Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-06T02:32:07.347Z Has data issue: false hasContentIssue false

Application of ice water to the face during controlled respiration—a measure of basal vagal tone

Published online by Cambridge University Press:  19 August 2008

Myung Kul Yum*
Affiliation:
From the Institute of Cardiovascular Research, Departments of Pediatric Cardiology and Anesthesiology, Gyeongsang National University, College of Medicine, Gyeongnam
Seung Hwan Kim
Affiliation:
From the Institute of Cardiovascular Research, Departments of Pediatric Cardiology and Anesthesiology, Gyeongsang National University, College of Medicine, Gyeongnam
Yeoung Geun Jung
Affiliation:
From the Institute of Cardiovascular Research, Departments of Pediatric Cardiology and Anesthesiology, Gyeongsang National University, College of Medicine, Gyeongnam
*
Dr. Myung Kul Yum, Department of Pediatric Cardiology, Gyeongsang National University Hospital, 92 Chilamdong, Chinju, Gyeongnam. 660-280, Korea. Tel. 591-50-8157; Fax.591-52-9339

Abstract

We examined the effectiveness of the application of ice water to the face during metronome-controlled respiration (15 breaths per minute) for vagalstimulation. We also examined the importance of basal vagal tone and sympathovagal interaction in determining the individual response to the stimulation. Fifty-three boys, aged 12 and 13, were included in this study. Vagal tone and sympathovagal interaction were assessed by power spectral analysis of the variability of the RR interval (heart rate). Basal heart rate, high frequency power, and low-to-high frequency power ratios were 81 ± 13(58–110 beats/min), 791 ± 1061(56–4161 m.sec2) and 1.08±1.22 (0.04–4.85) during controlled respiration. After application of ice water, 23 children developed frequent nodal escape beats due to severe sinus bradycardia. Minimum heart rate, high frequency power, and low to high power ratios changed to 42± 12 (19–72 beats/min), 1890±1882 (211–7258 m.sec2) and 0.64±0.43 (0.12–1.46). The increased ratio of high frequency power, maximum decrement in heart rate, and its percent after stimulation were 5.44±5.62 (0.63–24.26), 39±14 (10–81 beats/mm) and 47±15 (16–81%), respectively. The increased ratio of high frequency power was correlated with basal logarithmic high frequency power (r=−0.60, p=O.0004). Maximum heart rate decrement was correlated with basal logarithmic high frequency power (r=−0.60, p=O.OO18) and low-to-high frequency power ratio (r=0.27, p=O.O4). We conclude that application of ice water to the faceduring controlled respiration induces powerful vagal stimulation and bradycardia similar to, or even greater than, facial immersion in cold water. There is wide variability of individual response which can be explained by the magnitude of absolute basal vagal tone.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Sreeram, N, Wren, C. Supraventricular tachycardia in infants: response to initial treatment. Ach Djs Child 1990; 65: 127129.Google ScholarPubMed
2.Whiteman, V, Friedman, Z, Berman, W, Maisels, MJ. Supraventricular tachycardia in newborn infants: an approach to therapy. J Pediatr 1979; 91: 304305.CrossRefGoogle Scholar
3.Sperandeo, V, Pieri, D, Palazzolo, P, Donzelli, M, Spataro, G. Supraventricular tachycardia in infants: use of “diving reflex”. Am J Cardiol 1983; 51: 286287.CrossRefGoogle ScholarPubMed
4.Andersen, HT. The reflex nature of physiological adjustments to diving and their afferent pathway. Acta Physiol Scand 1962; 58: 263273.CrossRefGoogle Scholar
5.Kawakami, Y, Natelson, BH, Dubois, AB. Cardiovascular effects of face immersion and factors affecting diving reflex in man. J Appl Physiol 1967; 23: 964970.CrossRefGoogle ScholarPubMed
6.Paulev, PE. Cardiac rhythm during breath holding and water immersion in man. Acta Physiol Scand 1967; 73: 139150.CrossRefGoogle Scholar
7.Moore, TO, Lin, YG, Lally, DA, Hong, SK. Effects of temperature immersion and ambient pressure on human apneic bradycardia. J Appl Physiol 1972; 33: 3641.CrossRefGoogle ScholarPubMed
8.Hunt, NG, Whitaker, DK, Willmott, NJ. Watertemperature and the “diving reflex”. Lancet 1975; 8: 572.CrossRefGoogle Scholar
9.Vybiral, T, Bryg, RJ, Maddens, ME, Boden, WE. Effect of passive tilet on sympathetic and parasympathetic component of heart rate variability in normal subjects. Am J Cardio 1989; 63: 11171120.CrossRefGoogle Scholar
10.Finley, JP, Bonet, JF, Waxman, MB. Autonomic pathways responsible for bradycardiaon facial immersion. J Appl Physiol 1979; 47: 12181222.CrossRefGoogle ScholarPubMed
11.Yonce, LR, Folkow, B, Hill, C. The integration of the cardiovascular response to diving. Am Heart J 1970; 79: 14. [Editorial]CrossRefGoogle ScholarPubMed
12.Pagani, M, Lombardi, F, Guzzetti, S, Rimoldi, O, Furlan, R, Pizzinelli, P, Sandrone, G, Malfatto, G, ‘Orto, SD, Piccaluga, E, Tunel, M, Baselli, G, Cerutti, SMalliani, A. Power spectral analysis heart rate and arterial pressure variabilities as a marker of sympathovagal interaction in man and conscious dog. Circ Res 1986; 59: 178193.CrossRefGoogle ScholarPubMed
13.Akselrod, S, Gordon, DUbel, FA, Shannon, DC, Barger, AC, Cohen, RJ. Power spectrum analysis of heart rate fluctuation: A quantitative probe of beat to beat cardiovascular control. Science 1981; 213: 220222.CrossRefGoogle ScholarPubMed
14.Pomeranz, B, Macualay, RFB, Caudill, MA, Kutz, I, Adam, D, Gordon, D, Kilborn, KM, Barger, AC, Shannon, DC, Cohen, RJ, Benson, H. Assessment of autonomic function in humans by heart rate spectral analysis. Am J Physiol 1985; 248: H151H153.Google ScholarPubMed
15.Akselrod, S, Gordon, D, Madwed, JB, Snidman, NC, Shannon, DC, Cohen, RJ.. Hemodynamic regulation: investigation by spectral analysis. Am J Physiol 1985; 249: H867H875.Google ScholarPubMed
16.Adamopoulos, S, Piepoli, M, McCance, A, Bernardi, L, Rocadaelli, A, Ormerod, O, Forfar, C, Sleight, PCoarts, AJS. Comparison of different methods for assessing sympathovagal balance in chronic congestive heart failure secondary to coronary artery disease. Am J Cardiol 1992; 70: 15761582.CrossRefGoogle ScholarPubMed
17.Heistad, DD, Abboud, FM, Eokstein, JW. Vasoconstrictor response to simulated diving man. J Appl Physiol 1968; 25: 542549.CrossRefGoogle ScholarPubMed
18.Hirsch, JA, Bishop, B. Respiratory sinus arrhythmia in humans: how breathing pattern modulates heart rate. Am J Physiol 1981; 241: H620-H629.Google ScholarPubMed
19.Gootman, PM, Cohen, MI. Inhibitory effects on fast sympathetic rhythms. Brain Res 1983; 270: 134136.CrossRefGoogle ScholarPubMed
20.Melcher, A. Respiratory sinus arrhythmia in man. A study in heart rate regulating mechanisms. Acta Physiol Scand Supp 1976; 435: 131.Google ScholarPubMed
21.Eckerberg, DL, Kifle, YT, Roberts, VL. Phase relationship between normal human respiration and baroreflex responsiveness. J Physiol 1980; 304: 489502.CrossRefGoogle Scholar
22.Eckerberg, DL. Human sinus arrhythmia as an index of vagal cardiac outflow. J Appl Physiol 1983; 54: 961966.CrossRefGoogle Scholar
23.Arai, Y, Saul, JP, Albrecht, P, Hartley, LH, Lilly, LS, Cohen, RJ, Colucci, WS. Modulation of cardiac autonomic activity during and immediately after exercise. Am J Physiol 1989; 256: H132H141.Google ScholarPubMed