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J Sci Med Sport. 2014 Sep;17(5):457-62. doi: 10.1016/j.jsams.2013.09.001. Epub 2013 Sep 18.

Efficacy of oral versus intravenous hypertonic saline in runners with hyponatremia.

Author information

1
Sir Charles Gairdner Hospital, Australia.
2
St John of God Murdoch Hospital and University of Notre Dame, Australia.
3
VA Northern California Health Care System, United States; University of California Davis Medical Center, United States.
4
Gettysburg College, United States.
5
Via Christi family MEDICAL residency, United States.
6
VA Northern California Health Care System, United States.
7
Georgetown University Medical Center, United States.
8
Oakland University, United States. Electronic address: hew@oakland.edu.

Abstract

OBJECTIVES:

To determine more conclusively whether intravenous (IV) administration of 3% saline is more efficacious than oral administration in reversing below normal blood sodium concentrations in runners with biochemical hyponatremia.

DESIGN:

Randomized controlled trial.

METHODS:

26 hyponatremic race finishers participating in the 161-km Western States Endurance Run were randomized to receive either an oral (n=11) or IV (n=15) 100mL bolus of 3% saline. Blood sodium concentration (Na(+)), plasma protein (to assess %plasma volume change), arginine vasopressin (AVP), blood urea nitrogen (BUN) and urine (Na(+)) were measured before and 60 min following the 3% saline intervention.

RESULTS:

No significant differences were noted with respect to pre- to post-intervention blood [Na(+)] change between intervention groups, although blood [Na(+)] increased over time in both intervention groups (+2 mmol/L; p<0.0001). Subjects receiving the IV bolus had a greater mean (± SD) plasma volume increase (+8.6 ± 4.5% versus 1.4% ± 5.7%; p<0.01) without significant change in [AVP] (-0.2 ± 2.6 versus 0.0 ± 0.5 pg/mL; p=0.49). 69% of subjects completing the intervention trial were able to produce urine at race finish with a mean (± SD) pre-intervention urine [Na(+)] of 15.2 ± 8.5 mmol/L (range 0-35; NS between groups). [BUN] of the entire cohort pre-intervention was 30.7 ± 10.5mg/dL (range 13-50).

CONCLUSIONS:

No group difference was noted in the primary outcome measure of change in blood [Na(+)] over 60 min of observation following a 100mL bolus of either oral or IV 3% saline. Administration of an oral hypertonic saline solution can be efficacious in reversing low blood sodium levels in runners with mild EAH.

KEYWORDS:

EAH; Fluid balance; Ultra-endurance running

PMID:
24148616
DOI:
10.1016/j.jsams.2013.09.001
[Indexed for MEDLINE]

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