Intravenous Fluid Use in Athletes - 0 views
www.ncbi.nlm.nih.gov/...PMC3435915
IV intravenous fluid nutrition athletes athlete sports medicine sports exercise
shared by Nathan Goodyear on 13 Jan 15
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Treatment of exercise-associated hyponatremia with hypertonic IV infusion to correct plasma sodium levels is also a standard and accepted use of IV fluid infusions
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athletes who present for medical care with hypernatremia who cannot tolerate oral fluids can benefit from IV fluids
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Vaporization of sweat accounts for 80% of heat loss in hot, dry atmospheric conditions. This mechanism of water loss is the major contributor for exercise-associated dehydration
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The rate of water loss can be quantified through measurement of sweat rate
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Pre- and postexercise body weight measurements are the most common means to estimate overall water loss but are condition specific
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It appears that 1% to 2% body weight loss is well tolerated by the exercising athlete
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Dehydration, defined as greater than 2% loss of body weight, can negatively affect performance
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In highly trained endurance athletes, plasma volume and sodium serum concentration were preserved despite a 5% body weight loss
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In Ironman triathletes, dehydration to 5% body weight loss did not correlate with occurrence of medical complications
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hydration should begin hours prior to exercise, especially if known deficits are present, and fluids should be consumed at a slow, steady rate, with 5 to 7 mL/kg taken 4 hours prior to exercise
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Sodium concentration did not produce significant changes in the rate of absorption but was primarily dependent on carbohydrate concentration
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Replacing 150% of body weight loss over 60 minutes has been tolerated without complications
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IV treatment of severe dehydration (>7% body weight loss), exertional heat illness, nausea, emesis, or diarrhea, and in those who cannot ingest oral fluids for other reasons, is clinically indicated
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A recent survey of the National Football League teams revealed that 75% (24 of 32) of the teams utilized IV infusion of fluids for prehydration in at least some otherwise healthy individuals
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In the National Football League, an average of 1.5 L of normal saline was administered approximately 2.5 hours prior to competition
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after 2 hours of exercise, the rectal temperature was 0.6° higher in the group not receiving IV infusion. Also, stroke volume and cardiac output were 11% to 16% lower in the control group versus the IV infusion group.
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Recent evidence suggests the etiology of EAMC is related to muscle fatigue and neuronal excitability
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no correlation between hydration status or electrolyte concentrations with EAMC
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there may be a subset of muscle cramping that is associated with a loss of both body fluid and sodium
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Glycerol is the primary agent for oral hyperhydration
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elevation of plasma volume by 200 to 300 mL via dextran infusion resulted in 15% increase in stroke volume, 4% increase in VO2 max, and an increase in the exercise time to fatigue
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Neither the tonicity nor mode of hydration resulted in improved speed of rehydration, greater fluid retention, or improved performance
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There are beneficial anecdotal reports of EAMC treatment in elite and professional-level athletes with IV hydration during the course of an event
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Plasma volume was better restored during rehydration with IV fluids at preexercise and 5 minutes of exercise. At 15 minutes, there was no difference between IV and oral rehydration
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More rapid restoration of plasma volume was accomplished in the IV treatment group with no advantages over oral rehydration in physiological strain, heat tolerance, ratings of perceived effort, or thermal sensations
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No difference was found in exercise time to exhaustion. IV and oral rehydration methods were equally effective. Heart rates were statistically higher in the oral rehydration group through 75 minutes of exercise, and there were higher increases in norepinephrine plasma concentrations
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No significant differences between the groups were found for time to recovery, number of days with pain, number of days with stiffness, sleep disturbance, fatigue, rectal temperature, and loss of appetite
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The current data suggest that IV rehydration is faster than oral
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There may be physiological benefits of decreased heart rate and norepinephrine in athletes rehydrated via IV route
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Postexercise blood 1 hour and 24 hours showed no differences in circulating myoglobin or creatine kinase
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The use of IV fluid may be beneficial for a subset of fluid sensitive athletes
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this should be reserved for high-level athletes with strong histories of symptoms in well-monitored settings.
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Volume expanders may also be beneficial for some athletes