Hyponatremia among runners in the Boston Marathon.

@article{Almond2005HyponatremiaAR,
  title={Hyponatremia among runners in the Boston Marathon.},
  author={Christopher S Almond and Andrew Young Shin and Elizabeth B. Fortescue and Rebekah Mannix and David Wypij and Bryce A. Binstadt and Christine N. Duncan and David P. Olson and Annalisa Salerno and Jane W. Newburger and David S. Greenes},
  journal={The New England journal of medicine},
  year={2005},
  volume={352 15},
  pages={
          1550-6
        }
}
BACKGROUND Hyponatremia has emerged as an important cause of race-related death and life-threatening illness among marathon runners. [] Key Method Subjects completed a survey describing demographic information and training history. After the race, runners provided a blood sample and completed a questionnaire detailing their fluid consumption and urine output during the race. Prerace and postrace weights were recorded.

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References

SHOWING 1-10 OF 30 REFERENCES

Hyponatremia in runners requiring on-site medical treatment at a single marathon.

TLDR
This study found a 5.6% incidence of hyponatremia in marathon runners requiring medical treatment on-site and attempted to assess the contribution of fluid type ingested and nonsteroidal antiinflammatory drug (NSAID) use to the development of Hyponatremeia.

The Incidence, Risk Factors, and Clinical Manifestations of Hyponatremia in Marathon Runners

TLDR
Vomiting was the only clinical sign differentiating hyponatremia from other conditions that induce exercise-associated collapse, and there were no significant differences in vital signs, training variables, or NSAID use between H and NH groups, although there was a trend towards the less experienced runners presenting with lower post-race sodium levels.

Hyponatremia in ultradistance triathletes.

TLDR
Although mild hyponatremia was associated with variable body weight changes, fluid overload was the cause of most (73%) cases of severe, symptomatic Hyponatremeia, a common biochemical finding in ultradistance triathletes but usually asymptomatic.

The incidence of hyponatremia during prolonged ultraendurance exercise.

TLDR
Data suggest that, although symptomatic hyponatremia occurs in less than 0.3% of competitors during prolonged exercise even when they ingest little sodium chloride, it is found in a significant proportion (9%) of collapsed runners.

Hyponatremia, Cerebral Edema, and Noncardiogenic Pulmonary Edema in Marathon Runners

TLDR
It is demonstrated that in healthy marathon runners, noncardiogenic pulmonary edema can be a clinical manifestation of hyponatremic encephalopathy.

Hyponatremia associated with overhydration in U.S. Army trainees.

TLDR
The authors conclude that hyponatremia resulted from too aggressive fluid replacement practices for soldiers in training status and field medical policy should recognize the possibility of overhydration.

Overconsumption of fluids by athletes

  • T. Noakes
  • Education
    BMJ : British Medical Journal
  • 2003
TLDR
A recent report that a female participant in the 2002 Boston marathon died from hyponatraemic encephalopathy because she ingested excessive volumes of a sports drink before and during the race exposes an emotive debate that has raged for more than a decade about how much should athletes drink during exercise.

Hyponatremia and ultramarathon running.

Two ultramarathon runners were hospitalized with hyponatremic encephalopathy after completing 80 and 100 km (50 and 62 miles), respectively, of the 1983 American Medical Joggers Association

Death from hyponatremia as a result of acute water intoxication in an Army basic trainee.

TLDR
The first known death of an Army basic trainee as a result of acute water intoxication is reported, and the misinterpretation of his symptoms as those of dehydration and heat injury led to continued efforts at oral hydration until catastrophic cerebral and pulmonary edema developed.