title: Hydration Strategy for Endurance Running in an Athlete Requiring Home Parenteral Nutrition.
abstract: OBJECTIVE
  The purpose of this report is to share our experience with optimizing home parenteral nutrition (HPN) and hydration therapy for an HPN consumer who desired to run a marathon.
  
  
  METHODS
  A 34-year-old woman with idiopathic gastroparesis necessitating HPN and intravenous (IV) hydration desired to train for a marathon. For short runs, prerun and/or postrun hydration were adequate, but a marathon (26.2 miles) would be too long to run without IV hydration. During training, we instructed our consumer to record weights (pre/post run), ambient temperature, running distance, and duration of time. These data were used to calculate her sweat rate and estimate hydration volume during the marathon.
  
  
  RESULTS
  Ambient temperature was a significant factor influencing sweat rate. The estimate temperature for the marathon was 65 °F; therefore, our consumer would have an estimated sweat rate of approximately 720 mL/h. This exceeded the amount of fluid that could be infused during the marathon; therefore, we advised our consumer to overhydrate prior to the race. Initial postrace urine output was low and concentrated but returned to baseline after postrace hydration. Our consumer did not experience any symptoms of dehydration and had only minor muscle soreness.
  
  
  CONCLUSIONS
  Our consumer was able to complete a marathon with IV hydration. We have shown that with careful preparation, calculation, and planning, our HPN consumer was able to adequately maintain her state of hydration and accomplish her goal of running a marathon.
authors.affiliation: Department of Clinical Pharmacy, The University of Tennessee Health Science Center, Memphis, Tennessee etillman@uthsc.edu.
authors.forename: Emma M
authors.initials: EM
authors.lastname: Tillman
authors.affiliation: Nutrishare, Elk Grove, California.
authors.forename: Greg
authors.initials: G
authors.lastname: Killmeier
authors.affiliation: Nutrishare, Elk Grove, California.
authors.forename: Marianne
authors.initials: M
authors.lastname: Opilla
authors.affiliation: Methodist University Teaching Practice and Department of Internal Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee.
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Clarke
authors.affiliation: Nutrishare, Elk Grove, California.
authors.forename: Reid A
authors.initials: RA
authors.lastname: Nishikawa
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D056352:Athletes; D003681:Dehydration / Q000517:prevention & control*; D005260:Female; D018589:Gastroparesis / Q000178:diet therapy*; D006801:Humans; D016331:Parenteral Nutrition, Home; D010807:Physical Endurance; D011788:Quality of Life; D012420:Running; D013696:Temperature; D014883:Water-Electrolyte Imbalance / Q000517:prevention & control
keywords: exercise; home total parenteral nutrition; nutritional support; running; total parenteral nutrition; water-electrolyte balance