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Reaction to saline?

justy

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Has anybody here with MCAS etc ever reacted to IV saline? My reaction came straight after, or in the middle of a reaction to an IV abx, which was stopped. Then the saline was started and I was ok for a couple of minutes and then the reaction hit me hard and I seized etc for 1-2 hours afterwards with atypical anaphylaxis.

I feel like such a freak.
 

Plum

Senior Member
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Sorry you went through this @justy - I was wondering if you were perhaps reacting to the bag the saline is kept in? Or even the electrolytes added? I have heard of others reacting to saline but I myself am fine with it.
 

Gingergrrl

Senior Member
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16,171
@justy Am pretty sure you know my story so will make it very brief. I got pulmonary edema from one liter of saline in Nov 2014 but it turned out that it was infused too quickly. I did not yet know that I had MCAS and the test which showed my histamine was 4x the normal limit was not until the following month.

Long story short, with MCAS, if you are prone to third spacing from fluid (any fluid), it must be infused at a very slow speed (b/c histamine makes the membranes more permeable). I had one liter of saline in 3 hrs in 2014 and it literally almost killed me but I was not actually allergic to it. I am currently doing IVIG infusions of just slightly over 1/4 liter in 7 hrs. It sounds ridiculous but I have no allergic reactions and by spacing it out over three days, I actually do a pretty high dose.

Not sure if this helps but wanted to mention it just in case.

ETA: I re-read what I wrote and not sure if it makes sense. I don't mean spacing the 1/4 over three days. I mean doing 1/4 liter on each of the three days, so in total I am receiving between 3/4 liter to 1 liter of fluid (IVIG) spread over the three day period.
 
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justy

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@justy Am pretty sure you know my story so will make it very brief. I got pulmonary edema from one liter of saline in Nov 2014 but it turned out that it was infused too quickly. I did not yet know that I had MCAS and the test which showed my histamine was 4x the normal limit was not until the following month.

Long story short, with MCAS, if you are prone to third spacing from fluid (any fluid), it must be infused at a very slow speed (b/c histamine makes the membranes more permeable). I had one liter of saline in 3 hrs in 2014 and it literally almost killed me but I was not actually allergic to it. I am currently doing IVIG infusions of just slightly over 1/4 liter in 7 hrs. It sounds ridiculous but I have no allergic reactions and by spacing it out over three days, I actually do a pretty high dose.

Not sure if this helps but wanted to mention it just in case.

ETA: I re-read what I wrote and not sure if it makes sense. I don't mean spacing the 1/4 over three days. I mean doing 1/4 liter on each of the three days, so in total I am receiving between 3/4 liter to 1 liter of fluid (IVIG) spread over the three day period.

Yes, I know what you mean - it makes sense. Glad it is helping you.

For me I didn't have long enough to get much into my body - The reaction to the abx calmed once it was stopped and then started up again after only about 1 minute of the saline going in, slowly. The reaction to the abx also happened within minutes and was being infused VERY slowly.

Its a big worry because that rules out all medical procedures.
 

justy

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Sorry you went through this @justy - I was wondering if you were perhaps reacting to the bag the saline is kept in? Or even the electrolytes added? I have heard of others reacting to saline but I myself am fine with it.
Yes, I had wondered if it was the bag as my reaction to the abx was also immediate, or some additive in the saline. I did ask them what was in their saline, but they said just salt and purified water.

I even wondered if I was reacting to the cannula - I kept asking them to take it out, but they didn't until I was leaving three hours later... The reaction was on the 31st January and im still recovering - it was awful.
 

Plum

Senior Member
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512
Location
UK
Yes, I had wondered if it was the bag as my reaction to the abx was also immediate, or some additive in the saline. I did ask them what was in their saline, but they said just salt and purified water.

I even wondered if I was reacting to the cannula - I kept asking them to take it out, but they didn't until I was leaving three hours later... The reaction was on the 31st January and im still recovering - it was awful.

I'm so sorry @justy - have you had issues with saline anywhere else? If it were me I would research as much as I could about saline and the bags they're in... even look into cannulas. I'm sure you'll find something lurking.

(I react to the lining used in cans for foods. For ages I thought it was the foods themselves. There's hidden stuff everywhere. It's so hard for us to unravel).
 

justy

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I'm so sorry @justy - have you had issues with saline anywhere else? If it were me I would research as much as I could about saline and the bags they're in... even look into cannulas. I'm sure you'll find something lurking.

(I react to the lining used in cans for foods. For ages I thought it was the foods themselves. There's hidden stuff everywhere. It's so hard for us to unravel).
Good points. I have had saline in IV and the same cannulas at this clinic before - but of course its always possible to get new reaction. And I thought I was less reactive at the moment - but acutally im just on a ton of antihistamines to keep things bearable.
 

Apple

Senior Member
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@justy , I wonder if the saline pushed whatever IV abx that were in your blood further around your body. It may not have been the saline at all.
 

Research 1st

Severe ME, POTS & MCAS.
Messages
768
Has anybody here with MCAS etc ever reacted to IV saline? My reaction came straight after, or in the middle of a reaction to an IV abx, which was stopped. Then the saline was started and I was ok for a couple of minutes and then the reaction hit me hard and I seized etc for 1-2 hours afterwards with atypical anaphylaxis.

I feel like such a freak.

Things I'm thinking of:

1) You had a strange stop/start adverse reaction in the same time frame as coming into contact with antibiotics. Perhaps that made it look like it was the saline, (as you stopped the AB) started the saline and then reacted. What if it wasn't the saline at all and a delayed immune reaction - or an immune reaction then a neurological reaction (from the AB's)?

2) You had a seizure anyway not related to anything you came into contact with?

3) The tube of the IV line was made from a material you're sensitive to, so it wasn't a reaction to anything in the bag?

4) The plaster/sticky tape they hold the canula in place, perhaps with you, caused a CNS event, (seizure) not a skin reaction?

Sorry to hear about your horrible experience either way, and thankfully you're OK now, that's the most important thing.
 

Gingergrrl

Senior Member
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For me I didn't have long enough to get much into my body - The reaction to the abx calmed once it was stopped and then started up again after only about 1 minute of the saline going in, slowly. The reaction to the abx also happened within minutes and was being infused VERY slowly.

Apologies for not understanding this but is it possible you were allergic to the antibiotic and NOT to the saline at all? If they used the same IV line (vs. two separate lines) then even if they only started it back up for a minute, the ABX would still be in the line unless I am missing something.

When I do IVIG sometimes we use an "A" and a "B" line so the IVIG is in one and D5-Dextrose is in the other (my brand of IVIG does not mix w/saline and uses dextrose). Versus other times we have just used one line for both and at the end of the IVIG, we clear the remaining IVIG with the D5-Dextrose and it takes 20-30 min to get it all through the line. So if they only ran the line for one minute, I would think you would still be receiving the same ABX that caused the initial allergic reaction. Does that make sense?
 

justy

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Apologies for not understanding this but is it possible you were allergic to the antibiotic and NOT to the saline at all? If they used the same IV line (vs. two separate lines) then even if they only started it back up for a minute, the ABX would still be in the line unless I am missing something.

When I do IVIG sometimes we use an "A" and a "B" line so the IVIG is in one and D5-Dextrose is in the other (my brand of IVIG does not mix w/saline and uses dextrose). Versus other times we have just used one line for both and at the end of the IVIG, we clear the remaining IVIG with the D5-Dextrose and it takes 20-30 min to get it all through the line. So if they only ran the line for one minute, I would think you would still be receiving the same ABX that caused the initial allergic reaction. Does that make sense?
yes it does. I had just one line in, they didn't flush it between. The nurse said I must have only received about 10 drops of antibiotic and was shocked at my reaction. It clamed down a little when they stopped it running. Then they added saline to the same line, for the first minutes it felt good, like it was soothing me and all would be well, then suddenly I thought 'oh no here we go again' and it started up again really strongly and carried on for a couple of hours, even after they stopped the drip of saline. I felt instinctively that I wanted them at this point to remove the line, but I couldn't make myself understood and they didn't remove it until I left three hours later.
 

justy

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I very much doubt it was the saline which is sodium chloride in sterile water. Lots of that in your body cells.
I do know of others with MCAD who have reacted to saline, so its not impossible. It could also have been the canula, the stress etc all on top of each other.
 
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I do know of others with MCAD who have reacted to saline, so its not impossible. It could also have been the canula, the stress etc all on top of each other.

I am not sure this could ever be the case reacting to saline because Normal Saline as they call is a close approximation to the osmolarity of NaCl in blood so it should not cause an allergic reaction. I think hypersensitivity to normal saline has only been reported a very few times -- like less than 10. I believe the probability would increase if there was some kind of additive in the solution. You might want to ask them about that.

It could have been the cannula but that is unlikely. That being said I think a cannula coating could elicit an allergic reaction but if they left the cannula in for 3 hours, you would have likely had a three hour reaction.

Do you happen to remember if they wiped the cannula with an alcohol swab prior to insertion because those swabs usually contain isopropyl alcohol and chlorhexidine. A small amount could have entered your system during flushing it. I have heard of chlorhexidine hypersensitivity causing anaphylaxis.
 

Butydoc

Senior Member
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790
Yes, I had wondered if it was the bag as my reaction to the abx was also immediate, or some additive in the saline. I did ask them what was in their saline, but they said just salt and purified water.

I even wondered if I was reacting to the cannula - I kept asking them to take it out, but they didn't until I was leaving three hours later... The reaction was on the 31st January and im still recovering - it was awful.
Hi Justy,

Some IV saline has benzyl alcohol as a preservative, especially multi use containers used for reconstituting drugs to be given in an iv drip. I wonder if they used this and your are actually allergic to benzyl alcohol?

Best,
Gary
 

Silence

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Sorry you had to go through that. It must have been frightening. How do you feel when you eat salt, sea salt, or table salt? For me I cannot tolerate table salt in any of its forms, but I am not sure if I have a problem with saline soln.
 

justy

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Sorry you had to go through that. It must have been frightening. How do you feel when you eat salt, sea salt, or table salt? For me I cannot tolerate table salt in any of its forms, but I am not sure if I have a problem with saline soln.
No problem with salt at all.
 
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Rare poster, frequent lurker who happens to be an RN. Most IV abx are piggybacked into the line ABOVE the pump running the main solution. Since you told them that you were reacting to the abx, they should have stopped the pump, removed the whole line and started with a new set up. Even after the abx was clamped and/ or removed, there was most certainly more abx in that line until it flushed through. If "10 drops" was to cause a reaction, I venture the rest that was likely still in the line sent you over the edge.

If they did not start with a whole new bag and line, then there was indeed still abx in the infusion. I hope that helps.
 

justy

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Rare poster, frequent lurker who happens to be an RN. Most IV abx are piggybacked into the line ABOVE the pump running the main solution. Since you told them that you were reacting to the abx, they should have stopped the pump, removed the whole line and started with a new set up. Even after the abx was clamped and/ or removed, there was most certainly more abx in that line until it flushed through. If "10 drops" was to cause a reaction, I venture the rest that was likely still in the line sent you over the edge.

If they did not start with a whole new bag and line, then there was indeed still abx in the infusion. I hope that helps.
yes, thank you, makes perfect sense!