Pediatric syncope diagnosis and management: Validation of continuous blood pressure monitoring and alternatives to 24-hour urine sodium sampling

Syncope, or fainting, is common and has a devastating impact on quality of life. Diagnosis and management of syncope is challenging. In pediatric populations the current diagnostic gold standard, a tilt test, cannot be safely or properly performed, because the necessary non-invasive beat-to-beat blood pressure monitoring is not validated for children. In addition, low sodium intake is common in syncope patients, and salt supplementation is recommended. However, standard assessments of sodium from urine collections are difficult and unpleasant. This thesis demonstrated that: (i) continuous non-invasive finger blood pressure monitoring provides a novel, comfortable, and accurate approach for use in children compared to an intra-arterial catheter, (ii) Quantab test strips provide a valid alternative to flame photometry for the determination of 24-hour urine sodium levels, and corrected spot sample averages offer an acceptable and convenient alternative to 24-hour urine sampling. These advancements in diagnostic tools for syncope will enhance quality of life for affected individuals.