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温水和冷水浸泡期间对高碳酸血症的生理和感知反应。

Physiologic and perceptual responses to hypercarbia during warm- and cold-water immersion.

作者信息

Fothergill D M, Taylor W F, Hyde D E

机构信息

Naval Medical Research Institute, Bethesda, Maryland 20889-5607, USA.

出版信息

Undersea Hyperb Med. 1998 Spring;25(1):1-12.

PMID:9566081
Abstract

Thermoregulatory, respiratory, and perceptual responses to acute CO2 exposure during light exercise (75 W) were assessed in 12 U.S. Navy divers clad only in swim trunks while immersed to the neck in water at 18 degrees and 34 degrees C. The CO2 exposures consisted of a linear 10-min ramp increase in the inspired fraction of CO2 (FICO2) from 0 to 6% followed by 5 min of breathing 6% CO2. The ability to detect and rate the severity of hypercarbia, as well as subjective changes in thermal comfort, were assessed by comparing subjective ratings given during the CO2 exposures with those given during immersion trials where the FICO2 was maintained at 0%. Hypercarbia was recognized earlier and, at a given PETCO2, was perceived to be greater during cold- than during warm-water immersions (P < 0.01). The CO2 exposures did not affect the thermal balance of divers as assessed by changes in heat flux and rectal temperature. However, increased feelings of warmth were reported during both the cold and warm immersions when breathing raised concentrations of CO2 (P < 0.01). During the cold immersions, acute exposure to 6% CO2 significantly decreased forearm blood flow (P < 0.05), but did not affect finger blood flow. It is concluded that PETCO2 levels can reach unacceptably high concentrations (> 60 mmHg) before hypercarbia can be reliably detected by working divers. Furthermore, the ability to detect hypercarbia is poorer when immersed in warm water than when in cold water.

摘要

在18摄氏度和34摄氏度的水温下,让12名仅穿着泳裤的美国海军潜水员颈部以下浸入水中,评估他们在轻度运动(75瓦)期间对急性二氧化碳暴露的体温调节、呼吸和感知反应。二氧化碳暴露包括在10分钟内将吸入二氧化碳分数(FICO2)从0线性增加到6%,然后呼吸5分钟6%的二氧化碳。通过比较二氧化碳暴露期间给出的主观评分与FICO2维持在0%的浸入试验期间给出的主观评分,评估检测和评估高碳酸血症严重程度的能力以及热舒适度的主观变化。高碳酸血症在冷水浸泡时比温水浸泡时更早被识别,并且在给定的呼气末二氧化碳分压(PETCO2)下,被认为更严重(P<0.01)。通过热通量和直肠温度的变化评估,二氧化碳暴露并未影响潜水员的热平衡。然而,在呼吸高浓度二氧化碳时,无论是冷水浸泡还是温水浸泡,都报告有更强烈的温暖感(P<0.01)。在冷水浸泡期间,急性暴露于6%的二氧化碳显著降低了前臂血流量(P<0.05),但未影响手指血流量。研究得出结论,在工作潜水员能够可靠地检测到高碳酸血症之前,PETCO2水平可能会达到不可接受的高浓度(>60毫米汞柱)。此外,温水浸泡时检测高碳酸血症的能力比冷水浸泡时更差。

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