Water overdose
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Understanding Water Overdose: Causes, Symptoms, and Cases
Introduction to Water Overdose
Water overdose, also known as water intoxication or hyperhydration, occurs when an individual consumes an excessive amount of water in a short period. This can lead to a dangerous imbalance of electrolytes in the body, particularly sodium, resulting in a condition called hyponatremia. The following sections explore various causes, symptoms, and documented cases of water overdose.
Causes of Water Overdose
Accidental Medical Errors
One significant cause of water overdose is accidental medical errors. For instance, a case involving a 32-year-old morbidly obese pregnant woman undergoing a cesarean section under general anesthesia highlights this risk. The patient developed severe hypotension and water intoxication after an accidental large bolus injection of oxytocin. This incident underscores the importance of careful drug administration and monitoring during medical procedures to prevent such adverse outcomes1.
Iatrogenic Water Intoxication
Iatrogenic water intoxication refers to water overdose caused by medical treatment. A rare autopsy case of a 21-year-old healthy female worker illustrates this. She died after ingesting powder from 17 matches in a suicide attempt, leading to a misdiagnosis and subsequent gastric lavage with 7.8 liters of water within two hours. This case emphasizes the need for accurate diagnosis and cautious fluid administration in medical emergencies2.
Psychogenic Polydipsia
Psychogenic polydipsia, a condition often associated with psychiatric disorders, can also lead to water intoxication. A documented case involves a 41-year-old schizophrenic woman who compulsively drank water, resulting in a coma, convulsions, and congestive heart failure. This case is noted as one of the most severe instances of water intoxication reported, highlighting the critical need for monitoring and managing water intake in patients with psychiatric conditions3.
Symptoms of Water Overdose
Neurological Symptoms
Water overdose can lead to severe neurological symptoms due to the rapid decrease in sodium levels. These symptoms include confusion, seizures, and in extreme cases, coma. The schizophrenic woman mentioned earlier presented with convulsions and coma, demonstrating the severe impact of water intoxication on the brain3.
Cardiovascular Symptoms
Cardiovascular symptoms such as severe hypotension can also occur. The pregnant woman who received an excessive dose of oxytocin experienced abrupt hemodynamic changes, initially suspected to be an amniotic fluid embolism, but later identified as water intoxication1.
Systemic Symptoms
Systemic symptoms can include congestive heart failure, as seen in the schizophrenic patient, and other signs of fluid overload. These symptoms necessitate immediate medical intervention to prevent fatal outcomes3.
Conclusion
Water overdose is a serious and potentially fatal condition that can arise from various causes, including medical errors, iatrogenic factors, and psychiatric conditions. Recognizing the symptoms and understanding the underlying causes are crucial for preventing and managing this condition effectively. Medical professionals must exercise caution in fluid administration and closely monitor patients at risk to avoid the severe consequences of water intoxication.
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Most relevant research papers on this topic
Severe hypotension and water intoxication developed after an accidental oxytocin overdose in a morbidly obese patient undergoing cesarean section -A case report-
An accidental oxytocin overdose during cesarean section can cause severe hypotension and water intoxication in obese patients, highlighting the need for careful monitoring and confirmation of proper drug use.
Case Report
Very Rigorous JournalAutopsy case report of a rare acute iatrogenic water intoxication with a review of the literature.
Acute iatrogenic water intoxication is a rare but potentially fatal condition in which a healthy individual dies after swallowing match powder in an apparent suicide attempt.
Case ReportPsychogenic water intoxication: a case report.
A 41-year-old schizophrenic woman with compulsive water drinking presented in a coma, convulsions, and congestive heart failure, making her the most severe case of psychogenic water intoxication reported.
Case ReportFatal water intoxication during olanzapine treatment: a case report.
Olanzapine treatment may aggravate water intoxication, potentially leading to fatal hyponatremia in a case report.
Case ReportSelf-induced water intoxication without predisposing illness.
Self-induced water intoxication can occur in healthy individuals, causing symptoms of increased neuroexcitability, delirium, convulsions, and coma due to sudden lowering of the ratio of solutes to water in the body fluids.
Case ReportWater intoxication: one nursing staff's response and intervention.
A nursing staff intervention program can significantly modify patient behavior and assist them in self-limiting fluid and self-care, reducing the risk of water intoxication and death.
Acute Water-intoxication from Compulsive Water-drinking
Compulsive water-drinking can lead to acute water-intoxication, potentially harming thirsty patients, despite earlier claims that water "cannot harm thirsty patients."
Case ReportLife threatening water intoxication
Excessive water intake can lead to life-threatening conditions, including hyponatremia and cerebral oedema, and should be treated with caution.
Water intoxication with seizures.
Water intoxication in infants can cause seizures, lethargy, vomiting, and hyponatremia, but can be managed with fluid restriction and salt replacement.
Case Report