Supraventricular tachycardia in infants: Use of the “diving reflex”

Sperandeo, Velio; Pieri, D; Palazzolo, Pasquale; Donzelli, M; Spataro, G

doi:10.1016/s0002-9149(83)80051-4

Cited by 18 publications

(10 citation statements)

References 19 publications

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“…Apparently, this reflex reduces HR more effectively than massage of the carotid sinus during tachycardia (Arnold, 1985). This powerful vagal maneuver could thus serve as a prominent early intervention step in the termination of paroxysmal supraventricular tachycardia in both infants (Sperandeo et al, 1983) and adults (Valladares & Lemberg, 1983).…”

Section: Discussionmentioning

confidence: 99%

Diving reflex: can the time course of heart rate reduction be quantified?

Caspers¹,

Cleveland²,

Schipke³

2010

Scandinavian Med Sci Sports

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In this meta-analysis of diving bradycardia in humans, we sought to quantify any heart rate (HR) reduction using a relatively simple mathematical function. Using the terms "diving reflex,""diving bradycardia,""diving response,""diving plus heart rate," databases were searched. Data from the studies were fitted using HR=c+aexp(-(t-t(0))/τ), where c is the final HR, a is the HR decrease, τ is the time constant of HR decay, and t(0) is the time delay. Of 890 studies, 220 were given closer scrutiny. Only eight of these provided data obtained under comparable conditions. Apneic facial immersion decreased HR with τ=10.4 s and in air alone it was less pronounced and slower (τ=16.2 s). The exponential function fitted the time course of HR decrease closely (r(2)>0.93). The fit was less adequate for apneic-exercising volunteers. During apnea both with and without face immersion, HR decreases along a monoexponential function with a characteristic time constant. HR decrease during exercise with and without face immersion could not readily be described with a simple function: the parasympathetic reaction was partially offset by some sympathetic activity. Thus, we succeeded in quantifying the early time course of diving bradycardia. It is concluded that the diving reflex is useful to diagnose the integrity of efferent cardiovascular autonomic pathways.

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Section: Discussionmentioning

confidence: 99%

Diving reflex: can the time course of heart rate reduction be quantified?

Caspers¹,

Cleveland²,

Schipke³

2010

Scandinavian Med Sci Sports

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“…Across the 10 clinical studies, 18 patients required subsequent HDR interventions during the study for recurrent PSVT 1–3 5 21 23. Prehospital management of PSVT (and indeed all other aspects of care) by paramedics is limited by statutory regulation and authority to practice.…”

Section: Discussionmentioning

confidence: 99%

Use of the human dive reflex for the management of supraventricular tachycardia: a review of the literature

et al. 2012

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BackgroundThe human dive reflex (HDR), a physiological phenomenon similar to the bradycardia reflex used by marine mammals during prolonged submersion, can be employed in managing paroxysmal supraventricular tachycardia (PSVT). This review aims to identify a standardised HDR technique for haemodynamically stable PSVT, to determine the effectiveness of the HDR and to define its usefulness in the prehospital setting. Methods A review of the Medline, EMBASE and CINAHL databases was conducted. Articles were included if they described the use of the HDR to revert PSVT in the prehospital or emergency medical setting, the nature of the effectiveness of the HDR for PSVT or historically significant developments of HDR techniques for PSVT reversion. Articles not available in English or describing the use of HDR in animal studies only were excluded. Results 211 articles were identified, of which 21 were found to be relevant. These included 10 studies of HDR effectiveness in PSVT and three physiological studies of HDR effect. No standardised model of performance exists for the HDR. Elements of performance include: a cold stimulus applied to the entire face, a specific temperature of the cold stimulus, application duration, breath holding during HDR and posture assumed to perform the procedure. There are also safety and logistics issues with using the HDR in prehospital care. Conclusions The HDR represents an effective method of terminating PSVT in the hospital emergency department. Its usefulness in prehospital care requires further evaluation of the elements of the manoeuvre to determine appropriateness to this setting. BACKGROUND

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“…7 The use of this technique in neonates was first described in 1977 but it is still not widely used.8 Application of an ice cold facecloth has been recommended but is often ineffective.6 In our experience the best technique is to attach the baby to an electrocardiographic monitor, wrap him in a towel, and then immerse his whole face in iced water for about five seconds. No attempt is made to obstruct the mouth or nostrils as the baby will be temporarily apnoeic.…”

Section: Methodsmentioning

confidence: 99%

Supraventricular tachycardia in infants: response to initial treatment.

Sreeram¹,

Wren²

1990

Archives of Disease in Childhood

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All patients with supraventricular tachycardia during the first 12 months of life who presented between 1977 and 1988 were identified by a retrospective survey of records in this hospital and by a questionnaire sent to paediatricians in the Northern region. Twenty two of 29 patients (76%) were in heart failure and seven (24%) had cardiogenic shock. Seven patients (24%) were free of symptoms. All had narrow QRS tachycardia at 215-315

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Supraventricular tachycardia in infants: Use of the “diving reflex”

Cited by 18 publications

References 19 publications

Diving reflex: can the time course of heart rate reduction be quantified?

Diving reflex: can the time course of heart rate reduction be quantified?

Use of the human dive reflex for the management of supraventricular tachycardia: a review of the literature

Supraventricular tachycardia in infants: response to initial treatment.

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