Hazards of ultra-marathon running in the Scottish Highlands: exercise-associated hyponatraemia

Emergency Medicine Journal : EMJ
J A CuthillA Inglis

Abstract

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 with other associated pathophysiology including an inability to suppress fully antidiuretic hormone during exercise or to mobilise adequate sodium from osmotically inactive internal stores. Non-specific symptoms make this disorder difficult to diagnose on site without the assistance of serum sodium measurement, but any delay in treatment of patients with encephalopathy can prove fatal. Mainstays of treatment include fluid restriction, hypertonic saline, loop diuretics and mannitol.

Citations

Jan 15, 2014·Wilderness & Environmental Medicine·Susanne J SpanoTimothy Evans
Apr 24, 2018·BMJ Case Reports·Fiona MitchellFaith Gardner
May 10, 2011·Medicine and Science in Sports and Exercise·Brian J KrabakMelissa A Schiff
Jul 11, 2019·Praxis·Beat KnechtlePantelis T Nikolaidis
Jan 24, 2012·Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine·Zachary C LandmanPedram Fatehi
Feb 28, 2013·Journal of Strength and Conditioning Research·Kristian KarstoftBente K Pedersen
Jun 19, 2018·Frontiers in Physiology·Beat Knechtle, Pantelis T Nikolaidis
Sep 24, 2011·International Journal of Sports Physiology and Performance·Martin D HoffmanTamara Hew-Butler

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