Advertisement

Pediatric Cardiology

, Volume 36, Issue 4, pp 867–872 | Cite as

Oral Rehydration Salts: An Effective Choice for the Treatment of Children with Vasovagal Syncope

  • Weihong Chu
  • Cheng Wang
  • Lijia Wu
  • Ping Lin
  • Fang Li
  • Runmei Zou
Original Article

Abstract

To explore whether oral rehydration salts (ORS) is effective in the treatment of children with vasovagal syncope (VVS). One hundred and sixty-six consecutive patients with recurrent syncope and positive head-up tilt testing (HUTT) were recruited, randomly divided to conventional therapy (health education and tilt training) plus ORS (with 500 ml of water) group (Group I, 87 patients) and conventional therapy group (Group II, 79 patients). Therapeutic effect was evaluated by changes of syncopal episode and reperformed HUTT response. At the end of 6-month follow-up, syncopal episode did not reoccur in 49 (56.3 %) patients, decreased in 34 (39.1 %) patients, and had no obvious change or increased in four (4.6 %) patients in Group I, and the results were 31 (39.2 %), 37 (46.8 %), and 11 (14 %) in Group II, respectively. The difference was significant (χ 2 = 7.074, P < 0.05). When HUTT was reperformed, 57 (65.5 %) and 28 (35.4 %) patients had negative response and 30 (34.5 %) and 51 (64.6 %) patients had positive response, respectively, in Group I and Group II. The difference was also significant (χ 2 = 13.808, P < 0.01). In Group I, the two aspects had no difference between vasodepressor type and mixed type; however, syncopal episode had a significant difference between children aged ≤12 and >12 years (χ 2 = 6.371, P < 0.05); there was no difference in reperformed HUTT response. ORS with 500 ml of water is an effective therapy for VVS. It can be recommended as one of non- pharmacological treatment measures in children with VVS.

Keywords

Oral rehydration salts Vasovagal syncope Head-up tilt test Children 

Notes

Acknowledgments

The work was supported by the National Twelfth Five-Year Plan for Science and Technology Support of China (2012BAI03B03), the Natural Science Foundation of Hunan Province of China (13JJ5014).

Conflict of interest

None.

References

  1. 1.
    Bellard E, Fortrat JO, Custaud MA, Victor J, Greenleaf J, Lefthériotis G (2007) Increased hydration alone does not improve orthostatic tolerance in patients with neurocardiogenic syncope. Clin Auton Res 17(2):99–105CrossRefPubMedGoogle Scholar
  2. 2.
    Boedtkjer E, Aalkjaer C (2012) Intracellular pH in the resistance vasculature: regulation and functional implications. J Vasc Res 49(6):479–496. doi: 10.1159/000341235 CrossRefPubMedGoogle Scholar
  3. 3.
    Chen L, Du JB, Zhang QY et al (2007) A multicenter study on treatment of autonomous nerve-mediated syncope in children with beta-receptor blocker. Zhonghua Er Ke Za Zhi 45(12):885–888PubMedGoogle Scholar
  4. 4.
    Chu W, Wang C, Lin P, Li F, Wu L, Xie Z (2014) Transient aphasia: a rare complication of head-up tilt test. Neurol Sci 35(7):1127–1132. doi: 10.1007/s10072-014-1664-1 CrossRefPubMedGoogle Scholar
  5. 5.
    Cooper VL, Hainsworth R (2002) Effects of dietary salt on orthostatic tolerance, blood pressure and baroreceptor sensitivity in patients with syncope. Clin Auton Res 12(4):236–241CrossRefPubMedGoogle Scholar
  6. 6.
    Crimi E, Taccone FS, Infante T, Scolletta S, Crudele V, Napoli C (2012) Effects of intracellular acidosis on endothelial function: an overview. J Crit Care 27(2):108–118. doi: 10.1016/j.jcrc.2011.06.001 CrossRefPubMedGoogle Scholar
  7. 7.
    Driscoll DJ, Jacobsen SJ, Porter CJ, Wollan PC (1997) Syncope in children and adolescents. J Am Coll Cardiol 29(5):1039–1045CrossRefPubMedGoogle Scholar
  8. 8.
    El-Sayed H, Hainsworth R (1996) Salt supplement increases plasma volume and orthostatic tolerance in patients with unexplained syncope. Heart 75(2):134–140CrossRefPubMedCentralPubMedGoogle Scholar
  9. 9.
    Fang Y, Mu JJ, He LC, Wang SC, Liu ZQ (2006) Salt loading on plasma asymmetrical dimethylarginine and the protective role of potassium supplement in normotensive salt-sensitive asians. Hypertension 48(4):724–729CrossRefPubMedGoogle Scholar
  10. 10.
    Fenton AM, Hammill SC, Rea RF, Low PA, Shen WK (2000) Vasovagal syncope. Ann Intern Med 133(9):714–725CrossRefPubMedGoogle Scholar
  11. 11.
    Fitzpatrick AP, Theodorakis G, Vardas P, Sutton R (1991) Methodology of head-up tilt testing in patients with unexplained syncope. J Am Coll Cardiol 17(1):125–130CrossRefPubMedGoogle Scholar
  12. 12.
    Harris JP, Garfunkel LC, Wycoff C et al (1999) Cardiovascular aspects of neurally mediated syncope in adolescents. Pediatr Res 45:4ACrossRefGoogle Scholar
  13. 13.
    He FJ, Marciniak M, Carney C et al (2010) Effects of potassium Chloride and potassium bicarbonate on endothelial function, cardiovascular risk factors, and bone turnover in mild hypertensives. Hypertension 55(3):681–688. doi: 10.1161/HYPERTENSIONAHA.109.147488 CrossRefPubMedGoogle Scholar
  14. 14.
    Kapoor WN (2000) Syncope. N Engl J Med 343(25):1856–1862CrossRefPubMedGoogle Scholar
  15. 15.
    Linzer M, Pontinen M, Gold DT, Divine GW, Felder A, Brooks WB (1991) Impairment of physical and psychosocial function in recurrent syncope. J Clin Epidemiol 44(10):1037–1043CrossRefPubMedGoogle Scholar
  16. 16.
    McHarg ML, Shinnar S, Rascoff H, Walsh CA (1997) Syncope in childhood. Pediatr Cardiol 18(5):367–371CrossRefPubMedGoogle Scholar
  17. 17.
    Moya A, Sutton R, Ammirati F et al (2009) Guidelines for the diagnosis and management of syncope (version 2009). Eur Heart J 30(21):2631–2671. doi: 10.1093/eurheartj/ehp298 CrossRefPubMedCentralPubMedGoogle Scholar
  18. 18.
    Mtinangi BL, Hainsworth R (1998) Early effects of oral salt on plasma volume, orthostatic tolerance, and baroreceptor sensitivity in patients with syncope. Clin Auton Res 8(4):231–235CrossRefPubMedGoogle Scholar
  19. 19.
    Pilcher TA, Saarel EV (2014) A teenage fainter (dizziness, syncope, postural orthostatic tachycardia syndrome). Pediatr Clin N Am 61(1):29–43. doi: 10.1016/j.pcl.2013.09.009 CrossRefGoogle Scholar
  20. 20.
    Rose MS, Koshman ML, Spreng S, Sheldon R (2000) The relationship between health-related quality of life and frequency of spells in patients with syncope. J Clin Epidemiol 53(12):1209–1216CrossRefPubMedGoogle Scholar
  21. 21.
    Shannon RP, Wei JY, Rosa JY, Epstein FH, Rowe JW (1986) The effect of age and sodium deletion on cardiovascular response to orthostasis. Hypertension 8(5):438–443CrossRefPubMedGoogle Scholar
  22. 22.
    Shi DC, Mu JJ, Chen ER et al (2006) Endothelial function evaluation in salt-sensitive normotensive and mild hypertensive subjects and effects of potassium supplement. Zhonghua Xin Xue Guan Bing Za Zhi 34(1):38–41PubMedGoogle Scholar
  23. 23.
    Wieling W, Colman N, Krediet CT, Freeman R (2004) Nonpharmacological treatment of reflex syncope. Clin Auton Res 14(Suppl 1):62–70CrossRefPubMedGoogle Scholar
  24. 24.
    Xu Y, Lin P, Wang C et al (2013) Investigation of 24-hour blood pressure monitoring for evaluating treatment outcome of nerve-mediated syncope in children. Zhongguo Dang Dai Er Ke Za Zhi 15(6):458–461PubMedGoogle Scholar
  25. 25.
    Younoszai AK, Franklin WH, Chan DP, Cassidy SC, Allen HD (1998) Oral fluid therapy: a promising treatment for vasodepressor syncope. Arch Pediatr Adolesc Med 152(2):165–168CrossRefPubMedGoogle Scholar
  26. 26.
    Zhang FW, Liao Y, Li XY, Chen L, Jin HF, Du JB (2011) Therapies for postural tachycardia syndrome in children. Zhonghua Er Ke Za Zhi 49(6):428–432PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Weihong Chu
    • 1
  • Cheng Wang
    • 1
  • Lijia Wu
    • 1
  • Ping Lin
    • 1
  • Fang Li
    • 1
  • Runmei Zou
    • 1
  1. 1.Department of Pediatric Cardiovasology, Children’s Medical CenterThe Second Xiangya Hospital of Central South University/Institute of Pediatrics of Central South UniversityChangshaChina

Personalised recommendations