The study was conducted to assess the short-term efficacy of reduced-osmolarity oral rehydration salt formulation (ORS) and propranolol in children who were diagnosed with postural orthostatic tachycardia syndrome (POTS) during head-up tilt testing (HUTT).

Children were admitted who had symptoms of orthostatic intolerance (OI) that occurred in a standing position and disappeared in the supine position. Patients with heart rate increases of ≥40bpm and symptoms of OI consisted of the pediatric POTS group in HUTT. A total number of 70 pediatric patients with POTS were involved in the study. Two groups were made of the POTS patients based on whether they were given reduced-osmolarity ORS and propranolol or not. The study group included patients on a treatment of reduced-osmolarity ORS and propranolol (n=34), whereas the control group included patients who weren’t given any medication (n=36). The standardized symptom scores and the frequency of symptoms were evaluated before and after 3 months of treatment in both groups.

The results of the study stated that the post-treatment frequency of syncopal attacks was reduced significantly in both groups. The standardized symptom scores post-treatment were reduced significantly in the pediatric study group as compared to the control group.

Therefore, the study concluded that the frequency of syncopal attacks was significantly decreased and the symptom scores for OI were significantly improved in the study group. The improvement in OI symptom scores was higher in the treatment group as compared to the control group. The control group symptoms continued and led to extreme difficulty in their everyday activities. In pediatric patients with POTS, it is strongly promoted the use of combined treatment of reduced-osmolarity ORS and low-dose propranolol.

Source: Yozgat Y, Temur HO, Coban S, et al. Short-term efficacy of ORS formulation and propranolol regimen in children with POTS. Arch Pediatr. 2020 Aug;27(6):328-332. doi: 10.1016/j.arcped.2020.06.001. Epub 2020 Jul 7. PMID: 32651146.