Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine
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Exercise-associated hyponatremia (EAH) is a potentially fatal fluid imbalance largely resulting from sustained fluid intake beyond the capacity for fluid excretion during endurance exercise. Common symptoms include vomiting, confusion, altered mental status, and seizures; however, these symptoms can also be seen with hypernatremic encephalopathy, making measurement of plasma sodium concentration imperative when athletes present with these symptoms. Recent evidence supports the inappropriate secretion of the antidiuretic hormone, arginine vasopressin (AVP), as the primary pathophysiological mechanism underlying the development of dilutional EAH. ⋯ The prompt administration of an intravenous (IV) bolus of hypertonic saline in the field or hospital setting can be lifesaving once EAH is documented. Conversely, oral sodium supplementation will not prevent the development of EAH encephalopathy if exuberant fluid intake combined with non-osmotic secretion of AVP occurs during prolonged physical activity. As a result, the seemingly paradoxical use of sodium supplementation as the most effective practical management therapy (IV bolus) and ineffective preventive strategy can be reconciled through a more complete understanding of the pathophysiological mechanisms underlying EAH.
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Comparative Study
Effects of modern ski equipment on the overall injury rate and the pattern of injury location in Alpine skiing.
To identify whether the introduction of carving skis and related equipment has altered the overall injury rate and/or the pattern of injury location. ⋯ The maintenance of adequate binding adjustment is especially important for the prevention of knee injuries in female carving skiers.