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Titre du document / Document title

Hyponatremia associated with overhydration in U.S. army trainees

Auteur(s) / Author(s)

O'BRIEN Karen K. (1) ; MONTAIN Scott J. (1) ; CORR William P. (1) ; SAWKA Michael N. (1) ; KNAPIK Joseph J. (1) ; CRAIG Stephen C. (1) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Department of Family Practice and Community Medicine, Martin Army Community Hospital, Fort Benning, GA 31905, ETATS-UNIS

Résumé / Abstract

This report describes a series of hyponatremia hospitalizations associated with heat-related injuries and apparent overhydration. Data from the U.S. Army Inpatient Data System were used to identify all hospitalizations for hyposmolality/ hyponatremia from 1996 and 1997. Admissions were considered as probable cases of overhydration hyponatremia if this was the only, or primary, diagnosis or if it was associated with any heat-related diagnosis. Seventeen medical records were identified, and the events leading to hospitalization were analyzed. The average serum sodium level was 122 ± 5 mmol/L (range, 115-130 mmol/L). All 17 patients were soldiers attending training schools. Seventy-seven percent of hyponatremia cases occurred in the first 4 weeks of training. Nine patients had water intake rates equal to or exceeding 2 quarts per hour. Most patients were in good health before developing hyponatremia. The most common symptoms were mental status changes (88%), emesis (65%), nausea (53%), and seizures (31%). In 5 of 6 cases in which extensive history was known, soldiers drank excess amounts of water before developing symptoms and as part of field treatment. The authors conclude that hyponatremia resulted from too aggressive fluid replacement practices for soldiers in training status. The fluid replacement policy was revised with consideration given to both climatic heat stress and physical activity levels. Field medical policy should recognize the possibility of overhydration. Specific evacuation criteria should be established for exertional illness.

Revue / Journal Title

Military medicine    ISSN  0026-4075   CODEN MMEDA9 

Source / Source

2001, vol. 166, no5, pp. 405-410 (25 ref.)

Langue / Language

Anglais

Editeur / Publisher

Association of Military Surgeons, Bethesda, MD, ETATS-UNIS  (1955) (Revue)

Mots-clés anglais / English Keywords

Hydroelectrolytic balance disorder

;

Metabolic disorder

;

Inorganic element

;

Human

;

Risk factor

;

Heat

;

Case study

;

Accumulation

;

Hydration

;

Prevalence

;

Army

;

Hyponatremia

;

Mots-clés français / French Keywords

Trouble équilibre hydroélectrolytique

;

Trouble métabolisme

;

Elément minéral

;

Homme

;

Facteur risque

;

Chaleur

;

Etude cas

;

Accumulation

;

Hydratation

;

Prévalence

;

Armée

;

Hyponatrémie

;

Mots-clés espagnols / Spanish Keywords

Trastorno equilibrio hidroelectrolítico

;

Trastorno metabolismo

;

Elemento inorgánico

;

Hombre

;

Factor riesgo

;

Calor

;

Estudio caso

;

Acumulación

;

Hidratación

;

Prevalencia

;

Ejército

;

Hiponatremia

;

Localisation / Location

INIST-CNRS, Cote INIST : 2017, 35400009895039.0090

Nº notice refdoc (ud4) : 14135894



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