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The relation between hyperventilation and pediatric syncope
F Martinón-Torres1, A Rodríguez-Núñez, S Fernández-Cebrián
1Pediatric Critical and Emergency Care Division, Department of Pediatrics, Complejo Hospitalario Universitario de Santiago de Compostela, c/A Choupana s/n, 15706 Santiago de Compostela, Spain.
The Journal of Pediatrics
|June 8, 2001
Summary
Hyperventilation may contribute to neurocardiogenic syncope in children. Monitoring end-tidal carbon dioxide during tilt testing could improve diagnosis of fainting in pediatric patients.
Area of Science:
- Pediatric Cardiology
- Autonomic Nervous System Function
- Cardiorespiratory Physiology
Background:
- Neurocardiogenic syncope is a common cause of fainting in children.
- Head-upright tilt testing (HUTT) is used to diagnose syncope.
- The role of hyperventilation in pediatric syncope is not fully understood.
Purpose of the Study:
- To prospectively investigate the role of hyperventilation in the development of neurocardiogenic syncope in children during HUTT.
- To assess the association between hyperventilation and positive HUTT results.
Main Methods:
- 34 children with suspected syncope underwent HUTT.
- Continuous monitoring of respiratory rate and end-tidal carbon dioxide pressure was performed.
- Patients were categorized based on HUTT results (positive or negative).
Main Results:
- Hyperventilation occurred in 25% of negative HUTT cases and 68.2% of positive HUTT cases.
- In positive HUTT, hyperventilation was associated with longer times to syncope onset and symptom onset.
- Significantly longer latency times were observed in hyperventilating patients compared to non-hyperventilating patients (P = .002 and P = .04).
Conclusions:
- Spontaneous hyperventilation may play a significant role in the pathophysiology of pediatric neurocardiogenic syncope.
- Hyperventilation might indicate a specific response to orthostatic stress in susceptible children.
- Incorporating capnography into HUTT protocols could enhance syncope assessment in pediatric populations.