Cardiopulmonary responses to exercise in an individual with ME/CFS during long-term treatment with intravenous saline, 2020 Davenport et al

[Hoopoe]

BACKGROUND: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) causes significant impairment in dailyactivities, including the ability to pursue daily activities. Chronotropic intolerance is becoming better characterized in ME/CFS and may be the target of supportive treatment.

OBJECTIVE: To document the effect of repeated intravenous (IV) saline administration on cardiovascular functioning andsymptoms in a 38-year old female with ME/CFS.

METHODS: The patient received 1 L of 0.9% IV saline through a central line for a total of 675 days. Single CPETs were completed periodically to assess the effect of treatment on cardiopulmonary function at peak exertion and ventilatoryanaerobic threshold (VAT). An open-ended symptom questionnaire was used to assess subjective responses to CPET and self-reported recovery time.

RESULTS: Improvements were noted in volume of oxygen consumed (VO2), heart rate (HR), and systolic blood pressure(SBP) at peak and VAT. Self-reported recovery time from CPET reduced from 5 days to 1–2 days by the end of treatment. The patient reported improved quality of life related, improved capacity for activities of daily living, and reduced symptoms.

CONCLUSIONS:
IV saline may promote beneficial effects for cardiopulmonary function and symptoms in people withME/CFS, which should be the focus of formal study

https://content.iospress.com/articles/work/wor203214

https://sci-hub.se/10.3233/WOR-203214

 

[Hoopoe]

On the topic of a formal study, how can you blind patients to this treatment? If given via IV, the solution has to be isotonic, right? If patients drink salt water, they can taste the salt.

 

[Jonathan Edwards]

You could do a dose response study with 200, 600 and 1000ml. Even 200ml would lead to going for a pee.

I would worry about the ethics of doing a larger study because central intravenous lines are not without serious morbidity.

 

[Hoopoe]

I did daily salt water (drinks) last year for at least six months with good compliance and it seemed to be helpful.

Any other options? What about drugs that increase blood volume?

Do we even know whether the problem is blood volume or insufficient vasoconstriction? Or something else.

 

[Trish]

It's a pity they didn't have a few controls doing the same with oral saline and no saline, but still doing the repeated CPET.
I'll wait to see whether the difference looks very significant before I get interested. And of course with a fluctuating condition, who knows what was happening with this individual patient.

 

[Andy]

Full title: Cardiopulmonary responses to exercise in an individual with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome during long-term treatment with intravenous saline: A case study

Now open access at https://content.iospress.com/articles/work/wor203214 (same link as in opening post above).