Mammalian diving reflex

From Wikipedia, the free encyclopedia

The mammalian diving reflex is a reflex in mammals which optimizes respiration t
o allow staying underwater for extended periods of time. It is exhibited strongl
y in aquatic mammals (seals,[1] otters, dolphins, etc.), but exists in weaker ve
rsions in other mammals, including humans, in particular babies up to 6 months o
ld (see Infant swimming). Diving birds, such as penguins, have a similar diving
reflex. Every animal's diving reflex is triggered specifically by cold water con
tacting the face.[2]
Contents
1
2
3
4
5

Effect
Medical application
See also
References
External links

Effect
Upon initiation of the reflex, three changes happen to a body, in this order:
Bradycardia is the first response to submersion. Immediately upon facial con
tact with cold water, the human heart rate slows down ten to twenty-five percent
.[2] Seals experience changes that are even more dramatic, going from about 125
beats per minute to as low as 10 on an extended dive.[1][3] Slowing the heart ra
te lessens the need for bloodstream oxygen, leaving more to be used by other org
ans.
Next, peripheral vasoconstriction sets in. When under high pressure induced
by deep diving, capillaries in the extremities start closing off, stopping blood
circulation to those areas. Note that vasoconstriction usually applies to arter
ioles, but in this case is completely an effect of the capillaries. Toes and fin
gers close off first, then hands and feet, and ultimately arms and legs stop all
owing blood circulation, leaving more blood for use by the heart and brain. Huma
n musculature accounts for only 12% of the body's total oxygen storage, and the
body's muscles tend to suffer cramping during this phase. Aquatic mammals have a
s much as 25 to 30% of their oxygen storage in muscle, and thus they can keep wo
rking long after capillary blood supply is stopped.
Last is the blood shift. Peripheral vasoconstriction in the extremities star
ts as soon as the body enters the water, pushing blood into the thoracic organs,
particularly the lungs. This engorges the alveolar capillaries, increasing intr
a-alveolar gas pressure, the pressure inside the chest, and opposing submergence
pressure on the chest. As depth increases, peripheral vasoconstriction and hydr
ostatic pressure on the extremities continue to drive the blood shift. When dept
h increases to the point where chest compression limits are reached, the blood s
hift accelerates. This is due to the rapidly increasing difference between hydro
static pressure on the extremities and intra-alveolar gas pressure. The blood sh
ift keeps pressure inside the chest high enough to allow the diver to proceed de
eper without the chest collapsing. There is a risk, however - "A sufficient pres
sure difference between the blood pressure in the pulmonary capillaries and the
intra-alveolar gas pressure may cause stress failure with leakage of fluid and b
lood into the lungs" (pulmonary edema or lung squeeze).[4] Blood freely flows ba
ck into the extremities as the diver heads back to the surface. This stage of th
e diving reflex has been observed in humans (such as accomplished freediver Bret
Gilliam) during deep (over 90 metres or 300 ft) dives.[5] An incorrect impressi
on exists among some that during the blood shift, blood and plasma pass freely t
hroughout the thoracic cavity and into the alveoli. This is not normal, but rath
er a type of lung barotrauma. Blood in the alveoli is called pulmonary edema, an

d is dangerous at best and deadly at worst.

Thus, both a conscious and an unconscious person can survive longer without oxyg
en under cold water than in a comparable situation on dry land. Children tend to
survive longer than adults when deprived of oxygen underwater. The exact mechan
ism for this effect has been debated and may be a result of brain cooling simila
r to the protective effects seen in patients treated with deep hypothermia.[6][7
]
When the face is submerged, receptors that are sensitive to cold within the nasa
l cavity and other areas of the face supplied by the fifth (V) cranial nerve (th
e trigeminal nerve) relay the information to the brain and then innervate crania
l nerve X (the vagus nerve), which is part of the autonomic nervous system. This
causes bradycardia and peripheral vasoconstriction. Blood is diverted from the
limbs and all organs but the heart and the brain, creating a heart brain circuit a
nd allowing the mammal to conserve oxygen.
In humans, the mammalian diving reflex is not induced when limbs are introduced
to cold water. Mild bradycardia is caused by subjects holding their breath witho
ut submerging the face within water.[6] When breathing with face submerged this
causes a diving reflex which increases proportionally to decreasing water temper
ature.[2] Activating the diving reflex with cold water can be used to treat supr
aventricular tachycardia.[8] However the greatest bradycardia effect is induced
when the subject is holding breath with face submerged.
Medical application
The diving reflex is used in clinical practice as a means to treat supraventricu
lar tachycardia. This is an example of a vagal maneuver, whereby the vagus nerve
is stimulated in order to block the atrioventricular node, which interrupts the
abnormal electrical circuit taking place in a supraventricular tachycardia.[9]
This is especially useful in infants. A towel soaked in ice-cold water may be ap
plied to the 'snout' region of the face. In children, the valsalva maneuver or c
arotid sinus massage is more appropriate.[10]
See also
Underwater diving portal
Blood shift
Cold shock response
Bradycardia
References
Zapol WM, Hill RD, Qvist J, Falke K, Schneider RC, Liggins GC, Hochachka PW (Sep
tember 1989). "Arterial gas tensions and hemoglobin concentrations of the freely
diving Weddell seal". Undersea Biomed Res. 16 (5): 363 73. PMID 2800051. Retrieve
d 2008-06-14.
Speck DF, Bruce DS (March 1978). "Effects of varying thermal and apneic conditio
ns on the human diving reflex". Undersea Biomed Res. 5 (1): 9 14. PMID 636078. Ret
rieved 2008-06-14.
Thornton SJ, Hochachka PW (2004). "Oxygen and the diving seal". Undersea Hyperb
Med. 31 (1): 81 95. PMID 15233163. Retrieved 2008-06-14.
Peter Lindholm; Claes EG Lundgren. "Journal of Appied Physiology - The physiolog
y and pathophysiology of human breath-hold diving". Retrieved 4 April 2015.
Gilliam B (2011). "A practical discussion of nitrogen narcosis". Tech Diving Mag
. Retrieved 2013-10-05.
Lundgren, Claus EG; Ferrigno, Massimo (eds). (1985). "Physiology of Breath-hold
Diving. 31st Undersea and Hyperbaric Medical Society Workshop.". UHMS Publicatio
n Number 72(WS-BH)4-15-87. Undersea and Hyperbaric Medical Society. Retrieved 20
09-04-16.

Mackensen GB, McDonagh DL, Warner DS (March 2009). "Perioperative hypothermia: u

se and therapeutic implications". J. Neurotrauma. 26 (3): 342 58. doi:10.1089/neu.
2008.0596. PMID 19231924.
Mathew PK (January 1981). "Diving reflex. Another method of treating paroxysmal
supraventricular tachycardia". Arch. Intern. Med. 141 (1): 22 3. doi:10.1001/archi
nte.141.1.22. PMID 7447580.
Grahame IF, Hann IM (June 1978). "Use of the diving reflex to treat supraventric
ular tachycardia in an infant.". Arch Dis Child. 53 (6): 515 6. doi:10.1136/adc.53
.6.515.
Gardiner M, Eisen S, Murphy C. Training in paediatrics: the essential curric
ulum. Oxford University Press, Oxford 2009.
External links
Merck Medical Dictionary
[show]
v t e
Nervous system physiology: neurophysiology - reflex
[show]
v t e
Diving medicine, physiology, physics and environment
Categories:
Diving medicineReflexesCardiovascular physiology
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