Vatten är ett farligt gift ...Två fall av hyponatremi i samband med maratonsport och stort vätskeintag
Engelsk titel: Water is a dangerous poison...Two cases of hyponatremia associated with spinning and extensive fluid intake
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Författare:
Lorraine-Lichtenstein E
;
Albert J
;
Hjelmqvist H
Email: elizabeth.lichtenstein@ds.se
Språk: Swe
Antal referenser: 14
Dokumenttyp:
Fallbeskrivning
UI-nummer: 08061125
Sammanfattning
Hyponatremia due to increased fluid intake was first described in the early 1980s. This article describes two females who participated in a marathon spinning event. The first case describes an 18-year-old healthy woman. During the spinning event she drank close to 8 litres of water. Afterwards she fainted twice and came to the emergency room (ER). In the ER she was disorientated, drowsy and on and off agitated. On admission she showed no abnormalities regarding her physiological status besides a blood analysis that revealed a hyponatremia of 122 mmol/l. A CT-scan showed cerebral oedema. She was treated with an intravenous infusion of isotonic saline 0.9 % with additional sodium and stayed overnight in the ICU. Her condition improved and she could leave the ICU after 24 hours. Her sodium had increased to137 mmol/l when she left the hospital two days after being admitted. The second case describes a woman in her early 50s who also participated in the same marathon spinning event. She was healthy and exercised regularly. She reported drinking sports drinks during the marathon spinning. During the event she became nauseous and felt faint. An ambulance transported her to the ER where she vomited and had seizures. She was agitated and mentally confused. Neither did she show any other physiological abnormalities except a sodium level of 118mmol/l. She was treated with saline 0.9 % with additional sodium and spent two days in the ICU. As she left the hospital a day later her sodium levels had risen to 138 mmol/l.
Exercise Associated Hyponatremia is a serious medical condition which has increased during the last twenty years as prolonged endurance activities are becoming more and more common. There is also an overall incorrect assumption that athletes should drink as much as possible to replace the fluids that are lost during exercise. Several studies show that this is not the case - on the contrary - after completing a marathon or other prolonged endurance activities a slight weight loss is considered a sign of euhydration. More information and updated recommendations to organizers and participants of endurance sports is needed to avoid future cases as the ones described above.