion than is Teso.


Sign in / Sign up

Export Citation Format

Share Document