Oral versus intravenous hypertonic saline for exercise-associated hyponatraemia

Exercise-associated hyponatraemia is a potentially serious acute condition that may present early as asymptomatic or mildly symptomatic. Standard treatment is intravenous hypertonic saline, which can be challenging and carries some risk. An alternative may be oral therapy. We undertook a review of existing literature to assess whether paediatric populations should receive oral or intravenous hypertonic saline solutions. One study addressed our question but was aimed at a presumably adult population of runners. That study found that intravenous and oral solutions provide similar effects on biochemistry, but intravenous hypertonic saline provides superior effects on subjective relief and plasma volume.