Cold water immersion: kill or cure?

Abstract

What is the topic of this review? This is the first review to look across the broad field of 'cold water immersion' and to determine the threats and benefits associated with it as both a hazard and a treatment. What advances does it highlight? The level of evidence supporting each of the areas reviewed is assessed. Like other environmental constituents, such as pressure, heat and oxygen, cold water can be either good or bad, threat or treatment, depending on circumstance. Given the current increase in the popularly of open cold water swimming, it is timely to review the various human responses to cold water immersion (CWI) and consider the strength of the claims made for the effects of CWI. As a consequence, in this review we look at the history of CWI and examine CWI as a precursor to drowning, cardiac arrest and hypothermia. We also assess its role in prolonged survival underwater, extending exercise time in the heat and treating hyperthermic casualties. More recent uses, such as in the prevention of inflammation and treatment of inflammation-related conditions, are also considered. It is concluded that the evidence base for the different claims made for CWI are varied, and although in most instances there seems to be a credible rationale for the benefits or otherwise of CWI, in some instances the supporting data remain at the level of anecdotal speculation. Clear directions and requirements for future research are indicated by this review.

Accidental hypothermia in recreational activities in the mountains: A narrative review

“…This is not intended as a comprehensive review of all outdoor activities or organized sport. Hypothermia due to submersion or immersion in water during water‐based activities has not been reviewed and can be found elsewhere …”

“…Hypothermia due to submersion or immersion in water during water-based activities has not been reviewed and can be found elsewhere. 15,16 2 | DEFINITION OF ACCIDENTAL HYPOTHERMIA Accidental hypothermia refers to an involuntary drop in core body temperature below 35°C. The term accidental is used to differentiate this condition from induced and therapeutic hypothermia.…”

Humans: A homeothermic animal that needs perturbation?

“…Others adopt more idiosyncratic approaches, Thomas Jefferson used a cold foot bath every morning for six decades to ‘maintain his good health’. Many claim health benefits from regular whole‐body cold water immersion (Tipton, Collier, Massey, Corbett, & Harper, ).…”

Peripheral and central functions of monoamines: Can we use changes in plasma monoamine concentrations as a valid indicator of changes in the brain?

“…We read the article entitled ‘Cold water immersion: kill or cure?’ (Tipton, Collier, Massey, Corbett, & Harper, ) with great interest. The authors provide a fascinating and comprehensive literature review on the risks and benefits of cold water immersion (CWI) and possible new applications in new clinical subpopulations (e.g.…”

“…Furthermore, this distinction between central and peripheral concentrations of serotonin could also help us to understand the role of indoleamine 2,3‐dioxygenase in the serotonin pathway when relating it to more centrally oriented effects in an inflammatory hypothesis. Although the serotonin pathway is highlighted throughout the section of the review on inflammation, other potential mechanisms and hypotheses of how CWI might contribute to the improvement of symptoms of major depression are rather briefly discussed (Tipton et al., , fig. 5 on p. 1344).…”