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经验丰富的循环呼吸器潜水员的潜水反应:冷水潜水中的短期心率变异性

Diving Responses in Experienced Rebreather Divers: Short-Term Heart Rate Variability in Cold Water Diving.

作者信息

Lundell Richard V, Tuominen Laura, Ojanen Tommi, Parkkola Kai, Räisänen-Sokolowski Anne

机构信息

Diving Medical Centre, Finnish Defence Forces, Helsinki, Finland.

Department of Anaestesia, Tampere University Hospital, Tampere, Finland.

出版信息

Front Physiol. 2021 Apr 7;12:649319. doi: 10.3389/fphys.2021.649319. eCollection 2021.

Abstract

INTRODUCTION

Technical diving is very popular in Finland throughout the year despite diving conditions being challenging, especially due to arctic water and poor visibility. Cold water, immersion, submersion, hyperoxia, as well as psychological and physiological stress, all have an effect on the autonomic nervous system (ANS).

MATERIALS AND METHODS

To evaluate divers' ANS responses, short-term (5 min) heart rate variability (HRV) during dives in 2-4°C water was measured. HRV resting values were evaluated from separate measurements before and after the dives. Twenty-six experienced closed circuit rebreather (CCR) divers performed an identical 45-meter decompression dive with a non-physical task requiring concentration at the bottom depth.

RESULTS

Activity of the ANS branches was evaluated with the parasympathetic (PNS) and sympathetic (SNS) indexes of the Kubios HRV Standard program. Compared to resting values, PNS activity decreased significantly on immersion with face out of water. From immersion, it increased significantly with facial immersion, just before decompression and just before surfacing. Compared to resting values, SNS activity increased significantly on immersion with face out of water. Face in water and submersion measures did not differ from the immersion measure. After these measurements, SNS activity decreased significantly over time.

CONCLUSION

Our study indicates that the trigeminocardiac part of the diving reflex causes the strong initial PNS activation at the beginning of the dive but the reaction seems to decrease quickly. After this initial activation, cold seemed to be the most prominent promoter of PNS activity - not pressure. Also, our study showed a concurrent increase in both SNS and PNS branches, which has been associated with an elevated risk for arrhythmia. Therefore, we recommend a short adaptation phase at the beginning of cold-water diving before physical activity.

摘要

引言

尽管潜水条件具有挑战性,特别是由于北极水域和能见度差,但技术潜水在芬兰全年都非常受欢迎。冷水、浸泡、潜水、高氧以及心理和生理压力,都会对自主神经系统(ANS)产生影响。

材料与方法

为了评估潜水员的自主神经系统反应,测量了在2-4°C水温下潜水期间的短期(5分钟)心率变异性(HRV)。HRV静息值通过潜水前后的单独测量进行评估。26名经验丰富的封闭式循环呼吸器(CCR)潜水员进行了一次相同的45米减压潜水,在底部深度有一项需要集中注意力的非体力任务。

结果

使用Kubios HRV标准程序的副交感神经(PNS)和交感神经(SNS)指数评估自主神经系统分支的活动。与静息值相比,面部露出水面进行浸泡时,PNS活动显著降低。从浸泡开始,随着面部浸入、减压前和浮出水面之前,PNS活动显著增加。与静息值相比,面部露出水面进行浸泡时,SNS活动显著增加。面部在水中和潜水测量与浸泡测量没有差异。在这些测量之后,SNS活动随时间显著降低。

结论

我们的研究表明,潜水反射的三叉神经心脏部分在潜水开始时会引起强烈的初始PNS激活,但这种反应似乎很快就会减弱。在这种初始激活之后,寒冷似乎是PNS活动最突出的促进因素——而不是压力。此外,我们的研究表明SNS和PNS分支同时增加,这与心律失常风险升高有关。因此,我们建议在冷水潜水开始进行体力活动之前有一个短暂的适应阶段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8573/8058382/d617ca65f8e8/fphys-12-649319-g001.jpg

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