Suspension syndrome: a potentially fatal vagally mediated circulatory collapsean experimental randomized crossover trial

Rauch, Simon; Schenk, K.; Strapazzon, G.; Dal Cappello, T.; Gatterer, H.; Palma, M.; Erckert, M.; Oberhuber, L.; Bliemsrieder, B.; Brugger, H. und Paal, P. (2019): Suspension syndrome: a potentially fatal vagally mediated circulatory collapsean experimental randomized crossover trial. In: European Journal of Applied Physiology, Bd. 119, Nr. 6: S. 1353-1365

Abstract

PurposeSuspension 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.MethodsIn this experimental, randomized crossover trial, 20 healthy volunteers were suspended in a sit harness for a maximum of 60min, with and without prior climbing. Venous pooling was assessed by measuring the diameter of the superficial femoral vein (SFV), lower leg tissue oxygenation (StO(2)) 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.ResultsTwelve (30%) out of 40 tests were prematurely terminated due to pre-syncopal symptoms (mean 44.7min, minimum 13.4, maximum 59.7). SFV diameter increased, StO(2) 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 5min with participants in a supine position.ConclusionsSudden 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.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1439-6319
• Sprache: Englisch