Changes in serum and urine electrolytes of children with neurally mediated syncope after oral rehydration salts[I] treatment

Objective To explore the changes in serum and urine electrolytes of children with neurally mediated syncope (NMS) after oral rehydration salts (ORS) [Ⅰ] treatment. Methods The study group included 135 patients [60 male and 75 female, aged 4-16 years, average of (10.20±2.68) years old] with unexplained syncope and prodromal symptoms of syncope in our hospital between May 2014 and April 2015.The patients underwent head-up tilt test (HUTT), and completed serum electrolytes and 24-hour urine electrolytes, and the serum electrolytes and 24-hour urine electrolytes in different hemodynamic type of HUTT were compared.Positive HUTT patients were treated with health education and ORS[Ⅰ], while negative HUTT patients were received health education.Then 21-154(42.63±27.71) days later, the patients returned to hospital, for the inquiry of symptom improvement, and review of HUTT, 24-hour urine and serum electrolytes. Results (1)The total effective rate of ORS[Ⅰ] treatment was 62.96% (17/27 cases), while negative conversion rate of HUTT was 48.15% (13/27 cases). (2)There was no significant difference in serum electrolytes, 24-hour urine electrolytes or 24-hour urine volume between HUTT positive group and negative group during the first visit (all P>0.05). (3)In return visit, serum calcium [(2.30±0.10) mmol/L vs (2.20±0.09) mmol/L, t=2.72, P 0.05). (4)24-hour urine sodium [(159.06±72.76) mmol/24 h vs (118.97±52.75) mmol/24 h, t=2.712, P 0.05). (5)There was no significant difference in serum electrolytes, 24-hour urine electrolytes or 24-hour urine volume between vasovagal syncope group and postural orthostatic tachycardia syndrome group during the first visit(all P>0.05). Conclusions ORS[Ⅰ] treatment can obviously increase the 24-hour urine sodium, 24-hour urine chloride in children with NMS.ORS[Ⅰ] is an effective therapy for NMS. Key words: Neurally mediated syncope; Oral rehydration salts; Child; Electrolyte; 24-hour urine electroyte