Prospective Observational Study of Weight-based Assessment of Sodium Supplements on Ultramarathon Performance (WASSUP)

Abstract Background Sodium supplements are ubiquitous in endurance running, but their impact on performance has been subjected to much debate. The objective of the study was to assess the effect of sodium supplementation as a weight-based predictor of race performance in ultramarathon runners. Methods Prospective observational study during an 80 km (50 mi) stage of a 6-stage 250 km (155 mi) ultramarathon in Chile, Patagonia, Namibia, and Mongolia. Finish line hydration status as measured by weight change, point-of-care serum sodium, and questionnaire provided sodium ingestion categories at 33rd percentile and 66th percentile both for weight-adjusted rate and total sodium consumption, then analyzed for significant relationships to race performance, dysnatremia, and hydration. Results Two hundred sixty-six participants were enrolled, with 217 (82%) with complete sodium supplement rate data, 174 (80%) with finish line sodium, and 161 (74%) with both pre-race weights and total sodium ingestion allowing weight-based analysis. Sodium intake ranged from 131–533 mg/h/kg (2–7.2 gm), with no statistically significant impact on pace, race time, or quintile rank. These outcomes did not change when sodium intake was analyzed as a continuous variable or by sub-group analysis of the 109 (68%) normonatremic runners. When controlled for weight-adjusted sodium intake, performance was poorly correlated with hydration (r = − 0.152, 95% CI − 0.348–0.057). Dehydrated runners outperformed those overhydrated, with 11% of top 25th percentile finishers dehydrated (versus 2.8% overhydrated), with 3.6 min/km faster pace and time 4.6 h faster finishing time. Conclusions No association was found between sodium supplement intake and ultramarathon performance. Dehydrated runners were found to have the best performance. This reinforces the message to avoid overhydration.

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The taste of salt in the athlete’s soup: a short update with practical recommendations

Swiss Sports & Exercise Medicine ◽

10.34045/ssem/2017/2 ◽

2017 ◽

Vol 65 (1) ◽

Keyword(s):

Exercise Performance ◽

Sodium Intake ◽

Taste Preference ◽

Sodium Concentration ◽

Fluid Replacement ◽

Hydration Status ◽

Plasma Volume Expansion ◽

Increased Risk ◽

Sodium Ingestion ◽

The Right

The general recommendation for daily sodium consumption is about 6 g/d, as a higher intake was associated with an increased risk for cardiovascular mortality in individuals already suffering from hypertension. However, this recommendation is not necessarily valid for athletes as they often experience high sweat and sodium losses during exercise. While it is well-known that a balanced hydration status and fluid replacement are important factors to maintain an adequate exercise performance, the importance of salt losses during exercise seems to be often underestimated. This short update will focus on the role and impact of salt or sodium ingestion before, during and after exercise and its implication on performance. Pre-exercise ingestion of highly concentrated sodium solutions (164 mmol/l) induces a plasma volume expansion leading to a performance enhancing effect. Sodium intake during exercise of more than 60 min helps to prevent from or compensate dehydration. Sports drinks ingested during exercise commonly contain a sodium concentration of 30-50 mmol/l, whereas a higher concentration might be advantageous for so called salty sweaters or athletes prone to heat cramps. For a fast rehydration after exercise, drinks with a sodium concentration of around 100 mmol/l were found to be most effective. In any case, taste preference and gastrointestinal discomfort have to be considered individually and the amount of salt or sodium to be ingested in the different exercise settings depends highly on the desired goal. Finally, the timing of salt or sodium intake as well as the right dosage are of high importance to successfully influence exercise performance.

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Caudal block analgesia for paediatric infra-umbilical surgery: A prospective observational study

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v8i3.29713 ◽

2020 ◽

Vol 8 (3) ◽

pp. 122-130

Author(s):

Binod Gautam ◽

Manan Karki

Keyword(s):

Observational Study ◽

Large Scale ◽

Prospective Observational Study ◽

Anaesthetic Agent ◽

Group Analysis ◽

Control Group ◽

Single Shot ◽

Caudal Block ◽

Perioperative Analgesia ◽

Analgesic Regimen

Background: Caudal block is the most common regional anaesthesia technique used in children. It offers excellent perioperative analgesia in infra-umbilical surgeries. However, large-scale studies on caudal block in our paediatric population are not available.Objectives: We aimed to evaluate practice pattern, efficacy and safety of caudal block in paediatric infra-umbilical surgery.Methodology: Children (age less than 14 years) undergoing elective infra-umbilical surgery under general anaesthesia were included in this prospective observational study conducted over two years. Demographic characteristics, type of surgery, anaesthetic techniques and agents used, and details of caudal block were recorded. Perioperative events, complications and duration of analgesia were studied. Eligible children not receiving caudal block served as the control group. Analysis was performed using IBM Statistical Package for the Social Sciences version 20.Results: Caudal block was employed in 72 out of 183 children who completed the study. It was mostly preferred for children weighing less than 20 kilograms. Ketamine pre-medication was used in 123 children. Majority received Propofol induction and laryngeal mask. Halothane was preferred over Isoflurane for anaesthesia maintenance. Bupivacaine was the exclusively used local anaesthetic agent. Vascular puncture occurred in three children but no serious complication was observed. Need for supplement intraoperative analgesics was significantly lower, and duration of analgesia was significantly longer in caudal group. Intraoperative hypotension, laryngospasm during emergence and postoperative vomiting were the most frequent perioperative events.Conclusion: Pre-incisional single-shot caudal block is safe, effective and well accepted component of multi-modal perioperative analgesic regimen for younger children undergoing infra-umbilical surgery.

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