May fluids be overconsumed by means other than drinking?
The recommendations as to fluid consumption during athletic endurance
events should be welcomed by competitors at all levels.(1) However I am
concerned that there may be other serious problems relating to fluid
consumption at high level competitive sport.
Whilst taking part in a low-key endurance walking event last weekend,
on a very hot day, I overheard other walkers talking about how, last year,
a participant collapsed and had to be given intravenous fluid by the
paramedics. Those who watch ultra-long distance cycling events on obscure
satellite television stations may have noticed exhausted cyclists, who
have retired from the race, being given intravenous fluids. This put me
in mind of a Sports Medicine conference I attended last year during which
we were reliably informed that intravenous hydration, at half-time, was
not unknown in top level sport.
In hospital practice, apart from dire emergency, it is unknown to
give intravenous fluid without knowing sodium and potassium levels,
because of possibly fatal effects of hypokalaemia and hyponatraemia.
Let us suppose a professional sportsman had been suffering from
diarrhoea and vomiting prior to an event and started the match with
potassium or sodium depletion. Administration of intravenous fluids at
the end of the first half would, surely, be even more likely to cause
sudden death. This is a scenario which could easily take place in
international sport.
I can find only two references in the literature to intravenous
hydration in sport which appear to relate to Australian Rules Football.
If this procedure is taking place in international sport on a regular
basis then it is surely as dangerous as, for example anabolic steroid use
which is of course banned.
It occurs to me that half-time intravenous hydration is unlikely to
happen without the team doctor's knowledge. Maybe other reader's of this
journal may be able to offer information about how widespread this
procedure is in high level sport. Perhaps it is something the medical
profession should take up with international sporting authorities.
Should a top athlete die suddenly on the field of play, it is
submitted that the contributory role of possibly inappropriate intravenous
hydration should be considered.
(1) Noakes TD. Overcomsumption of fluids by athletes.
BMJ 2003;327:113-4.
Competing interests:
None declared
Competing interests:
No competing interests
23 July 2003
Gareth Williams
Consultant Physician
Darlington Memorial Hospital, Hollyhurst Road, Darlington, DL3 6HX.
Rapid Response:
May fluids be overconsumed by means other than drinking?
The recommendations as to fluid consumption during athletic endurance
events should be welcomed by competitors at all levels.(1) However I am
concerned that there may be other serious problems relating to fluid
consumption at high level competitive sport.
Whilst taking part in a low-key endurance walking event last weekend,
on a very hot day, I overheard other walkers talking about how, last year,
a participant collapsed and had to be given intravenous fluid by the
paramedics. Those who watch ultra-long distance cycling events on obscure
satellite television stations may have noticed exhausted cyclists, who
have retired from the race, being given intravenous fluids. This put me
in mind of a Sports Medicine conference I attended last year during which
we were reliably informed that intravenous hydration, at half-time, was
not unknown in top level sport.
In hospital practice, apart from dire emergency, it is unknown to
give intravenous fluid without knowing sodium and potassium levels,
because of possibly fatal effects of hypokalaemia and hyponatraemia.
Let us suppose a professional sportsman had been suffering from
diarrhoea and vomiting prior to an event and started the match with
potassium or sodium depletion. Administration of intravenous fluids at
the end of the first half would, surely, be even more likely to cause
sudden death. This is a scenario which could easily take place in
international sport.
I can find only two references in the literature to intravenous
hydration in sport which appear to relate to Australian Rules Football.
If this procedure is taking place in international sport on a regular
basis then it is surely as dangerous as, for example anabolic steroid use
which is of course banned.
It occurs to me that half-time intravenous hydration is unlikely to
happen without the team doctor's knowledge. Maybe other reader's of this
journal may be able to offer information about how widespread this
procedure is in high level sport. Perhaps it is something the medical
profession should take up with international sporting authorities.
Should a top athlete die suddenly on the field of play, it is
submitted that the contributory role of possibly inappropriate intravenous
hydration should be considered.
(1) Noakes TD. Overcomsumption of fluids by athletes.
BMJ 2003;327:113-4.
Competing interests:
None declared
Competing interests: No competing interests