ORIGINAL RESEARCH article
Front. Sports Act. Living
Sec. Exercise Physiology
Cold Shock Response in Healthy Children: Reassessment and First Comparison Between Cold and Warm Water Immersion
Provisionally accepted
Sophie Peter1*
Anna Michaelis1Robert Wagner2
Robert Percy Marshall3,4Mia Bovet1Johannes Weickmann1Michael Weidenbach1Ingo Dähnert1Christian Paech1- 1Department of Pediatric Cardiology, Heart Centre, University of Leipzig, Leipzig, Germany
- 2Pediatric practice, Leipzig, Germany
- 3RasenBallsport Leipzig GmbH, Leipzig, Germany
- 4Department of Orthopedic and Trauma Surgery, Martin-Luther-University Halle-Wittenberg, Halle, Germany
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INTRODUCTION: Swimming and diving are popular recreational activities and essential skills to prevent death from drowning. While most drownings occur in cold water, cold shock response is discussed as a major cause of drowning. Until now, the data on the physiology of drowning and cold shock response in children are scarce, while drowning remains a significant concern in this population. This study was conducted to investigate the cold shock response in healthy children and compare cold and warm water immersion. METHODS: Participants were first immersed up to the neck in warm water (34°C, close to thermoneutral) and then in cold water (11°C), while skin temperature, ECG, heart rate, respiratory rate, oxygen saturation and peripheral perfusion index were continuously monitored. RESULTS: Heart rate and respiratory rate remained constant in warm water. In cold water, heart rate increased by 31% and respiratory rate by 58%, peaking at 30 seconds and beginning to normalize after 60 seconds. CONCLUSION: The current study presents new data on the cold shock response in healthy children and the first comparison between cold water immersion and warm water immersion in this population. Data showed that immersion into 11°C (52°F) cold water leads to significant increases in heart rate and respiratory rate, in contrast to immersion in warm water. Remarkably, there is a lower intensity of the cold shock response in children compared to adults.
Keywords: Children, Cold shock response, Diving, Drowning, Hyperventilation, Immersion, Swimming
Received: 11 Apr 2025; Accepted: 08 Dec 2025.
Copyright: © 2025 Peter, Michaelis, Wagner, Marshall, Bovet, Weickmann, Weidenbach, Dähnert and Paech. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Sophie Peter
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