DIAGNOSIS AND MANAGEMENT OF HYPONATRAEMIA IN HOSPITALISED PATIENTS

Hyponatraemia is a commonly encountered electrolyte abnormality in hospitalised patients and is associated with significant morbidity and mortality. The fact that most cases of hyponatraemia are the result of water imbalance rather than sodium imbalance underscores the role of antidiuretic hormone (ADH) in the pathophysiology. Hyponatraemia can be classified according to the measured plasma osmolality [...]

H2O COMA

INTRODUCTION: Water intoxication is a rare cause of coma. The leading causes of excessive hydration are endurance exercise, drug abuse, iatrogenic, cerebral salt wasting, or psychiatric conditions. Self-induced water intoxication in an otherwise healthy person is exceedingly rare. METHODS: Single patient case report and review of the literature. RESULTS: We describe a previously fit and [...]

HAZARDS OF ULTRA-MARATHON RUNNING IN THE SCOTTISH HIGHLANDS: EXERCISE-ASSOCIATED HYPONATRAEMIA

The case histories are presented of four athletes taking part in a 95-mile ultra-endurance foot race in Scotland who were hospitalised after developing exercise-associated hyponatraemia and rhabdomyolysis. Exercise-associated hyponatraemia is relatively uncommon in temperate climates. Risk factors disposing to this disorder are discussed. Exercise-associated hyponatraemia is thought to be due to overconsumption of hypotonic fluid [...]

THE TREATMENT OF HYPONATREMIA

Virtually all investigators now agree that self-induced water intoxication, symptomatic hospital-acquired hyponatremia, and hyponatremia associated with intracranial pathology are true emergencies that demand prompt and definitive intervention with hypertonic saline. A 4- to 6-mmol/L increase in serum sodium concentration is adequate in the most seriously ill patients and this is best achieved with bolus infusions [...]

ELECTROLYTE AND PLASMA CHANGES AFTER INGESTION OF PICKLE JUICE, WATER, AND A COMMON CARBOHYDRATE-ELECTROLYTE SOLUTION

Context:nHealth care professionals advocate that athletes who are susceptible to exercise-associated muscle cramps (EAMCs) should moderately increase their fluid and electrolyte intake by drinking sport drinks. Some clinicians have also claimed drinking small volumes of pickle juice effectively relieves acute EAMCs, often alleviating them within 35 seconds. Others fear ingesting pickle juice will enhance dehydration-induced [...]

EXERCISE-ASSOCIATED HYPONATREMIA

Disorders of serum sodium occur commonly in athletes participating in endurance sports. The most life-threatening of these is hyponatremia, which can occur in as many as 2% to 7% of participants. Exercise-associated hyponatremia (EAH) is caused by a combination of excessive water or hypotonic fluid intake as well as high levels of arginine vasopressin, which [...]

RESPONSE TO A FLUID LOAD IN ATHLETES WITH A HISTORY OF EXERCISE INDUCED HYPONATREMIA

PURPOSE: To determine whether athletes who had previously developed hyponatremia during an ultradistance triathlon show an impaired ability to excrete a large fluid load compared with athletes who had completed the same race without developing hyponatremia. METHODS: Six athletes who had developed hyponatremia ([Na] < 135 mmol x L(-1)) in the 1997 Ironman Triathlon (study [...]

REHYDRATION WITH DRINKS DIFFERING IN SODIUM CONCENTRATION AND RECOVERY FROM MODERATE EXERCISE-INDUCED HYPOHYDRATION IN MAN.

To investigate how differing moderate sodium chloride concentrations affect rehydration after exercise and subsequent exercise capacity, eight males lost 1.98 +/- 0.1% body mass exercising in the heat, then consumed one of four drinks in a volume equivalent to 150% of mass loss. Drinks were identical except for sodium chloride content (1 +/- 1, 31 [...]