The Turkish Journal of Pediatrics 2020 , Vol 62 , Num 5
Duration of treatment with oral rehydration salts for vasovagal syncope in children and adolescents
Chuan Wen 1 ,Shuo Wang 2-3 ,Runmei Zou 1 ,Yuwen Wang 1 ,Chuanmei Tan 2-3 ,Yi Xu 1 ,Cheng Wang 1
1 Department of Pediatric Cardiovasology, Children’s Medical Center, The Second Xiangya Hospital, Central South University / Institute of Pediatrics, Central South University, Changsha 410011, Hunan, China
2 Jishou University School of Medicine, Jishou,416000, China
3 Department of Pediatrics, The First People’s Hospital of Changde City, Changde, Hunan, 415003, China
DOI : 10.24953/turkjped.2020.05.014 Background. Oral rehydration salt (ORS) is a first-line medication for vasovagal syncope (VVS) in children and adolescents. We retrospectively investigated the treatment with ORS-I (Na 90 mmol/L) for VVS in children and adolescents to define appropriate duration of treatment.

Methods. All patients with a diagnosis of VVS, based on the first head-up tilt test (HUTT) response, and who accepted ORS-I treatment were enrolled. ORS was stopped when the HUTT response turned negative. Patients were followed for six months after cessation of ORS treatment.

Results. The study group included 129 patients (57 male, 72 female; mean age, 11.8 ± 2.0 years, age range, 7.0- 17.0 years). Median duration of VVS was 4 months (range, 1 week to >10 years). The number of syncope ranged from 2 times to >20 times. Mean follow-up time was 27.8 ± 6.9 weeks (range, 26-33 weeks). It took to 2~13 weeks for HUTT response to turn negative, with an average time of 8.4 weeks (95% confidence interval, 6.89~9.84 weeks). There was no statistical difference for the time to negative HUTT response according to age groups (<12-year-old vs. ≥12-year-old), syncope type (vasodepressor vs. mixed), and the syncope frequency. No patient experienced syncope after cessation of ORS treatment.

Conclusions. Our findings suggest that ORS-I is an effective measure to treat children and adolescents with VVS. We recommend a treatment course of 2 months. Keywords : oral rehydration salts, vasovagal syncope, medication course, children, adolescents

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