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Suspension syndrome refers to a potentially life-threatening condition that can occur in unconscious persons after prolonged suspension in a harness. To date, our understanding of the pathophysiology and appropriate treatment is based primarily on case reports and expert opinion. The main pathophysiological hypothesis implicates blood pooling in the lower extremity and lack of return via muscle pumping. However, a recent French study could not support this hypothesis. Other mechanisms, such as a central vagal reflex may play a role in the pathophysiology of suspension syndrome. The aim of this study is to better understand the pathophysiological basis of suspension syndrome and to develop practical recommendations for prevention and treatment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Suspension without prior climbing | Experimental | Free Suspension in a harness after baseline measurements and without prior climbing |
|
| Suspension with prior climbing | Experimental | Free Suspension in a harness after baseline measurements and after climbing in moderate intensity for 10 minutes |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Suspension in a harness | Other |
| ||
| Climbing |
| Measure | Description | Time Frame |
|---|---|---|
| Heart rate | Change from baseline (measurement at minute 0) -> suspension phase (minute 10, timepoint immediately before interruption of suspension phase [max 60 minutes]) -> minute 5 and minute 15 after suspension phase | |
| Blood pressure | Change from baseline (measurement at minute 0) -> suspension phase (minute 10, timepoint immediately before interruption of suspension phase [max 60 minutes]) -> minute 5 and minute 15 after suspension phase |
| Measure | Description | Time Frame |
|---|---|---|
| Change in maximal Diameter of superficial femoral vein | Ultrasound measurement of the Diameter of the superficial femoral vein in millimeters | Change from baseline (measurement at minute 0) -> suspension phase (minute 10, timepoint immediately before interruption of suspension phase [max 60 minutes]) -> minute 5 and minute 15 after suspension phase |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Peter Paal, MD, MBA | Barts Heart Centre, London | Study Director |
| Hermann Brugger, MD | Eurac, Institute of mountain emergency medicine | Study Director |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21420883 | Result | Pasquier M, Yersin B, Vallotton L, Carron PN. Clinical update: suspension trauma. Wilderness Environ Med. 2011 Jun;22(2):167-71. doi: 10.1016/j.wem.2010.12.006. Epub 2010 Dec 23. | |
| 17384373 | Result | Lee C, Porter KM. Suspension trauma. Emerg Med J. 2007 Apr;24(4):237-8. doi: 10.1136/emj.2007.046391. |
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| ID | Type | URL | Comment |
|---|---|---|---|
| Study Protocol | View IPD |
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| ID | Term |
|---|---|
| D012769 | Shock |
| D019462 | Syncope, Vasovagal |
| D007024 | Hypotension, Orthostatic |
| ID | Term |
|---|---|
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D054971 | Orthostatic Intolerance |
| D054969 | Primary Dysautonomias |
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| ID | Term |
|---|---|
| D013535 | Suspensions |
| D000072799 | Stair Climbing |
| ID | Term |
|---|---|
| D003102 | Colloids |
| D045424 | Complex Mixtures |
| D004304 | Dosage Forms |
| D004364 | Pharmaceutical Preparations |
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| Other |
|
| Change in interbeat-interval | electrocardiographic measurement of interbeat interval in milliseconds (ms) | Change from baseline (measurement at minute 0) -> suspension phase (minute 10, timepoint immediately before interruption of suspension phase [max 60 minutes]) -> minute 5 and minute 15 after suspension phase |
Unfortunately available only in German |
| Informed Consent Form | View IPD | Unfortunately available only in German or Italian |
| D001342 | Autonomic Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D013575 | Syncope |
| D014474 | Unconsciousness |
| D003244 | Consciousness Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D007022 | Hypotension |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D016138 |
| Walking |
| D008124 | Locomotion |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
| D015444 | Exercise |
| D009043 | Motor Activity |