Immersion Treatment for Exertional Hyperthermia: Cold or Temperate Water?

The Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, CT, USA.
Medicine and science in sports and exercise (Impact Factor: 4.48). 07/2010; 42(7):1246-52. DOI: 10.1249/MSS.0b013e3181e26cbb
Source: PubMed
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    ABSTRACT: Despite previous reviews and commentaries, significant misconceptions remain concerning deep-body (core) and skin temperature measurement in humans. Therefore, the authors have assembled the pertinent Laws of Thermodynamics and other first principles that govern physical and physiological heat exchanges. The resulting review was aimed at providing theoretical and empirical justifications for collecting and interpreting these data. The primary emphasis is upon deep-body temperatures, with discussions of intramuscular, subcutaneous, transcutaneous and skin temperatures included. These are all turnover indices resulting from variations in local metabolism, tissue conduction and blood flow. Consequently, inter-site differences and similarities may have no mechanistic relationship unless those sites have similar metabolic rates, are in close proximity and are perfused by the same blood vessels. Therefore, it is proposed that a gold standard deep-body temperature does not exist. Instead, the validity of each measurement must be evaluated relative to the research objectives, whilst satisfying equilibration and positioning requirements. When using thermometric computations of heat storage, the establishment of steady-state conditions is essential, but for clinically relevant states, targeted temperature monitoring becomes paramount. However, when investigating temperature regulation, the response characteristics of each temperature measurement must match the forcing function applied during experimentation. Thus, during dynamic phases, deep-body temperatures must be measured from sites that track temperature changes in the central blood volume.
    Journal of Thermal Biology 10/2014; 46. DOI:10.1016/j.jtherbio.2014.10.006 · 1.54 Impact Factor
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    ABSTRACT: We examined whether treatment for exertional heat stress via ice water immersion (IWI) or natural recovery is affected by the intensity of physical work performed and, thus, the time taken to reach hyperthermia. Nine adults (18-45 years; 17.9 +/- A 2.8 percent body fat; 57.0 +/- A 2.0 mL kg(-1) min(-1) peak oxygen uptake) completed four conditions incorporating either walking or jogging at 40 A degrees C (20 % relative humidity) while wearing a non-permeable rain poncho. Upon reaching 39.5 A degrees C rectal temperature (T (re)), participants recovered either via IWI in 2 A degrees C water or via natural recovery (seated in a similar to 29 A degrees C environment) until T (re) returned to 38 A degrees C. Cooling rates were greater in the IWI [T (re): 0.24 A degrees C min(-1); esophageal temperature (T (es)): 0.24 A degrees C min(-1)] than the natural recovery (T (re) and T (es): 0.03 A degrees C min(-1)) conditions (p < 0.001) with no differences between the two moderate and the two low intensity conditions (p > 0.05). Cooling rates for T (re) and T (es) were greater in the 39.0-38.5 A degrees C (T (re): 0.19 A degrees C min(-1); T (es): 0.31 A degrees C min(-1)) compared with the 39.5-39.0 A degrees C (T (re): 0.11 A degrees C min(-1); T (es): 0.13 A degrees C min(-1)) period across conditions (p < 0.05). Similar reductions in heart rate and mean arterial pressure were observed during recovery across conditions (p > 0.05), albeit occurred faster during IWI. Percent change in plasma volume at the end of natural recovery and IWI was 5.96 and 9.58 %, respectively (p < 0.001). The intensity of physical work performed and, thus, the time taken to reach hyperthermia does not affect the effectiveness of either IWI treatment or natural recovery. Therefore, while the path to hyperthermia may be different for each patient, the path to recovery must always be immediate IWI treatment.
    Arbeitsphysiologie 08/2014; 114(12). DOI:10.1007/s00421-014-2971-1 · 2.30 Impact Factor

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