• Wilderness Environ Med · Sep 2015

    Comparative Study

    Comparison of Distal Limb Warming With Fluidotherapy and Warm Water Immersion for Mild Hypothermia Rewarming.

    • Parveen Kumar, Gerren K McDonald, Radhika Chitkara, Alan M Steinman, Phillip F Gardiner, and Gordon G Giesbrecht.
    • Laboratory for Exercise and Environmental Medicine, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Manitoba, Canada (all authors); and the Gupta Faculty of Kinesiology and Applied Health, University of Winnipeg, Winnipeg, Manitoba, Canada (Mr McDonald).
    • Wilderness Environ Med. 2015 Sep 1; 26 (3): 406-11.

    ObjectiveThe purpose of the study was to determine the effectiveness of Fluidotherapy rewarming through the distal extremities for mildly hypothermic, vigorously shivering subjects. Fluidotherapy is a dry heat modality in which cellulose particles are suspended by warm air circulation.MethodsSeven subjects (2 female) were cooled on 3 occasions in 8˚C water for 60 minutes, or to a core temperature of 35°C. They were then dried and rewarmed in a seated position by 1) shivering only; 2) Fluidotherapy applied to the distal extremities (46 ± 1°C, mean ± SD); or 3) water immersion of the distal extremities (44 ± 1°C). The order of rewarming followed a balanced design. Esophageal temperature, skin temperature, heart rate, oxygen consumption, and heat flux were measured.ResultsThe warm water produced the highest rewarming rate, 6.1°C·h(-1), 95% CI: 5.3-6.9, compared with Fluidotherapy, 2.2°C·h(-1), 95% CI: 1.4-3.0, and shivering only, 2.0°C·h(-1), 95% CI: 1.2-2.8. The Fluidotherapy and warm water conditions increased skin temperature and inhibited shivering heat production, thus reducing metabolic heat production (166 ± 42 W and 181 ± 45 W, respectively), compared with shivering only (322 ± 142 W). Warm water provided a significantly higher net heat gain (398.0 ± 52 W) than shivering only (288.4 ± 115 W).ConclusionsFluidotherapy was not as effective as warm water for rewarming mildly hypothermic subjects. Although Fluidotherapy is more portable and technically simpler, it provides a lower rate of rewarming that is similar to shivering only. It does help decrease shivering heat production, lowering energy expenditure and cardiac work, and could be considered in a hospital setting, if convenient.Copyright © 2015 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

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