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Exercise Associated Hyponatremia

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https://www.readbyqxmd.com/read/28696993/special-communication-of-a-case-of-hypovolemic-associated-eah-lessons-learned-during-recovery
#1
Tamara Hew-Butler, Rus Hamilton, Bridget Hamilton, Zachary Colesa
Severe exercise-associated hyponatremia (EAH) is largely dilutional, whereas contributions of sodium loss remain equivocal. We present a case of EAH with encephalopathy involving an experienced male cyclist with no recollection of the event. We thereby conducted a retrospective analysis of biochemical trajectories during hospital recovery. The normalization of serum [Na], in context with changes in other variables, offered a 'reverse' perspective of the underlying pathophysiology. The following biochemical changes were temporally observed, with the return of normonatremia: 1) a decrease in serum potassium and calcium concentrations (absence of extracellular fluid dilution); 2) a decrease in total protein, blood urea nitrogen, hematocrit and hemoglobin (plasma volume expansion); and 3) an increase in mean platelet and red cell corpuscular volumes (cellular expansion after total body water and sodium deficits)...
July 2017: Current Sports Medicine Reports
https://www.readbyqxmd.com/read/28653967/exercise-associated-hyponatremia-in-a-lactating-female
#2
Zach Bailowitz, Raymond Grams, David Teeple, Tamara Hew-Butler
A 37-year-old woman presented to the emergency department with severe headache, which quickly progressed to altered mental status and seizure activity in hospital. Her initial serum sodium concentration ([Na]) was 126 mmol/L. In the 24 hours before admission, she exercised vigorously for 120 minutes (interval training plus yoga) and also consumed more than 4 liters of fluid during that time to both stay hydrated and facilitate milk production because she was actively nursing 2 children. Her serum [Na] and altered mental status corrected slowly over the next 48 hours with furosemide, hypertonic saline, and fluid restriction...
July 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/28512433/reported-hydration-beliefs-and-behaviors-without-effect-on-plasma-sodium-in-endurance-athletes
#3
Daniela Chlíbková, Pantelis T Nikolaidis, Thomas Rosemann, Beat Knechtle, Josef Bednář
Purpose: Little information is available on the association of hydration beliefs and behaviors in endurance athletes and exercise-associated hyponatremia (EAH). The aim of the present study was to determine hydration beliefs and behaviors in endurance athletes. Method: A 100 and 38 recreational athletes [107 mountain bikers (MTBers) and 31 runners] competing in seven different endurance and ultra-endurance races completed pre- and post-race questionnaires, and a subgroup of 113 (82%) participants (82 MTBers and 31 runners) also provided their blood samples...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28476693/oxytocin-administration-during-spontaneous-labor-guidelines-for-clinical-practice-chapter%C3%A2-6-fetal-neonatal-and-pediatric-risks-and-adverse-effects-of-using-oxytocin-augmentation-during-spontaneous-labor
#4
A Burguet, A Rousseau
No abstract text is available yet for this article.
May 2, 2017: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/28316971/exercise-associated-hyponatremia-2017-update
#5
REVIEW
Tamara Hew-Butler, Valentina Loi, Antonello Pani, Mitchell H Rosner
Exercise-associated hyponatremia (EAH) was initially described in the 1980s in endurance athletes, and work done since then has conclusively identified that overdrinking beyond thirst and non-osmotic arginine vasopressin release are the most common etiologic factors. In recent years, EAH has been described in a broader variety of athletic events and also has been linked to the development of rhabdomyolysis. The potential role of volume and sodium depletion in a subset of athletes has also been described. This review focuses on the most recent literature in the field of EAH and summarizes key new findings in the epidemiology, pathophysiology, treatment, and prevention of this condition...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28282356/management-of-suspected-fluid-balance-issues-in-participants-of-wilderness-endurance-events
#6
Martin D Hoffman, Jeremy Joslin, Ian R Rogers
Dehydration and exercise-associated hyponatremia (EAH) are both relatively common conditions during wilderness endurance events. Whereas dehydration is treated with fluids, EAH is appropriately managed with fluid restriction and a sodium bolus but can worsen with isotonic or hypotonic fluids. Therefore, caution is recommended in the provision of postevent rehydration in environments where EAH is a potential consideration because accurate field assessment of hydration status can be challenging, and measurement of blood sodium concentration is rarely possible in the wilderness...
March 2017: Current Sports Medicine Reports
https://www.readbyqxmd.com/read/27747851/sodium-intake-during-an-ultramarathon-does-not-prevent-muscle-cramping-dehydration-hyponatremia-or-nausea
#7
Martin D Hoffman, Kristin J Stuempfle, Taylor Valentino
BACKGROUND: Ultramarathon runners commonly believe that sodium replacement is important for prevention of muscle cramping, dehydration, hyponatremia, and nausea during prolonged continuous exercise. The purpose of this study was to measure total sodium intake to determine if these beliefs are supported. METHODS: Participants of a 161-km ultramarathon (air temperature reaching 39 °C) provided full dietary information during the race, underwent body weight measurements before and after the race, completed a post-race questionnaire about muscle cramping and nausea or vomiting during the race, and had post-race plasma sodium concentration measured...
December 2015: Sports Medicine—Open
https://www.readbyqxmd.com/read/27721832/management-of-severe-rhabdomyolysis-and-exercise-associated-hyponatremia-in-a-female-with-anorexia-nervosa-and-excessive-compulsive-exercising
#8
Marwan El Ghoch, Simona Calugi, Riccardo Dalle Grave
This case report describes the management of a 49-year-old female with restricting-type anorexia nervosa and excessive compulsive exercising associated with rhabdomyolysis, high levels of serum creatine kinase (CK) (3,238 U/L), and marked hyponatremia (Na(+): 123 mEq/L) in the absence of purging behaviours or psychogenic polydipsia; it is the first case report to describe exercise-associated hyponatremia in a patient with anorexia nervosa. The patient, who presented with a body mass index (BMI) of 13.4 kg/m(2), was successfully treated by means of an adapted inpatient version of an enhanced form of cognitive behavioural therapy (CBT-E)...
2016: Case Reports in Medicine
https://www.readbyqxmd.com/read/27714955/restricting-dietary-sodium-reduces-plasma-sodium-response-to-exercise-in-the-heat
#9
E E Koenders, C P G Franken, J D Cotter, S N Thornton, N J Rehrer
Exercise-associated hyponatremia can be life-threatening. Excessive hypotonic fluid ingestion is the primary etiological factor but does not explain all variability. Possible effects of chronic sodium intake are unknown. The aim of this study was to determine whether dietary sodium affects plasma sodium concentration [Na(+) ] during exercise in the heat, when water intake nearly matches mass loss. Endurance-trained men (n = 9) participated in this crossover experiment. Each followed a low-sodium (lowNa) or high-sodium (highNa) diet for 9 days with 24-h fluid intakes and urine outputs measured before experimental trials (day 10)...
October 7, 2016: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/27548748/are-we-being-drowned-by-overhydration-advice-on-the-internet
#10
Martin D Hoffman, Theodore L Bross, R Tyler Hamilton
OBJECTIVE: Because inappropriate recommendations about hydration during exercise appear widespread and potentially dangerous, we assessed the quality of a sampling of information currently available to the public on the Internet. METHODS: Internet searches using the Google search engine were conducted using the terms "hydration," "hydration guidelines," "drinking fluids" and "drinking guidelines" combined with "and exercise." From the first 50 websites for each search phrase, duplicates were removed yielding 141 unique websites that were categorized by source and examined for specific hydration related information and recommendations...
November 2016: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/27536693/current-challenges-in-the-evaluation-and-management-of-hyponatremia
#11
REVIEW
Kerri McGreal, Pooja Budhiraja, Nishank Jain, Alan S L Yu
BACKGROUND: Hyponatremia is a common electrolyte imbalance that clinicians face on a regular basis. SUMMARY: This review aims to discuss four current challenges that can arise when diagnosing and treating hyponatremia: low solute intake, heart failure, exercise-associated hyponatremia, and mild chronic hyponatremia. Low solute intake in a person who already has a urinary concentrating defect will lead to increased retention of free water. The free water retention will cause or worsen hyponatremia that is already present...
June 2016: Kidney Diseases
https://www.readbyqxmd.com/read/26972268/exercise-associated-collapse-is-hyponatremia-in-our-head
#12
REVIEW
Brian J Krabak, Kelsey M Parker, Anthony DiGirolamo
Exercise-associated hyponatremia (EAH) is one of the most common causes of exercise-associated collapse. The primary pathogenesis of EAH is largely the result of excessive fluid intake but is influenced by other factors, including hormonal abnormalities (ie, inappropriate arginine vasopressin secretion), renal abnormalities, and mobilization of sodium stores. Early recognition of EAH is crucial to appropriate treatment, because symptoms are varied and may be confused with other causes of exercise-associated collapse...
March 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/26747653/proof-of-concept-hypovolemic-hyponatremia-may-precede-and-augment-creatine-kinase-elevations-during-an-ultramarathon
#13
Ross S Cairns, Tamara Hew-Butler
PURPOSE: It is not known if exercise-associated hyponatremia (EAH) is a cause or consequence of exertional rhabdomyolysis (ER).We hypothesized that osmotic stress (EAH) coupled with mechanical stress (running) potentiated muscle cell breakdown (ER). This concept would be supported if a nadir in serum sodium concentration ([Na(+)]) temporally preceded peak creatine kinase levels (CK) during an ultramarathon run. METHODS: Fifteen participants ran ≥104 km and had blood drawn: prior to start; 53; 104 km; and 24-h post run...
March 2016: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/26709371/sodium-intake-during-an-ultramarathon-does-not-prevent-muscle-cramping-dehydration-hyponatremia-or-nausea
#14
Martin D Hoffman, Kristin J Stuempfle, Taylor Valentino
BACKGROUND: Ultramarathon runners commonly believe that sodium replacement is important for prevention of muscle cramping, dehydration, hyponatremia, and nausea during prolonged continuous exercise. The purpose of this study was to measure total sodium intake to determine if these beliefs are supported. METHODS: Participants of a 161-km ultramarathon (air temperature reaching 39 °C) provided full dietary information during the race, underwent body weight measurements before and after the race, completed a post-race questionnaire about muscle cramping and nausea or vomiting during the race, and had post-race plasma sodium concentration measured...
2015: Sports Medicine—Open
https://www.readbyqxmd.com/read/26679208/in-response-to-incidence-of-exercise-associated-hyponatremia-and-its-association-with-nonosmotic-stimuli-of-arginine-vasopressin-in-the-gnw100s-ultraendurance-marathon
#15
LETTER
Martin D Hoffman, Jeremy Joslin, Ian R Rogers
No abstract text is available yet for this article.
January 2016: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/26661748/sweat-sodium-loss-influences-serum-sodium-concentration-in-a-marathon
#16
B Lara, J J Salinero, F Areces, D Ruiz-Vicente, C Gallo-Salazar, J Abián-Vicén, J Del Coso
The aim of this investigation was to determine the influence of sweat electrolyte concentration on body water and electrolyte homeostasis during a marathon. Fifty-one runners completed a marathon race in a warm and dry environment (24.4 ± 3.6 °C). Runners were classified as low-salt sweaters (n = 21; <30 mmol/L of sweat Na(+) concentration), typical sweaters (n = 20; ≥30 and <60 mmol/L of sweat Na(+) concentration), and salty sweaters (n = 10; ≥60 mmol/L of sweat Na(+) concentration)...
February 2017: Scandinavian Journal of Medicine & Science in Sports
https://www.readbyqxmd.com/read/26600233/fatal-hyponatremic-encephalopathy-as-a-result-of-child-abuse-from-forced-exercise
#17
Michael L Moritz, James R Lauridson
We report a case of fatal hyponatremic encephalopathy in a child who was forced to exercise as a form of punishment. A 9-year-old girl with attention-deficit/hyperactivity disorder was forced to run repeated 50-ft sprints to the point of exhaustion by her grandmother as punishment for taking candy from a classmate. After more than 3 hours of forced running, the child collapsed, began to vomit, and had repeated clonic seizures. Upon presentation to the emergency department, she was nonresponsive with a Glasgow Coma Scale score of 11 and had noncardiogenic pulmonary edema with serum sodium of 117 mEq/L...
March 2016: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/26565425/exertional-heat-stroke-and-susceptibility-to-malignant-hyperthermia-in-an-athlete-evidence-for-a-link
#18
Mathias Poussel, Philippe Guerci, Pierre Kaminsky, Marie Heymonet, Nathalie Roux-Buisson, Julien Faure, Emilien Fronzaroli, Bruno Chenuel
OBJECTIVE: To describe the possible association (pathophysiologic and clinical features) between exertional heat stroke (EHS) and malignant hyperthermia (MH). BACKGROUND: Both EHS and MH are acute and life-threatening disorders. It has repeatedly been shown that EHS can occur in well-trained patients with known MH-associated mutation in the RYR1 gene in the absence of any extreme environmental conditions or extreme physical activity, thereby supporting a possible link between EHS and MH...
November 2015: Journal of Athletic Training
https://www.readbyqxmd.com/read/26270309/kenney-et-al-respond
#19
COMMENT
Erica L Kenney, Michael W Long, Angie L Cradock, Steven L Gortmaker
No abstract text is available yet for this article.
October 2015: American Journal of Public Health
https://www.readbyqxmd.com/read/26229538/exercise-induced-pulmonary-edema-in-a-triathlon
#20
Hirotomo Yamanashi, Jun Koyamatsu, Masaharu Nobuyoshi, Kunihiko Murase, Takahiro Maeda
Introduction. Family physicians have more opportunities to attend athletic competitions as medical staff at first-aid centers because of the increasing popularity of endurance sports. Case. A 38-year-old man who participated in a triathlon race experienced difficulty in breathing after swimming and was moved to a first-aid center. His initial oxygen saturation was 82% and a thoracic computed tomography scan showed bilateral ground glass opacity in the peripheral lungs. His diagnosis was noncardiogenic pulmonary edema associated with exercise or swimming: exercise-induced pulmonary edema (EIPE) or swimming-induced pulmonary edema (SIPE)...
2015: Case Reports in Medicine
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