Safety and efficacy of intravenous labetalol for hypertensive crisis in infants and small children

Thomas, Christopher; Moffett, Brady S.; Wagner, Jeffrey L.; Mott, Antonio R.; Feig, Daniel I.

doi:10.1097/pcc.0b013e3181e328d8

Cited by 54 publications

(24 citation statements)

References 19 publications

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“…Our experience [114] and that of others [115] suggest that infusions of the calcium channel blocker nicardipine may be particularly useful in infants with acute severe hypertension. Other drugs that have been successfully used in neonates include esmolol [116], labetalol [117], and nitroprusside [118]. Oral agents in general are probably not appropriate given their variable onset and duration of effect and unpredictable antihypertensive response [112].…”

Section: Therapymentioning

confidence: 99%

Hypertension in infancy: diagnosis, management and outcome

2011

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Advances in the ability to identify, evaluate, and care for infants with hypertension, coupled with advances in the practice of Neonatology, have led to an increased awareness of hypertension in modern neonatal intensive care units. This review will present updated data on blood pressure values in neonates, with a focus on the changes that occur over the first days and weeks of life in both term and preterm infants. Optimal blood pressure measurement techniques as well as the differential diagnosis of hypertension in the neonate and older infants will be discussed. Recommendations for the optimal immediate and long-term evaluation and treatment, including potential treatment parameters, will be presented. We will also review additional information on outcome that has become available over the past decade.

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Section: Therapymentioning

confidence: 99%

Hypertension in infancy: diagnosis, management and outcome

2011

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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: 98%

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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“…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%