What are the Third International Exercise-Associated Hyponatremia Consensus Development Conference guidelines for exercise-associated hyponatremia?

Updated: Dec 28, 2018
  • Author: Kartik Shah, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

A Statement of the Third International Exercise-Associated Hyponatremia Consensus Development Conference provides the following guidelines for exercise-associated hyponatremia: [24, 25]

  • Any athlete with exercise-associated hyponatremia (EAH) associated with signs or symptoms of encephalopathy should be immediately treated with an IV bolus or infusion of hypertonic saline (HTS) to acutely reduce brain edema, with additional IV boluses administered until there is clinical improvement.
  • The dose and route of HTS administration should be based upon the severity of clinical symptoms and the available HTS formulations.
  • The goal of IV HTS therapy is to stabilize the athlete for transfer to an advanced medical care facility.
  • The use of IV HTS as the definitive treatment for acute hyponatremic encephalopathy is well validated, with the IV HTS bolus able to increase serum sodium levels 2-5 mmol/L, which decreases intracranial pressure and reduces symptoms.
  • If the diagnosis of EAH is not confirmed, administration of HTS in small boluses is not associated with any negative consequences and serves as an excellent volume expander.

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