Three cases of severe hyponatremia during a river run in Grand Canyon National Park.

Abstract:

:We present 3 cases of severe hyponatremia occurring on a commercially guided river rafting trip on the Colorado River in Grand Canyon National Park. All 3 women appeared to have been overhydrating because of concern about dehydration and required evacuation within 24 hours of each other after the staggered onset of symptoms, which included fatigue and emesis progressing to disorientation or seizure. Each was initially transferred to the nearest hospital and ultimately required intensive care. Imaging and laboratory data indicated all 3 patients had hypervolemic hyponatremia. Unlike the well-documented exercise-associated hyponatremia cases commonly occurring in prolonged endurance athletic events, these 3 unique cases of acute hyponatremia were not associated with significant exercise. The cases illustrate the diagnostic and treatment challenges related to acute hyponatremia in an austere setting, and underscore the importance of preventive measures focused on avoidance of overhydration out of concern for dehydration.

journal_name

Wilderness Environ Med

authors

Pearce EA,Myers TM,Hoffman MD

doi

10.1016/j.wem.2014.08.007

subject

Has Abstract

pub_date

2015-06-01 00:00:00

pages

189-95

issue

2

eissn

1080-6032

issn

1545-1534

pii

S1080-6032(14)00267-1

journal_volume

26

pub_type

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