{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T14:41:13Z","timestamp":1788446473153,"version":"build-2803163510"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T00:00:00Z","timestamp":1763683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Cold-water immersion induces autonomic stress responses including sympathetic cold shock and parasympathetic diving and trigeminovagal reflexes, potentially leading to arrhythmias or bronchospasm. Another important complication of cold-water immersion is hypothermia. This study evaluates physiological responses during ice-self-rescue training to assess safety and temperature monitoring accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective observational cohort study of 80 healthy Mountain Infantry soldiers during a standardized ice-self-rescue training in Norway (air temperature \u221210 \u00b0C). Participants underwent partial immersion (0.5 \u00b0C water) resulting in transitory submersion (&amp;lt;5 s). They were equipped with continuous 3-lead ECG (n = 34) spirometry (n = 26); and core temperature monitoring (ingestible telemetric capsule (n = 23) versus bilateral tympanic thermometry with and without ear channel occlusion (n = 34). Primary outcomes included cardiac rhythm changes, lung function parameters and temperature measurement agreement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      ECG analysis revealed significant post-immersion tachycardia (median increase of 17 bpm, p = 0.03) and increased RR-interval variability (+90 ms, p &amp;lt; 0.01), without malignant arrhythmias. Spirometry showed no clinically significant changes in FVC or FEV\n                      <jats:sub>1<\/jats:sub>\n                      and peak expiratory flow. Tympanic readings underestimated core temperature post-immersion (median difference \u22122.8 \u00b0C versus capsules, p &amp;lt; 0.01), with ear canal occlusion did not improve accuracy (p = 0.15).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Supervised cold-water immersion during military training exercise elicited expected autonomic stress responses without life-threatening complications in healthy soldiers. These findings suggest structured cold-water training can be safely conducted for fit individuals. Tympanic thermometry proved unreliable following immersion, even after ear channel occlusion. Ingestible capsule thermometry may be a viable approach if invasive measurement is not possible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>\n                      This trial was registered under \u201c\n                      <jats:ext-link>Cold induced stress reactions during cold water immersion<\/jats:ext-link>\n                      \u201d in the German Clinical Trial Register (DRKS) under the registration number DRKS00032345 (\n                      <jats:ext-link>https:\/\/www.drks.de\/search\/de\/trial\/DRKS00032345\/details<\/jats:ext-link>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphys.2025.1679550","type":"journal-article","created":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T05:14:18Z","timestamp":1763702058000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Cold-induced stress responses during a self-rescue exercise from accidental immersion in ice water in military personnel"],"prefix":"10.3389","volume":"16","author":[{"given":"Yannick","family":"Beres","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raimund","family":"Lechner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"August","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Koch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Radermacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Kulla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Staps","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1152\/jappl.1987.63.2.659","article-title":"Cold-induced bronchoconstriction: role of cutaneous reflexes vs. direct airway effects","volume":"63","author":"Berk","year":"1987","journal-title":"J. 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