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: adolescents; children; medication course; oral rehydration salts; vasovagal syncope.