Department of Epidemiology and Preventative Medicine, Monash University, Faculty of Medicine, Nursing and Health Sciences, Alfred Centre, 99 Commercial Road, Melbourne 3004, Australia.
Emerg Med J. 2012 Aug;29(8):611-6. doi: 10.1136/emermed-2011-200877. Epub 2012 Mar 3.
The human dive reflex (HDR), a physiological phenomenon similar to the bradycardia reflex used by marine mammals during prolonged submersion, can be employed in managing paroxysmal supraventricular tachycardia (PSVT). This review aims to identify a standardised HDR technique for haemodynamically stable PSVT, to determine the effectiveness of the HDR and to define its usefulness in the prehospital setting.
A review of the Medline, EMBASE and CINAHL databases was conducted. Articles were included if they described the use of the HDR to revert PSVT in the prehospital or emergency medical setting, the nature of the effectiveness of the HDR for PSVT or historically significant developments of HDR techniques for PSVT reversion. Articles not available in English or describing the use of HDR in animal studies only were excluded.
211 articles were identified, of which 21 were found to be relevant. These included 10 studies of HDR effectiveness in PSVT and three physiological studies of HDR effect. No standardised model of performance exists for the HDR. Elements of performance include: a cold stimulus applied to the entire face, a specific temperature of the cold stimulus, application duration, breath holding during HDR and posture assumed to perform the procedure. There are also safety and logistics issues with using the HDR in prehospital care.
The HDR represents an effective method of terminating PSVT in the hospital emergency department. Its usefulness in prehospital care requires further evaluation of the elements of the manoeuvre to determine appropriateness to this setting.
人类潜水反射（HDR）是一种类似于海洋哺乳动物在长时间潜水期间使用的心动过缓反射的生理现象，可用于治疗阵发性室上性心动过速（PSVT）。本综述旨在确定一种用于血流动力学稳定 PSVT 的标准化 HDR 技术，以确定 HDR 的有效性，并定义其在院前环境中的有用性。
对 Medline、EMBASE 和 CINAHL 数据库进行了回顾。如果文章描述了 HDR 在院前或急诊医疗环境中用于逆转 PSVT 的情况、HDR 对 PSVT 的有效性的性质或 HDR 技术用于 PSVT 逆转的历史重要发展，则将其纳入。排除了未以英文发表或仅描述 HDR 在动物研究中使用的文章。
确定了 211 篇文章，其中发现 21 篇相关。这些文章包括 10 项关于 HDR 在 PSVT 中有效性的研究和 3 项关于 HDR 效应的生理学研究。目前还没有 HDR 性能的标准化模型。表现的要素包括：将冷刺激应用于整个面部、冷刺激的特定温度、应用持续时间、在 HDR 期间屏住呼吸以及执行该程序时采取的姿势。在院前护理中使用 HDR 还存在安全和后勤问题。
HDR 是在医院急诊科终止 PSVT 的有效方法。它在院前护理中的有用性需要进一步评估该操作的要素，以确定其在该环境中的适用性。
