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Hyperventilation & Chronic Fatigue Syndrome (CFS)

  [ 16 votes ]   [ Discuss This Article ] • January 3, 1994

We studied the link between chronic fatigue syndrome (CFS) and
hyperventilation in 31 consecutive attenders at a chronic
fatigue clinic (19 females, 12 males) who fulfilled criteria
for CFS based on both Oxford and Joint CDC/NIH criteria. All
experienced profound fatigue and fatigability associated with
minimal exertion, in 66% developing after an infective
episode. Alternative causes of fatigue were excluded.
Hyperventilation was studied during a 43-min protocol in which
end-tidal PCO2 (PETCO2) was measured non-invasively by
capnograph or mass spectrometer via a fine catheter taped in a
nostril at rest, during and after exercise (10-50 W) and for
10 min during recovery from voluntary overbreathing to
approximately 2.7 kPa (20 mmHg). PETCO2 < 4 kPa (30 mmHg) at
rest, during or after exercise, or at 5 min after the end of
voluntary overbreathing, suggested either hyperventilation or
a tendency to hyperventilate. Most patients were able
voluntarily to overbreathe, but not all were able to exercise.
Twenty-two patients (71%) had no evidence of hyperventilation
during any aspect of the test. Only four patients had
unequivocal hyperventilation, in one associated with asthma
and in three with panic. Only one patient with severe
functional disability and agoraphobia had hyperventilation
with no other obvious cause. A further five patients had
borderline hyperventilation, in which PETCO2 was < 4 kPa (30
mmHg) for no more than 2 min, when we would have expected it
to be normal. There was no association between level of
functional impairment and degree of hyperventilation. There is
only a weak association between hyperventilation and chronic
fatigue syndrome.

Saisch SG, Deale A, Gardner WN, Wessely S

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