THE MODERN STRATEGIES FOR THE PEDIATRIC SYNCOPE TREATMENT AND PREVENTION
DOI:
https://doi.org/10.11603/24116-4944.2023.2.13885Keywords:
non-cardiac syncope, cardiac syncope, treatment, prevention, childrenAbstract
The aim of the study – to analyze modern scientific achievements in the search and implementation of effective and innovative approaches in the treatment and prevention of syncope in childhood.
Materials and Methods. PubMed Medline and Scopus databases were used to search for scientific studies using the search terms "syncope" and "treatment" and "children"; "syncope" and "prevention" and "children". Fifty full-text articles in English published between January 2018 and December 2022 were included in this literature review.
Results and Discussion. Based on the results of research in recent years, it is shown that such non-pharmacological methods as avoidance of potential triggers, safe body positioning during the development of presyncope symptoms, physical counterpressure maneuvers, tilt training, as well as increased salt and water intake are potentially effective and most commonly used methods of syncope treatment and prevention in pediatric practice. Midodrine and fludrocortisone can be used in children with recurrent non-cardiac syncope if non-medical treatment is ineffective. There is no convincing evidence of the efficacy and safety of β-blockers and selective serotonin reuptake inhibitors in children with vasovagal syncope or syncope due to orthostatic hypotension. Despite the effectiveness of catheter ablation and cardiac stimulation in adults with severe recurrent vasovagal syncope, these treatment methods are used in pediatrics only if the syncope is of cardiac origin.
Conclusion. A better understanding of the pathophysiology of syncope development, depending on the mechanisms of its formation, opens up a number of opportunities in the search for new, effective, and most importantly, patient-centered treatment strategies in each individual case of transient loss of consciousness in children.
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