often see news reports in the media about drinking a lot of water and getting poisoned.
Some people even say that drinking 3 or 4 liters of water every 24 hours can cause water poisoning.
In fact, these so-called " water poisoning " events are not very authentic and scientific.
In rigorous medical literature, people with physical and mental health are almost unable to find any person with physical and mental health. In the absence of sodium loss (usually, vigorous exercise in high temperature environments for several hours without supplementing with beverages containing sodium ion ), drinking water and drinking water poisoning reports.
Theoretically, people with healthy body and mind can ensure that they will not drink water uncontrollably;
The normal function of the kidneys can ensure that the extra water they drink is filtered out in time and excreted from the body through urine, thus ensuring that it is impossible to drink water independently and poison yourself to drink water, or even death.
To date, only one such extreme case has been reported in the medical literature.
Now, through the review of this case, we realize how difficult it is to get poisoned by drinking water independently.
A 20-year-old female black recruit in the United States drank a lot of water and was poisoned by poisoning
2002's magazine Military Medicine reported a rare case. A black US Army recruit cadet who was only 20 years old and only 14 weeks into the army. In order to provide a urine sample for drug urine tests, he drank a lot of water under the supervision of the instructor and was poisoned by poisoning. The treatment was ineffective.
According to records, there is no consensus on how much water the student drank before the incident.
According to witnesses, she drank 10 to 12 liters of water under the surveillance of the instructor between about 7:45 and 9:15 am.
, and her comrades said they drank up to 6 liters of water in 2 to 5 hours. Note that these students are talking about their own amount of water they drink, and how much water the female students who did not prove that they died had drunk.
According to the female student's self-report before the loss of consciousness, she drank a total of 12 liters of water from the night before before the incident and discharged urination twice.
Overall, the statements of witnesses and the female student themselves can confirm each other that she did drink more than 10 liters of water in a short period of time before the incident.
According to records, this female student was in good health. She felt uncomfortable three days before the incident. She had flu-like symptoms of infection with on the upper respiratory tract of and vomited for 3 days.
In order to provide urine samples for urine tests, she was asked to drink plenty of water with other students until she was able to urinate.
She and other students who did not provide urine samples were also asked to perform frequent and vigorous exercises, including push-ups, side jumps, kicks and running in place, to promote the generation of urine samples.
During this process, the student suddenly began to complain about dizziness and headaches. A few minutes later, she had incontinence and had urinary and defecation. Her upper limbs also showed autonomous exercise . No vomiting.
She was quickly taken to the local hospital.
At 10:15 am, on the way to the hospital, she was still awake and could speak, but she was even a little dazed. It was during this period that she told the person who took her to the hospital that she had drunk 12 liters of water and urinated twice since the night before.
In the hospital, heart monitoring showed normal sinus rhythm , heartbeat 66 times per minute. When
was admitted to the hospital, the hospital did not conduct a blood biochemical examination on him because she did not know her blood sodium level at that time; The urine specific gravity of at that time was still in the normal range, at 1.025.
At 10:30 a.m. shortly after arriving at the hospital, the patient lost consciousness.
She was intubated and an intravenous tube was placed.
At that time, her body temperature was 37℃, her pulse was 120 times per minute, and her blood pressure was 120/80 mm Hg.
There are burst sounds and wet rales in the lungs, and there is foamy liquid flowing out of the tracheal catheter - this all suggests pulmonary edema . No heart murmur was heard , and no obvious abnormalities were found in the abdominal and limb examination.
neurological examination, deep tendon reflexes are intact, Babinsky signs are descending, and the pupil responds to light.
Shortly thereafter, her blood pressure dropped to 70/40mm Hg, and after receiving intravenous dopamine drip boosting treatment, her blood pressure rose to 110/70mm Hg.
At this time, the serum biochemical test results showed obvious dilution hyponatremia, with serum sodium of being 123 mmol/liter (normally 135~145) ; other indicators also showed signs of blood dilution, potassium 2.7 mmol/liter, chloride 87 mmol/liter, bicarbonate 18 mmol/liter, glucose being 181 mg/delitre, blood urea nitrogen is 12 mg/delitre, creatinine being 0.7 mg/delitre, and hematocrit is 32%.
ECG shows sinus tachycardia , and head CT (about 3 hours after the onset of neurological symptoms) shows edema in the brain, cerebellum and posterior fossa.
Then, the patient was transferred to an tertiary hospital and arrived at 3 pm, 5 hours after the incident.
During the treatment process of this tertiary hospital, some important matters and examination indicators were that after admission, had been urinating a large amount of urination (all recorded through the indwelling catheter ) , and the specific gravity of urine dropped to 1.010 ; the serum sodium of in the hospital was 126 mmol/liter , glucose was 166 mg/dL, and hematocrit was 31%.
to 6:30 pm, the consultation expert recorded the neurological signs of brain death and .
At 7:00 pm, the patient was injected with the powerful diuretic furosemide 40 mg intravenously.
to 9:15 pm, her serum sodium increased to a normal 140 mmol/L, which has been 5 hours since the last measured 126 mmol/L. During this html 5 hours during
, the patient excreted a total of about 7 liters of urine , and only ingested about 0.7 liters of normal saline through intravenous veins. Her weight dropped from 67.9 kg at the time of admission to the tertiary hospital to 61.7 kg the next morning, reducing 6.2 kg of .
At 4:25 am, serum sodium further recovered at 144 mmol/liter, glucose was 234 mg/decl, and hematocrit reached 36%.
Her condition has not changed during the remaining hospitalization period and was pronounced dead 2 days after the incident.
5 days after the incident, that is, 3 days after death, an autopsy was performed. The lungs showed diffuse bilateral edema and congestion in the alveolar alveolar , and no kidney was found (had been removed after death for transplantation). The fixed brain weighs 1.350 grams, within the normal range. General observation of the brain showed mild cerebral edema . There are no obvious signs of external compression around brain stem , indicating that brain hernia has not occurred.
The body retains more than 7 liters of water, which is consistent with the water poisoning caused by drinking a lot of water
The student had a history of excessive water drinking before the incident;
The local hospital did not conduct a blood biochemical examination as soon as possible, and failed to record her serum sodium level at that time.
The serum sodium recorded in both hospitals was significantly lower than normal, namely 123 mmol/liter and 126 mmol/liter, respectively.
The additional urine discharged exceeded 6.3 liters within 5 hours of increasing serum sodium from 126 mmol/liter to 140 mmol/liter; by the next day, the weight was reduced by 6.2 kg. This means that an additional 6.3 liters to 12 liters of water were discharged from the body during the period.
According to my , a new coronavirus infected person in Sichuan has a fever and drinks a lot of water and gets poisoned? Really? The calculation method provided in the article shows that for a person weighing 60 kg, every 1 mmol/liter of serum sodium increases and decreases, corresponding to a decrease in water of 0.4 liters.
The student increased serum sodium from 126 mmol/liter to 140 mmol/liter within 5 hours, corresponding to at least 5.6 liters of water being discharged from the body.
and the water she actually discharged was at least 6.3 liters (no consideration of water loss in other ways other than urine, such as breathing - the chance of breathing loses more water), which can also be explained by the loss of weight greatly exceeds that of the urine pathway.
In short, the student's condition is fully consistent with the diagnosis of water poisoning and death from cerebral edema.
, and this is the result of her drinking 10 to 12 liters of water within 2 or 3 hours - this is something that ordinary people cannot do in any case.
Therefore, this case further proves what I said that people with good physical and mental health cannot get poisoned by drinking water by drinking it independently.
's own abnormality may be the root cause of her death from water poisoning
Even if the student drank 10 to 12 liters of water in a short time under the strong supervision of the instructor (more likely forced), according to the principle of physiology , this water cannot completely enter the blood, but is mostly trapped in the stomach.
In fact, her two urine specific gravity tests also illustrate this point. The urine specific gravity measured when
was sent to the local hospital was 1.025, which was within the normal range, which means that she did not urinate heavily due to the decrease in blood osmotic pressure, causing obvious dilution of the urine. When the urine was significantly diluted and the specific gravity of the urine decreased to 1.010, it had been 5 hours since the attack of water poisoning.
Physiologically, this is absolutely impossible for normal people.
I rumored in that domestic beer contains diuretics? This is true, and there is more than one type of article. The reason why I often go to the toilet when I drink beer is that in addition to alcohol , which is a strong diuretic, the larger amount of water in beer itself is also a strong diuretic . Drinking a lot of water without electrolytes will quickly reduce blood osmotic pressure and inhibit the release of antidiuretic hormone , thereby producing a powerful diuretic effect, which is medically called "water diuretic" .
. The student seemed to have a bad reaction to "water diuretics". She claimed that she drank 12 liters of water the night before and only urinated twice. Even if 500 ml is used for each time (normal people are around 350 ml), only 1000 ml is discharged.
Moreover, it is obvious that these two urination did not occur during the next day when drinking water. The purpose of drinking water was to take urine samples. If you urinate during the period, nothing happened later.
In other words, from the time she started drinking a lot of water to the time she was intoxicated, she drank at least 10 liters of water, but she did not urinate once, and all of this water was trapped in her body.
did not decrease when he was admitted to the hospital, which also shows that "water diuresis" has no effect on her at all.
Therefore, we can speculate that if is replaced by another person, even if she drinks so much water she drinks, it will not be possible to have fatal water poisoning.
In addition, the instructor's ignorance also played a role in helping the evil.
On the one hand, how can a 20-year-old woman drink 10 to 12 liters of water within 2 or 3 hours?
In the other direction, he ordered the students to exercise vigorously while drinking water. This not only did not promote urination, but the effect was exactly the opposite and would inhibit urine production.
Because strenuous exercise will allow blood circulation to redistribute, and a large amount of blood flows through the muscles, greatly reducing the amount of renal perfusion, thereby inhibiting the filtration and production of urine.
Also, neither hospital did not provide diuretic and dehydration treatment in time (maybe because she had hypotensive shock. The tertiary hospital did not start diuretic treatment until her blood pressure rose normally), and may also be responsible for the death of the student.
In short, through this case, we can further understand that it is impossible for people with physical and mental health to get poisoned by drinking water independently, or even to death by drinking it; it is probably comparable to the difficulty of trying to suffocate themselves to death by holding their breath.
The legendary "hidden story" behind drinking water is often caused by poisoning.
