Intravenously administered labetalol for treatment of hypertension in children

Bunchman, Timothy E.; Lynch, Robert E.; Wood, Ellen G.

doi:10.1016/s0022-3476(05)80619-5

Cited by 49 publications

(20 citation statements)

References 22 publications

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“…It should also be used with caution in children with diabetes. Caution should also be exercised in children with brain injury as they are more likely to develop hypotension [62,63]. Labetalol has the potential to worsen hyperkalemia, and this has to be considered in children with impaired kidney function.…”

Section: Management Of Hypertensive Crisismentioning

confidence: 99%

Hypertensive crisis in children

Chandar

Zilleruelo

2011

Pediatr Nephrol

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Hypertensive crisis is rare in children and is usually secondary to an underlying disease. There is strong evidence that the renin-angiotensin system plays an important role in the genesis of hypertensive crisis. An important principle in the management of children with hypertensive crisis is to determine if severe hypertension is chronic, acute, or acute-on-chronic. When it is associated with signs of end-organ damage such as encephalopathy, congestive cardiac failure or renal failure, there is an emergent need to lower blood pressures to 25-30% of the original value and then accomplish a gradual reduction in blood pressure. Precipitous drops in blood pressure can result in impairment of perfusion of vital organs. Medications commonly used to treat hypertensive crisis in children are nicardipine, labetalol and sodium nitroprusside. In this review, we discuss the pathophysiology, differential diagnosis and recent developments in management of hypertensive crisis in children.

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Section: Management Of Hypertensive Crisismentioning

confidence: 99%

Hypertensive crisis in children

Chandar

Zilleruelo

2011

Pediatr Nephrol

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“…Administered intravenously, it is this vasodilatation which accounts for labetalol's efficacy in the treatment of severe hypertension. The hypotensive effects of a single dose of intravenous labetalol appear within 2-5 min after administration, peak at 5-15 min, and last up to 2-4 h. Intravenously administered labetalol has been extensively studied in adults with severe hypertension [37], and case series of successful use in children with severe hypertension have been published [5,38]. Adverse reactions are those expected from a beta-adrenergic blocker, including bradycardia and bronchospasm.…”

Section: Intravenous Agents Currently Used In Children With Severe Hymentioning

confidence: 99%

Severe hypertension in children and adolescents: pathophysiology and treatment

2009

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Severe, symptomatic hypertension occurs uncommonly in children, usually only in those with underlying congenital or acquired renal disease. If such hypertension has been long-standing, then rapid blood pressure reduction may be risky due to altered cerebral hemodynamics. While many drugs are available for the treatment of severe hypertension in adults, few have been studied in children. Despite the lack of scientific studies, some agents, particularly continuous intravenous infusions of nicardipine and labetalol, are preferred in many centers. These agents generally provide the ability to control the magnitude and rapidity of blood pressure reduction and should--in conjunction with careful patient monitoring--allow the safe reduction of blood pressure and the avoidance of complications. This review provides a summary of the underlying causes and pathophysiology of acute severe hypertension in childhood as well as a detailed discussion of drug treatment and the optimal clinical approach to managing children and adolescents with acute severe hypertension.

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“…It has a relatively slow onset of action (5-10 min), and hypotension can last for up to 4 h [17]. Despite its wide use in hypertensive emergencies in children, published informations are very limited and mainly based on small retrospective trials and case reports [18][19][20][21][22][23][24][25].…”

Section: Resultsmentioning

confidence: 99%