July 25, 2014Journal of Applied PhysiologyOpen Access

Acute volume loading and exercise capacity in postural tachycardia syndrome

Q: What is the clinical evidence from this study?

Population: Postural tachycardia syndrome (POTS) (n=19). Intervention: Intravenous saline (NaCl 0.9%) vs. Placebo pill (lactose tablet). Primary outcome: Peak oxygen consumption (VO2peak) in ml/min/kg (p=0.615).

Q: What does this research mean for the field?

Acute volume loading with intravenous saline does not significantly improve peak oxygen consumption or cardiovascular responses during exercise in patients with postural tachycardia syndrome, despite improving resting hemodynamic function. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Acute volume loading with intravenous saline did not significantly improve peak oxygen consumption (26.25 vs 27.74 ml/min/kg, p=0.615) during exercise in patients with postural tachycardia syndrome.

Why the study?

Does acute volume loading with 1 liter of intravenous saline improve peak exercise capacity (VO2peak) in patients with postural tachycardia syndrome?

Population

19 patients with postural tachycardia syndrome and mild to moderate hypovolemia

Comparison

1 liter of intravenous saline (NaCl 0.9%) vs Placebo

Follow-up

Acute (measured on two separate study days)

Authors

RFRocío FigueroaClinica Universidad de Navarra AAAmy C. ArnoldGeneral Cardiology VNVictor C. NwazueVanderbilt University Medical Center

Discussion

Member takes

Implication

Does not support acute saline loading to boost exercise capacity in POTS; leaves open effects of chronic volume strategies on functional outcomes.

Structured PICO

Does acute volume loading with 1 liter of intravenous saline improve peak exercise capacity (VO2peak) in patients with postural tachycardia syndrome?

Population

19 patients with postural tachycardia syndrome (POTS) and mild to moderate hypovolemia (blood volume deficits of -13.4 ± 1.4% ideal volume)

Intervention

1 liter of intravenous saline (NaCl 0.9%)

Comparator

Placebo

Outcome

Peak exercise capacity (VO2peak)surrogate

Main Result

Absolute Event Rate: 26.25% vs 27.74%

p-value: p=0.615

Acute volume loading with intravenous saline improves resting hemodynamics but does not improve peak exercise capacity in patients with postural tachycardia syndrome.

Limitations

Patients evaluated at a specialized care center may not be representative of the broader population
Small sample size may have limited statistical power for some parameters
Lack of a healthy control group
Blood volume was not evaluated after saline infusion
Used a pill as placebo instead of an intravenous placebo
Nonrandomized, open-label treatment order

Cite This Study

Figueroa et al. (2014) studied Postural tachycardia syndrome (POTS) (n=19). Intravenous saline (NaCl 0.9%) vs. Placebo pill (lactose tablet) was evaluated on Peak oxygen consumption (VO2peak) in ml/min/kg (p=0.615). Acute volume loading with intravenous saline did not significantly improve peak oxygen consumption (26.25 vs 27.74 ml/min/kg, p=0.615) during exercise in patients with postural tachycardia syndrome.

synapsesocial.com/papers/6a13edaef88db7183c599453 https://doi.org/10.1152/japplphysiol.00367.2014

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Implication

Does not support acute saline loading to boost exercise capacity in POTS; leaves open effects of chronic volume strategies on functional outcomes.

Acute volume loading and exercise capacity in postural tachycardia syndrome

Discussion

Member takes

Implication

Structured PICO

Main Result

Limitations

Cite This Study

Acute volume loading and exercise capacity in postural tachycardia syndrome

Discussion

Member takes

Implication

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider