Evidence map›Paper›PMID 29222399›Full record

ReviewPediatrics2018

Pediatric Disorders of Orthostatic Intolerance.

Julian M Stewart, Jeffrey R Boris, Gisela Chelimsky, Phillip R Fischer, John E Fortunato, Blair P Grubb, Geoffrey L Heyer, Imad T Jarjour, Marvin S Medow, Mohammed T Numan and 5 more

Open access · greenAbstract readReview
In one paragraph

Review in Pediatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 97 papers.

0numbers the graph read from it
0cells of the map it votes in
97citing papers in PubMed
14.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

97 citing papers in PubMed, 216 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. Postural tachycardia during active standing: diagnostic criteria in adolescents.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026
    Article
  6. Article
  7. Article
  8. Difference in clinical characteristics between functional syncope and vasovagal syncope in children.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Article
  9. Article
  10. Article
  11. Review
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article

37 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 10 institutions in 1 country.

Julian M StewartNew York Medical College, Valhalla, New York; julian_stewart@nymc.edu.
Jeffrey R BorisChildren's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Gisela ChelimskyMedical College of Wisconsin, Milwaukee, Wisconsin.
Phillip R FischerMayo Clinic, Rochester, Michigan.
John E FortunatoAnn and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
Blair P GrubbUniversity of Toledo Medical Center, Toledo, Ohio.
Geoffrey L HeyerNationwide Children's Hospital, Columbus, Ohio.
Imad T JarjourTexas Children's Hospital, Houston, Texas.
Marvin S MedowNew York Medical College, Valhalla, New York.
Mohammed T NumanUniversity of Texas Houston, Houston, Texas; and.
Paolo T PianosiMayo Clinic, Rochester, Michigan.
Wolfgang SingerMayo Clinic, Rochester, Michigan.
Sally TarbellChildren's Hospital of Colorado, Aurora, Colorado.
Thomas C ChelimskyMedical College of Wisconsin, Milwaukee, Wisconsin.
Pediatric Writing Group of the American Autonomic Society
Mayo Clinic in Florida · USMedical College of Wisconsin · USNew York Medical College · USChildren's Hospital of Philadelphia · USLurie Children's Hospital · USNationwide Children's Hospital · USTexas Children's Hospital · USUniversity of Colorado Denver · USUniversity of Houston · USUniversity of Toledo Medical Center · US

Funding

Synucleinopathies – Novel Targets in Early Diagnosis, Pathophysiology, and Therapeutic ApproachR01NS092625 · NINDS · MAYO CLINIC ROCHESTER · PI SINGER, WOLFGANG, VEMURI, PRASHANTHI · 2015 to 2025
$6.6M
Neurophysiologic & Autonomic Characterization of Interstitial Cystitis/Painful BlR01DK083538 · NIDDK · MEDICAL COLLEGE OF WISCONSIN · PI HELMS, ANN K · 2009 to 2020
$6.6M
Local Vasoconstriction in Postural Tachycardia SyndromeR01HL074873 · NHLBI · NEW YORK MEDICAL COLLEGE · PI STEWART, JULIAN M · 2004 to 2013
$3.4M
Cardiovagal baroreflex deficits impair neurovascular coupling and cognition in Postural Tachycardia SyndromeR01HL134674 · NHLBI · NEW YORK MEDICAL COLLEGE · PI STEWART, JULIAN M · 2017 to 2020
$2.5M
Mechanisms of Vasovagal SyncopeR01HL112736 · NHLBI · NEW YORK MEDICAL COLLEGE · PI STEWART, JULIAN M · 2013 to 2016
$2.1M
Differential Approach to the Postural Tachycardia SyndromeK23NS075141 · NINDS · MAYO CLINIC ROCHESTER · PI SINGER, WOLFGANG · 2012 to 2016
$872k
Reducing Orthostatic Intolerance with Oral Rehydration in Patients with Myalgic Encephalomyelitis/Chronic Fatigue SyndromeR21NS094644 · NINDS · NEW YORK MEDICAL COLLEGE · PI MEDOW, MARVIN S · 2016 to 2017
$451k
AHRQ HHS HHSA290201500013IFDA HHS R01 FD004789NHLBI NIH HHS R01 HL074873NHLBI NIH HHS R01 HL112736NHLBI NIH HHS R01 HL134674NIDDK NIH HHS R01 DK083538NINDS NIH HHS K23 NS075141NINDS NIH HHS R01 NS092625NINDS NIH HHS R21 NS094644
6 · The paper itself

Abstract

Orthostatic intolerance (OI), having difficulty tolerating an upright posture because of symptoms or signs that abate when returned to supine, is common in pediatrics. For example, ∼40% of people faint during their lives, half of whom faint during adolescence, and the peak age for first faint is 15 years. Because of this, we describe the most common forms of OI in pediatrics and distinguish between chronic and acute OI. These common forms of OI include initial orthostatic hypotension (which is a frequently seen benign condition in youngsters), true orthostatic hypotension (both neurogenic and nonneurogenic), vasovagal syncope, and postural tachycardia syndrome. We also describe the influences of chronic bed rest and rapid weight loss as aggravating factors and causes of OI. Presenting signs and symptoms are discussed as well as patient evaluation and testing modalities. Putative causes of OI, such as gravitational and exercise deconditioning, immune-mediated disease, mast cell activation, and central hypovolemia, are described as well as frequent comorbidities, such as joint hypermobility, anxiety, and gastrointestinal issues. The medical management of OI is considered, which includes both nonpharmacologic and pharmacologic approaches. Finally, we discuss the prognosis and long-term implications of OI and indicate future directions for research and patient management.

Indexed as

AdolescentAge FactorsChildFemaleHumansHypotension, OrthostaticIncidenceMaleOrthostatic IntolerancePediatricsPostural BalancePostural Orthostatic Tachycardia SyndromePrognosisRisk AssessmentSyncope, VasovagalTilt-Table Test

Identifiers

PMID29222399
PMCPMC5744271
OpenAlexW2771422290

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.