Noncardiogenic Pulmonary Edema in Marathon Runners
Authors: J. Carlos Ayus
Journal: Annals of Internal Medicine (2000)

Letters19 December 2000Noncardiogenic Pulmonary Edema in Marathon RunnersJ. Carlos Ayus, MD and Allen I. Arieff, MDJ. Carlos Ayus, MDBaylor College of Medicine; Houston, TX 77024 (Ayus)University of California, San Francisco; San Francisco, CA 94965 (Arieff) and Allen I. Arieff, MDBaylor College of Medicine; Houston, TX 77024 (Ayus)University of California, San Francisco; San Francisco, CA 94965 (Arieff)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-133-12-200012190-00025 SectionsAboutFull Text ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We believe that Dr. Siegel's concern about osmotic demyelination is unfounded. There is no actual evidence that "osmotic demyelination" has ever been caused by any rate of correction of hyponatremia (1). A recent prospective study showed no relationship (2). More important, in patients with hyponatremic encephalopathy, therapy with small increases in plasma sodium, as suggested by Dr. Siegel, leads to 100% mortality (2). With symptomatic hyponatremia, increased intracranial pressure secondary to cerebral edema is the critical factor, and its management determines patient outcome. Thus, such patients must be treated with hypertonic sodium chloride, which increases plasma sodium levels ...References1. Sarnaik AP, Meert K, Hackbarth R, Fleischmann L. Management of hyponatremic seizures in children with hypertonic saline: a safe and effective strategy. Crit Care Med. 1991;19:758-62. CrossrefMedlineGoogle Scholar2. Ayus JC, Arieff AI. Chronic hyponatremic encephalopathy in postmenopausal women: association of therapies with morbidity and mortality. JAMA. 1999;281:2299-304. CrossrefMedlineGoogle Scholar3. Speedy DB, Noakes TD, Rogers IR, Thompson JM, Campbell RG, Kuttner JA, et al . Hyponatremia in ultradistance triathletes. Med Sci Sports Exerc. 1999;31:809-15. CrossrefMedlineGoogle Scholar4. Garigan TP, Ristedt DE. Death from hyponatremia as a result of acute water intoxication in an Army basic trainee. Mil Med. 1999;164:234-8. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Baylor College of Medicine; Houston, TX 77024 (Ayus)University of California, San Francisco; San Francisco, CA 94965 (Arieff) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByDiabetes Insipidus and Syndrome of Inappropriate Antidiuretic HormoneHyponatremia in the intensive care unit: How to avoid a Zugzwang situation?Etiology and management of exercise-associated hyponatremic encephalopathy (EAHE)Disorders of Water MetabolismHyponatremia is Associated With Higher NT-proBNP Than Normonatremia After Prolonged ExerciseElectrolyte disturbances associated with commonly prescribed medications in the intensive care unitDiabetes Insipidus and SIADHPreventing neurological complications from dysnatremias in childrenThe pathophysiology and treatment of hyponatraemic encephalopathy: an update 19 December 2000Volume 133, Issue 12Page: 1011KeywordsBlood plasmaBrainBrain diseasesEdemaHyponatremiaNeuroimagingProspective studiesRespiratory failureSodiumSodium chloride ePublished: 19 December 2000 Issue Published: 19 December 2000 CopyrightCopyright © 2000 by American College of Physicians. All Rights Reserved.Loading ...