Wilderness Medical Society Practice Guidelines for Treatment of Exercise-Associated Hyponatremia: 2014 Update
- 1 December 2014
- journal article
- research article
- Published by SAGE Publications in Wilderness & Environmental Medicine
- Vol. 25 (4), S30-S42
- https://doi.org/10.1016/j.wem.2014.08.009
Abstract
Exercise-associated hyponatremia (EAH) is defined by a serum or plasma sodium concentration below the normal reference range of 135 mmol/L that occurs during or up to 24 hours after prolonged physical activity. It is reported to occur in individual physical activities or during organized endurance events conducted in austere environments in which medical care is limited and often not available, and patient evacuation to definitive care is often greatly delayed. Rapid recognition and appropriate treatment are essential in the severe form to ensure a positive outcome. Failure in this regard is a recognized cause of event-related fatality. In an effort to produce best practice guidelines for EAH in the austere environment, the Wilderness Medical Society convened an expert panel. The panel was charged with the development of evidence-based guidelines for management of EAH. Recommendations are made regarding the situations when sodium concentration can be assessed in the field and when these values are not known. These recommendations are graded on the basis of the quality of supporting evidence and balance between the benefits and risks/burdens for each parameter according to the methodology stipulated by the American College of Chest Physicians. This is an updated version of the original WMS Practice Guidelines for Treatment of Exercise-Associated Hyponatremia published in Wilderness & Environmental Medicine 2013;24 (3): 228-240.Keywords
This publication has 87 references indexed in Scilit:
- Hyponatremia is Associated With Higher NT-proBNP Than Normonatremia After Prolonged ExerciseClinical Journal of Sport Medicine, 2012
- Marathon Runner with Acute Hyponatremia: A Neurological DisorderCase Reports in Emergency Medicine, 2012
- Changes in Copeptin and Bioactive Vasopressin in Runners With and Without HyponatremiaClinical Journal of Sport Medicine, 2011
- An Intervention Study of Oral Versus Intravenous Hypertonic Saline Administration in Ultramarathon Runners With Exercise-Associated Hyponatremia: A Preliminary Randomized TrialClinical Journal of Sport Medicine, 2011
- Supplementary oxygen for nonhypoxemic patients: O2 much of a good thing?Critical Care, 2011
- Beliefs about hydration and physiology drive drinking behaviours in runnersBritish Journal of Sports Medicine, 2010
- Changes in plasma arginine vasopressin concentrations in cyclists participating in a 109-km cycle raceBritish Journal of Sports Medicine, 2008
- Osmotic and Nonosmotic Regulation of Arginine Vasopressin during Prolonged Endurance ExerciseJournal of Clinical Endocrinology & Metabolism, 2008
- Ad libitum fluid intakes and thermoregulatory responses of female distance runners in three environmentsJournal of Sports Sciences, 2001
- Cardiovascular Adaptations to Prolonged Physical EffortCirculation, 1954