Objective: This study was designed to assess the efficacy of increased
salt and water intake in the treatment of pediatric
vasovagal syncope (VVS) based on a meta-analysis of global data. Methods: Following the established inclusion criteria, seven databases, Cochrane Library, EMBASE, PubMed, Web of Science, VIP, Wanfang, and China National Knowledge Infrastructure (CNKI), were searched using specific terms. The Cochrane Bias risk assessment tool was used as a quality assessment tool of the included studies, and publication bias was assessed by funnel plots. Review Manager 5.4 software was used to analyze the efficacy of the included studies, taking the negative changing rate of the head-up tilt test (HUTT) and recurrence rate of
syncope or
presyncope as therapeutic efficacy evaluations. Results: In total, 5 randomized controlled trials (RCTs) were finally obtained, using the negative changing rate of the HUTT as an efficacy evaluation, while in 4 of the studies, the recurrence rate of
syncope or
presyncope was also evaluated. A total of 233 children with VVS were included in the
salt and water intervention group. The cases in the control group were treated with non-medicinal conventional
therapy. The results revealed that the negative changing rate of the HUTT in the intervention group (144/233, 61.8%) was higher than that in the control group (48/179, 26.8%), and the difference was significant (P < 0.00001). The recurrence rate of
syncope or
presyncope in the intervention group (85/195, 43.6%) was lower than that in the control group (86/144, 59.7%), and the difference was significant (P = 0.002). Conclusion: The current findings suggest that increased
salt and water intake may increase the negative changing rates of the HUTT and reduce
syncope or
presyncope recurrence rates in pediatric patients with VVS.