Short-term efficacy of ORS formulation and propranolol regimen in children with POTS.
Adolescent
Child
Female
Humans
Male
Adrenergic beta-Antagonists
/ therapeutic use
Combined Modality Therapy
Electrolytes
/ therapeutic use
Fluid Therapy
/ methods
Follow-Up Studies
Postural Orthostatic Tachycardia Syndrome
/ therapy
Propranolol
/ therapeutic use
Prospective Studies
Rehydration Solutions
/ therapeutic use
Treatment Outcome
Oral rehydration salt
Orthostatic intolerance
Postural orthostatic tachycardia syndrome
Propranolol
Journal
Archives de pediatrie : organe officiel de la Societe francaise de pediatrie
ISSN: 1769-664X
Titre abrégé: Arch Pediatr
Pays: France
ID NLM: 9421356
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
26
02
2020
revised:
09
04
2020
accepted:
01
06
2020
pubmed:
12
7
2020
medline:
6
7
2021
entrez:
12
7
2020
Statut:
ppublish
Résumé
To evaluate the short-term effectiveness of reduced-osmolarity oral rehydration salt formulation (ORS) and propranolol in children diagnosed with postural orthostatic tachycardia syndrome (POTS) in head-up tilt testing (HUTT). Children were admitted with symptoms of orthostatic intolerance (OI) occurring in a standing position and disappearing in the supine position. Patients with heart rate increments of ≥40bpm and symptoms of OI constituted the pediatric POTS group in HUTT. A total of 70 pediatric patients with POTS were included in the study. POTS patients were divided into two groups based on whether they were prescribed reduced-osmolarity ORS and propranolol or not. The study group comprised patients on a regimen of reduced-osmolarity ORS and propranolol (n=34), while the control group comprised patients who were not prescribed any medication (n=36). The frequency of symptoms and standardized symptom scores were analyzed before and after 3 months of treatment in both groups. The post-treatment frequency of syncopal attacks was significantly reduced in both groups (P<0.01 for both groups), but the post-treatment standardized symptom scores were significantly reduced in the pediatric study group compared with the control group (P<0.01). The frequency of syncopal attacks was significantly reduced and the symptom scores for OI were improved in the study group. The improvement in OI symptom scores was better in the treatment group than in the control group. The control group symptoms persisted and caused extreme difficulty in their daily activities. In view of its clinical efficacy, we strongly advocate the use of combined treatment of reduced-osmolarity ORS and low-dose propranolol in pediatric patients with POTS.
Sections du résumé
BACKGROUND
BACKGROUND
To evaluate the short-term effectiveness of reduced-osmolarity oral rehydration salt formulation (ORS) and propranolol in children diagnosed with postural orthostatic tachycardia syndrome (POTS) in head-up tilt testing (HUTT).
METHODS
METHODS
Children were admitted with symptoms of orthostatic intolerance (OI) occurring in a standing position and disappearing in the supine position. Patients with heart rate increments of ≥40bpm and symptoms of OI constituted the pediatric POTS group in HUTT. A total of 70 pediatric patients with POTS were included in the study. POTS patients were divided into two groups based on whether they were prescribed reduced-osmolarity ORS and propranolol or not. The study group comprised patients on a regimen of reduced-osmolarity ORS and propranolol (n=34), while the control group comprised patients who were not prescribed any medication (n=36). The frequency of symptoms and standardized symptom scores were analyzed before and after 3 months of treatment in both groups.
RESULTS
RESULTS
The post-treatment frequency of syncopal attacks was significantly reduced in both groups (P<0.01 for both groups), but the post-treatment standardized symptom scores were significantly reduced in the pediatric study group compared with the control group (P<0.01).
CONCLUSION
CONCLUSIONS
The frequency of syncopal attacks was significantly reduced and the symptom scores for OI were improved in the study group. The improvement in OI symptom scores was better in the treatment group than in the control group. The control group symptoms persisted and caused extreme difficulty in their daily activities. In view of its clinical efficacy, we strongly advocate the use of combined treatment of reduced-osmolarity ORS and low-dose propranolol in pediatric patients with POTS.
Identifiants
pubmed: 32651146
pii: S0929-693X(20)30135-4
doi: 10.1016/j.arcped.2020.06.001
pii:
doi:
Substances chimiques
Adrenergic beta-Antagonists
0
Electrolytes
0
Propranolol
9Y8NXQ24VQ
Rehydration Solutions
0
Types de publication
Controlled Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
328-332Informations de copyright
Copyright © 2020 French Society of Pediatrics. Published by Elsevier Masson SAS. All rights reserved.