Avoid adding insult to injury - correct management of sick female endurance athletes

作者：Hew Butler T^*; Boulter J; Bhorat R; Noakes T D

来源：SAMJ South African Medical Journal, 2012, 102(12): 927-930.

DOI：10.7196/SAMJ.6156

Objectives. To evaluate the efficacy of Ringer%26apos;s lactate, isotonic saline and hypertonic saline on the clinical and biochemical recovery of athletes with exercise-associated hyponatraemic encephalopathy caused by fluid overload. %26lt;br%26gt;Methods. We retrospectively reviewed serial blood sodium concentrations (Na+) and qualitative signs of recovery and time to recovery in two healthy menstruant females hospitalised with dilutional exercise-associated hyponatraemic encephalopathy after withdrawal from the 2011 Comrades Marathon (89 km) and Argus Cycle Tour (109 km). %26lt;br%26gt;Results. Improvements in blood Na+ did not occur with intravenous administration of Ringer%26apos;s lactate solution, but did occur with administration of isotonic and hypertonic saline. Qualitative improvements in mental status were not quantitatively related to the biochemical value of blood Na+ or subsequent return to normonatraemia. %26lt;br%26gt;Conclusions. Hyponatraemia should be suspected in all female athletes presenting to the medical area of endurance races with vomiting, altered mental status and a history of high fluid intake. If a diagnosis of exercise associated hyponatraemia with cerebral encephalopathy is Confirmed, die treatment of choice is administration of an intravenous bolus of hypertonic saline. Administration of Ringer%26apos;s lactate should: be discouraged,:as this does not correct Na+ and appears to delay recovery. S Afr Med J 2012;102(12):921-9-30. DOI:10.7196/SAMJ.6156

• 出版日期2012-12