Water poisoning, or hypotonic overhydration, is a disturbance of water balance - excess water in the body is accompanied by a simultaneous reduction in the level of sodium in the blood. Water poisoning is rare and most often affects athletes who drink large amounts of electrolyte-free fluids after competitions or people with mental he alth problems. Find out what are the causes and symptoms of water poisoning and how to treat hypotonic fluid overload.
Water poisoning , in other wordshypotonic hyperhydration , is a symptom complex caused by excessive storage of water in the body. This type ofwater disturbanceis associated with hyponatremia (low sodium levels in the blood serum).
Water poisoning: causes
Water poisoning results from the excessive supply of electrolyte-free fluids to the body without the possibility of their excretion. This type of situation happens:
1) in patients with impaired renal water excretion;
2) in cases of excessive production of vasopressin (an antidiuretic hormone, ADH), which causes urine concentrating by resorbing water and sodium ions in the renal tubules. It often happens in patients who struggle with:
- inadequate ADH secretion syndrome - SIADH
- porphyria
- inflammation of the brain and lungs (e.g. tuberculosis)
And also in patients who take certain medications - e.g. sulfonylureas, carbamazepine (amizepine), amitriptyline, thioridazine, diuretics, cyclophosphamide, vincristine.
3) in people suffering from paraneoplastic syndrome, e.g. bronchial oatmeal carcinoma, duodenal and pancreatic cancer or thymoma (doctors found a substance similar to ADH in the blood of patients suffering from this type of cancer).
Water poisoning can also occur in the case of:
- hypoproteinemia (low level and altered quantitative composition of blood plasma proteins)
- hypothyroidism
- adrenal insufficiency
Water poisoning: symptoms
In water poisoning, the basic symptom is mineral disorders that resemble sodium ion deficiency, which can lead to:
- symptoms of brain edema - weakness, nausea, vomiting, anorexia, conditionsconfusion, pupil unevenness, muscle spasms, seizures, coma. If not treated properly, coma, CNS damage, acidosis, and death can occur.
- increase in blood pressure and decrease in heart rate
- oliguria and anuria
In the state of water poisoning, the body weight increases, and due to the thinning of the blood, the concentration of hemoglobin and plasma proteins is usually decreased (the total number of erythrocytes decreases). Plasma sodium and chloride levels are usually low, and potassium is normal. In addition, urine is relatively high in sodium and chloride, which allows to distinguish the state of water poisoning from the primary sodium deficiency in the body
Water poisoning: treatment
The goal of treatment, which takes place only in a hospital setting, is to restore the sodium balance.
1. Limiting the supply of free water and supplementing sodium deficiencies.
2. In cases of cerebral edema, the doctor may administer 100 ml of 20% mannitol intravenously.
3. In severe cases, peritoneal dialysis or hemodialysis is used
4. In case of edema of cardiac or hepatic origin, the doctor may use glucocorticosteroids (e.g. Encorton 30-40 mg).