Institute of Mountain Emergency Medicine, Eurac Research, Viale Druso 1, 39100, Bolzano, Italy.
Department of Sports Science, Medical Section, University of Innsbruck, 6020, Innsbruck, Austria.
Eur J Appl Physiol. 2019 Jun;119(6):1353-1365. doi: 10.1007/s00421-019-04126-5. Epub 2019 Mar 20.
Suspension syndrome describes a potentially life-threatening event during passive suspension on a rope. The pathophysiological mechanism is not fully understood and optimal treatment unknown. We aimed to elucidate the pathophysiology and to give treatment recommendations.
In this experimental, randomized crossover trial, 20 healthy volunteers were suspended in a sit harness for a maximum of 60 min, with and without prior climbing. Venous pooling was assessed by measuring the diameter of the superficial femoral vein (SFV), lower leg tissue oxygenation (StO) and by determining localized bioelectrical impedance. Hemodynamic response was assessed by measuring heart rate, blood pressure, stroke volume, and left ventricular diameters. Signs and symptoms of pre-syncope were recorded.
Twelve (30%) out of 40 tests were prematurely terminated due to pre-syncopal symptoms (mean 44.7 min, minimum 13.4, maximum 59.7). SFV diameter increased, StO and the capacitive resistance of the cells decreased indicating venous pooling. Heart rate and blood pressure did not change in participants without pre-syncope. In contrast, in participants experiencing pre-syncope, heart rate and blood pressure dropped immediately before the event. All symptoms dissolved and values returned to normal within 5 min with participants in a supine position.
Sudden pre-syncope during passive suspension in a harness was observed in 30% of the tests. Blood pools in the veins of the lower legs; however, a vagal mechanism finally leads to loss of consciousness. Time to pre-syncope is unpredictable and persons suspended on a rope should be rescued and put into a supine position as soon as possible.
悬垂综合征是指在绳索被动悬垂过程中发生的一种潜在危及生命的事件。其病理生理机制尚未完全阐明，最佳治疗方法也尚不清楚。本研究旨在阐明其病理生理学机制并提出治疗建议。
在这项实验性、随机交叉试验中，20 名健康志愿者采用坐姿悬吊带进行最长 60 分钟的被动悬垂，其中部分志愿者预先进行了攀爬。通过测量股浅静脉（SFV）直径、小腿组织氧合（StO）和局部生物电阻抗来评估静脉淤积情况。通过测量心率、血压、每搏量和左心室直径来评估血液动力学反应。记录先兆晕厥的症状和体征。
40 次测试中有 12 次（30%）因先兆晕厥症状而提前终止（平均 44.7 分钟，最短 13.4 分钟，最长 59.7 分钟）。SFV 直径增加，StO 和细胞电容电阻降低，表明静脉淤积。未出现先兆晕厥的参与者的心率和血压没有变化。相比之下，在出现先兆晕厥的参与者中，心率和血压在事件发生前立即下降。所有症状在参与者处于仰卧位 5 分钟内溶解并恢复正常。
在吊带的被动悬垂中，30%的测试会突然出现先兆晕厥。血液淤积在小腿静脉中，但最终会导致迷走神经机制导致意识丧失。先兆晕厥的时间不可预测，因此应尽快将悬垂者救出并置于仰卧位。
