Comparison of Sodium Lactate Infusion and Carbon Dioxide Inhalation Panic Provocation Tests: A Meta-analysis

 

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Abstract

Background Sodium lactate (NaL) infusion and carbon dioxide (CO₂) inhalation are proven to provoke acute panic attacks (PAs) in patients with panic disorder (PD). A systematic literature search and meta-analysis were performed to compare the effect sizes of these methods.

Methods Odds ratios were calculated for each of the original studies and were pooled using the random-effects model.

Results Either NaL or CO₂ provocations significantly increased the rates of PAs in individuals with PD compared to those in healthy controls. However, the effect size of NaL infusion (OR=25.13, 95% CI=15.48–40.80) was significantly greater than that of CO₂ inhalation (OR=10.58, 95%CI=7.88–14.21).

Conclusion The evidence for the efficacy of the two panic provocation tests is very strong. Yet, the results support the superiority of NaL infusion over CO₂ inhalation challenge as a panic provocation test. Thus, lactate seems a much stronger stimulus than CO₂ for the brain suffocation detector.

Publication History

Received: 20 April 2021

Accepted: 16 June 2021

Article published online:
19 October 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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