Muscular damage and intravascular haemolysis during an 18 hour subterranean exploration in a cave of 700 m depth

Abstract

Objective: To verify presence and severity of muscular and/or intravascular damage during a subterranean exploration of long duration. Methods: We measured serum levels of creatine kinase (CK) and lactate dehydrogenase (LDH) as markers of muscular damage. We also measured haptoglobin as a marker of intravascular haemolysis, and platelets and leucocytes as markers of inflammation. Results: We found in all the participants an increase in CK, LDH, and platelets and leucocytes (mainly due to neutrophilia and monocytosis), and a decrease in the level of haptoglobin and circulating lymphocytes. Conclusions: The observed data suggest that continuous effort during long alpine subterranean explorations, environmental conditions, sleep deprivation, multiple impacts on rocks, and compression caused by bindings of the caving harness cause muscle damage, intravascular haemolysis, inflammation response, and immunological changes.

Hormonal responses to a long duration exploration in a cave of 700 m depth

“…Secondly, the compression of the bindings of the climbing sit harness probably contributed to the marked rise with respect to the initial values. This is because the upper part of the harness, for a technical reason, is bound very tightly, thus likely aVecting blood circulation in the lower limbs with some vascular hypo-perfusion, especially after so many hours (Stenner et al 2006). The compression could favor the regional accumulation of metabolites (i.e., lactate), which is one of the earlier processes known to be involved in the stimulation of hypophyseal secretions of GH (Takarada et al 2000;Reeves et al 2006).…”

Red Cell and Core Temperature in Spelunking

“…Firstly, they could be due to the typical, but not completely understood, reverse shift of water back into the intravascular space that opens up during a prolonged acute effort after the initial haemoconcentration stage [11,21]. Secondly, the intravascular haemolysis that we demonstrated during this ex-periment in these spelunkers (published results: [16]) should be considered, as well as, even if we did not study them, the osmotic and oxidative damage to erythrocytes and occult blood loss. Finally, we agree with authors who consider the post-resting over-expansion of PV to be the result of the rehydration and renin, aldosterone and vasopressin responses [14].…”

Excessive increase of creatine kinase after one hour of horse riding

“…In connection with sports rhabdomyolysis has been reported after overexertion, in a hot or cold environment and trauma during performance [2,3,4]. Furthermore, the training status of the individuals seems to be a relevant additional factor influencing the degree of creatine kinase [CK) elevation [5].…”