how many mL?

water intoxication
In medicine, water intoxication (also known as hyperhydration or water poisoning) is a potentially fatal disturbance in brain function that results when the normal balance of electrolytes in the body is pushed outside of safe limits by a very rapid intake of water.


Physiology of water intoxication
Body fluids contain electrolytes (particularly sodium compounds, such as sodium chloride) in concentrations that must be held within very narrow limits. Water enters the body orally or intravenously, and leaves the body primarily in the urine and in sweat. If water enters the body more quickly than it can be removed, body fluids are diluted and a potentially dangerous shift in electrolyte balance occurs.

Most water intoxication is caused by hyponatremia, an overdilution of sodium in the blood plasma, which in turn causes an osmotic shift of water from extracellular fluid (outside of cells) to intracellular fluid (within cells). The cells swell as a result of changes in osmotic pressure and may cease to function. When this occurs in the cells of the central nervous system and brain, water intoxication is the result. Additionally, many other cells in the body may undergo cytolysis, wherein cell membranes that are unable to stand abnormal osmotic pressures rupture, killing the cells. Initial symptoms typically include light-headedness, sometimes accompanied by nausea, vomiting, headache and/or malaise. Plasma sodium levels below 100 mmol/L (2.3g/L) frequently result in cerebral edema, seizures, coma, and death within a few hours of drinking the excess water. As with an alcohol poisoning, the progression from mild to severe symptoms may occur rapidly as the water continues to enter the body from the stomach or intravenously.

A person with two healthy kidneys can excrete about 1.5 litres of water per hour at maximum filtration (other studies find the limit to be as little as 0.9L/h [1]). Consuming as little as 1.8 litres of water in a single sitting may prove fatal for a person adhering to a low-sodium diet, or 3 litres for a person on a normal diet. However, this must be modulated by potential water losses via other routes. For example, a person who is perspiring heavily may lose 1 L/h of water through perspiration alone, thereby raising the threshold for water intoxication. The problem is further complicated by the amount of electrolytes lost in urine or sweat, which is variable within a range controlled by the body's regulatory mechanisms. Water intoxication can be prevented by consuming water that is isotonic with water losses, but the exact concentration of electrolytes required is difficult to determine and evolves over time, and the greater the time period involved, the smaller the disparity that may suffice to produce electrolyte imbalance and water intoxication.