Temperature of the ingested water on fatigue during exercise until exhaustion in a thermoneutral environment

Os efeitos da ingestão de água durante o exercício em ambiente termoneutro, assim como os efeitos da temperatura da água ingerida sobre a fadiga ainda não estão bem estudados. Este trabalho foi realizado para estudar os efeitos de três diferentes temperaturas da água ingerida sobre a tolerância ao esforço submáximo de seis voluntários sadios (idade 24,0 ± 3,5 anos; peso 67,0 ± 4,8 kg; V 02pjCo 47,8 ± 9,1 mL/kg.min*1 e percentual de gordura 9,5 ± 2,0%) durante o repouso (60 min) ou durante o esforço submáximo numa bicicleta ergométrica (60% da V02PiCO) até a exaustão. As temperaturas da água foram escolhidas para produzir resfriamento corporal (10 °C), ou para simular a temperatura corporal interna (38 °C) ou constituir um ponto intermediário (24 °C). Foram medidos continuamente o consumo de oxigênio (V02), a extração de gás carbônico (VC02), a freqüência cardíaca (FC), as temperaturas retal (Tr) e média da pele (TMP), e o calor acumulado (S). O lactato plasmático (La) foi dosado antes e ao final do exercício. Em todas as situações experimentais, os indivíduos ingeriam 1320 mL de água (nas temperaturas de 10, 24 e 38 °C), assim distribuídas: 600 mL 15 minutos antes do procedimento experimental e três doses de 240 mL, aos 15, 30 e 45 minutos, do repouso ou do exercício. A temperatura e a umidade relativa do ar durante os experimentos variaram de 22,4 a 22,8 °C e 62,6 a 65%, respectivamente. O estudo seguiu o delineamento de um Quadrado Latino e a análise de variância de dois fatores (para o TTE) com medidas repetidas no segundo fator (para Tre, TMP, S, FC e V 02) seguidas do teste de Tukey (p < 0,05). A temperatura da água não afetou o tempo máximo de exercício. O exercício aumentou todas as variáveis, como esperado, mas a temperatura da água não interferiu nas respostas. No repouso, observou-se uma redução da Tre, TMP e S ao longo do tempo, sugerindo um resfriamento decorrente do repouso ou das condições térmicas do ambiente. Os resultados mostram que a temperatura da água ingerida não interferiu na temperatura corporal e na performanceThe effects of water ingestion during exercise at a thermoneutral environment and the effects of the ingested water temperature on fatigue have not been studied. This research was designed to study the effects of three different temperatures of ingested water on fatigue of six healthy male subjects (age 24.0 ± 3.5 years; weight 67.0 ± 4.8 kg; V 0 2Peak 47.8 ± 9.1 mL/kg.min'1 and body fat 9.5 ± 2.0%) during rest (60 min) or at a sub-maximal cycle ergometer exercise (60% V O 2 peak) to the exhaustion (ET). The water temperatures were chosen to produce physical cooling (10 °C), to simulate the body temperature (38 °C) and to find an intermediate point (24 °C). There were continuous measurements of oxygen uptake ( V 0 2), carbonic gas extraction (V C 0 2), heart rate (HR), rectal (Tre) and skin (Tsk) temperatures, and heat storage (S). Plasma lactate (La) was measured before and at the end of exercise. In all of the six experimental conditions the volunteers ingested 1320 mL of water (at 38 °C or 24 °C or 10 °C) following the schedule: 600 mL (15 min before) and three doses of 240 mL each at 19, 34 and 49 minutes of resting or exercise. The temperature and air relative humidity during the experiments ranged from 22.4 to 22.8 °C and 62.6 to 65% respectively. The experimental design followed a latin square model and a two-way anova (for TE) and repeated measures (for Tre, TMP, S, FC, V 0 2 and V C 0 2) with post hoc Tukey’s test was used to analyze data, with significance level of p < 0.05. The temperature of ingested water did not change the time to exhaustion. The exercise increased all variables, as expected, but the temperature of ingested water did not modify their responses. During resting, there were lower Tre, TMP, and S, suggesting an cooling effect that could be due to the resting itself or to the thermal environmental conditions. The results showed that the temperature of ingested water did not modify the body temperatures neither the time do exhaustio

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Desempenho e termorregulação de corredores jovens e de meia-idade com VO2 máx similar em corridas de intensidades fixa e autorregulada em ambientes quente e termoneutro

Para comparar o desempenho de corridas de intensidades fixa e autorregulada no calor entre corredores jovens e de meia-idade com VO2máx similar, 26 corredores de rua; sete homens (MI_HOM; 54 ± 2 anos; 58 ± 4 ml.kg-1.min-1) e seis mulheres de meia-idade (MI_MUL; 54 ± 4 anos; 48 ± 3 ml.kg-1.min-1); sete homens (JV_HOM; 28 ± 1 anos; 61 ± 5 ml.kg-1. min-1) e seis mulheres jovens (JV_MUL; 24 ± 3 anos; 49 ± 3 ml.kg-1.min-1) foram submetidos a corridas de 10 km com intensidade autorregulada na maior velocidade possível e de intensidade fixa até a fadiga em ambiente quente (CAR40 e CFIX40; 40 0C e 30% URA) e moderado (CAR20 e CFIX20; 20 0C e 50% URA) em sessões separadas por uma semana, realizadas em esteira ergométrica. A intensidade fixa correspondeu a 90% da velocidade em prova oficial de 10 km. Tempo total de corrida (TTE), velocidade média, índice de estresse fisiológico, temperatura retal, taxa de acúmulo de calor, taxa de sudorese, número de glândulas de suor ativadas (GLSUOR) e taxa de sudorese por glândula (TXSUDGL) foram medidos ou calculados. As características antropométricas, VO2max, TTE, velocidade média e as respostas termorregulatórias, à exceção da TXSUDGL e do GLSUOR, foram similares entre os grupos etários. As TXSUDGL de homens de meia-idade (CAR40: 0,19±0,1 e CAR20: 0,19±0,1; CFIX40: 0,26±0,1 e CFIX20: 0,21±0,1 g.m-2.min-1.cm-2) foram menores do que as de corredores jovens (CAR40: 0,48±0,1 e CAR20: 0,46±0,2; CFIX40: 0,59±0,1 e CFIX20: 0,48±0,1 g.m-2.min-1.cm-2) e os GLSUOR (CAR40: 88±1 e CAR20: 80±2; CFIX40: 90±2 e CFIX20: 66±1 cm-1) foram maiores do que os de jovens (CAR40: 43±1 e CAR20: 32±1; CFIX40: 37±1 e CFIX20: 31±1 cm-2). Os TTE na CFIX40 (MI_HOM: 27±2 e JV_HOM: 27±2; MI_MUL: 29±3 e JV_MUL: 28±2 min) foram menores do que nas CAR40 (MI_HOM: 59±3 e JV_HOM: 60±2; MI_MUL: 70±7 e JV_MUL: 64±7 min). As velocidades médias nas CAR40 (MI_HOM: 10±1 e JV_HOM: 10±0,3; MI_MUL: 9±1 e JV_MUL: 9±1 km.h-1) foram menores do que na CAR20 (MI_HOM: 12±1 e JV_HOM: 12±1; MI_MUL: 10±1 e JV_MUL: 10±1 min) e foram menores do que nas corridas de intensidade fixa (MI_HOM: 13±1 e JV_HOM: 13±1; MI_MUL: 10±1 e JV_MUL: 11±0,3 min). As taxas de sudorese e de acúmulo de calor e o GLSUOR foram maiores em ambiente quente, comparado com o moderado. As taxas de sudorese de homens de meia-idade e de jovens foram maiores do que as de mulheres de meia-idade e as de mulheres jovens. Concluiu-se que 1. os desempenhos de corridas de intensidade fixa e autorregulada no calor não são diferentes entre corredores jovens e de meia-idade com VO2max similar. 2. Entre corridas de intensidade fixa e autorregulada, apenas em ambiente quente, o desempenho e as respostas termorregulatórias são diferentes e estas diferenças foram atribuídas à menor velocidade empregada durante CAR40. 3. O calor compromete o desempenho da corrida independente da modalidade e da faixa etária. 4. Comparadas com homens, mulheres apresentam menores taxa de sudorese e desempenhos em corridas de intensidade fixa e autorregulada, independente da faixa etária.In order to compare the heat exercise performance between middle-aged and young runners with similar VO2peak using self-paced and fixed workload intensity, 26 endurance runners; seven men (MA_M: 54 ± 2 years; 58 ± 4 ml.kg-1.min-1) and six middle-aged women (MA_W: 54 ± 4 years; 48 ± 3 ml.kg-1.min-1); seven men (YO_M: 28 ± 1 years; 61 ± 5 ml.kg-1.min-1) and six young women (YO_W: 24 ± 3 years; 49 ± 3 ml.kg-1.min-1), underwent to 10 km of self-paced, as fast as possible, and fixed work load run until fatigue on a treadmill in hot (SP40 and FX40; 40 0C and 30% RH) and in moderate (SP20 and FX20; 20 0C and 50% RH) environments on sessions separated for a week . Fixed intensity was 90% speed run in an official 10-km race of each individual. Total time (TT), average speed, physiological strain index, rectal temperature, heat storage rate, sweat rate, number of heat-activated sweat glands (HASG) and sweat rate per sweat activated gland (SR/SG) were measured or calculated. Anthropometric characteristics, VO2peak, TT, average speed and thermoregulatory responses, besides HASG and SR/SG, were similar between the age groups. In MA_M, SR/SG (SP40: 0.19±0.1 and SP20: 0.19±0.1; FX40: 0.26±0,1 and FX20: 0.21±0.1 g.m-2.min-1.cm-2) were smaller than in younger runners (SP40: 0.48±0.1 and SP20: 0.46±0.2; FX40: 0.59±0,1 and FX20: 0.48±0.1 g.m-2.min-1.cm-2) and HASG (SP40: 88±1 and SP20: 80±2; FX40: 90±2 and FX20: 66±1 cm-1) were higher than in younger (SP40: 43±1 and SP20: 32±1; FX40: 37±1 and FX20: 31±1 cm-2). FX40 total time (MA_M: 27±2 and YO_M: 27±2; MA_W: 29±3 and YO_W: 28±2 min) were smaller than in SP40 (MA_M: 59±3 and YO_M: 60±2; MA_W: 70±7 and YO_W: 64±7 min). SP40 average speeds (MA_M: 10±1 and YO_M: 10±0,3; MA_W: 9±1 and YO_W: 9±1 km.h-1) were smaller than in SP20 (MA_M: 12±1 and YO_M: 12±1; MA_W: 10±1 and YO_W: 10±1 min) and were smaller than in run with fixed work load (MA_M: 13±1 and YO_M: 13±1; MA_W: 10±1 and YO_W: 11±0.3 min). Sweat rate, heat storage rate and HASG were higher in hot, compared with moderate environment. MA_M sweat rates and YO_M sweat rates were higher than MA_W and YO_W. It is concluded 1. Fixed and self-paced run performance are not different between middle-aged and young runners of similar VO2peak. 2. Self-paced run performance and thermoregulatory responses are different from those in fixed run only in hot environment. These differences were attributed to the lower speed used in SP40. 3. The heat affects run performance, independent of their modality and age group. 4. Compared with men, women present lower self-paced and fixed run performance and sweat rates, independent of the age group

Cold water immersion to the control of exertional heat illness

A incapacidade de dissipar o calor gerado pela atividade muscular prejudica o desempenho e aumenta a predisposição a lesões do organismo. A hipertermia severa induzida pelo esforço físico (HTE) prejudica a saúde e está associada à morbidade e mortalidade de indivíduos em diferentes atividades ocupacionais e atléticas. Estudos sobre a eficiência de métodos de resfriamento corporal têm recomendado a imersão em água fria para o tratamento da HTE. Sua utilização nos minutos iniciais pós-hipertemia parece a melhor recomendação por reduzir o tempo no qual a temperatura central permanece elevada. A manutenção de infraestrutura necessária para a realização desse procedimento deve ser considerada em atividades físicas e condições ambientais nas quais os indivíduos estão mais suscetíveis ao acometimento da HTE. As taxas de resfriamento observadas através da imersão em água a diferentes temperaturas podem servir de referência para o controle da duração do procedimento. Esta revisão analisa a recomendação da imersão em água fria como procedimento de resfriamento corporal para o manejo da HTE.The incapacity of dissipating heat generated by muscular activity hampers performance and increases predisposition to physical injuries. Exertional heat illness (HTE) harms health and is associated with morbidity and mortality of individuals in different occupational and athletic activities. Studies on the efficiency of body cooling methods have recommended cold-water immersion for the treatment of HTE. Its use in the initial minutes of post-hyperthermia seems to be the best recommendation to reduce the time central temperature remains high. Maintenance of the infrastructure needed to perform this procedure should be considered in physical activities and environmental conditions in which the individuals are more prone to HTE. The cool- ing rates observed through water immersion in different water temperatures may serve as reference to the control of HTE procedure duration. This review analyses the recommendation of cold-water immersion as a body cooling procedure for management of HTE

Cold water immersion to the control of exertional heat illness

A incapacidade de dissipar o calor gerado pela atividade muscular prejudica o desempenho e aumenta a predisposição a lesões do organismo. A hipertermia severa induzida pelo esforço físico (HTE) prejudica a saúde e está associada à morbidade e mortalidade de indivíduos em diferentes atividades ocupacionais e atléticas. Estudos sobre a eficiência de métodos de resfriamento corporal têm recomendado a imersão em água fria para o tratamento da HTE. Sua utilização nos minutos iniciais pós-hipertemia parece a melhor recomendação por reduzir o tempo no qual a temperatura central permanece elevada. A manutenção de infraestrutura necessária para a realização desse procedimento deve ser considerada em atividades físicas e condições ambientais nas quais os indivíduos estão mais suscetíveis ao acometimento da HTE. As taxas de resfriamento observadas através da imersão em água a diferentes temperaturas podem servir de referência para o controle da duração do procedimento. Esta revisão analisa a recomendação da imersão em água fria como procedimento de resfriamento corporal para o manejo da HTE.The incapacity of dissipating heat generated by muscular activity hampers performance and increases predisposition to physical injuries. Exertional heat illness (HTE) harms health and is associated with morbidity and mortality of individuals in different occupational and athletic activities. Studies on the efficiency of body cooling methods have recommended cold-water immersion for the treatment of HTE. Its use in the initial minutes of post-hyperthermia seems to be the best recommendation to reduce the time central temperature remains high. Maintenance of the infrastructure needed to perform this procedure should be considered in physical activities and environmental conditions in which the individuals are more prone to HTE. The cool- ing rates observed through water immersion in different water temperatures may serve as reference to the control of HTE procedure duration. This review analyses the recommendation of cold-water immersion as a body cooling procedure for management of HTE

Imersão em água fria para o manejo da hipertermia severa Cold water immersion to the control of exertional heat illness

A incapacidade de dissipar o calor gerado pela atividade muscular prejudica o desempenho e aumenta a predisposição a lesões do organismo. A hipertermia severa induzida pelo esforço físico (HTE) prejudica a saúde e está associada à morbidade e mortalidade de indivíduos em diferentes atividades ocupacionais e atléticas. Estudos sobre a eficiência de métodos de resfriamento corporal têm recomendado a imersão em água fria para o tratamento da HTE. Sua utilização nos minutos iniciais pós-hipertemia parece a melhor recomendação por reduzir o tempo no qual a temperatura central permanece elevada. A manutenção de infraestrutura necessária para a realização desse procedimento deve ser considerada em atividades físicas e condições ambientais nas quais os indivíduos estão mais suscetíveis ao acometimento da HTE. As taxas de resfriamento observadas através da imersão em água a diferentes temperaturas podem servir de referência para o controle da duração do procedimento. Esta revisão analisa a recomendação da imersão em água fria como procedimento de resfriamento corporal para o manejo da HTE.<br>The incapacity of dissipating heat generated by muscular activity hampers performance and increases predisposition to physical injuries. Exertional heat illness (HTE) harms health and is associated with morbidity and mortality of individuals in different occupational and athletic activities. Studies on the efficiency of body cooling methods have recommended cold-water immersion for the treatment of HTE. Its use in the initial minutes of post-hyperthermia seems to be the best recommendation to reduce the time central temperature remains high. Maintenance of the infrastructure needed to perform this procedure should be considered in physical activities and environmental conditions in which the individuals are more prone to HTE. The cooling rates observed through water immersion in different water temperatures may serve as reference to the control of HTE procedure duration. This review analyses the recommendation of cold-water immersion as a body cooling procedure for management of HTE

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat