Sodium nitroprusside treatment of severe arterial hypertension in children

Gordillo-Paniagua, G; L, Velásquez-Jones; Martini, R; Valdez-Bolaños, Eduardo

doi:10.1016/s0022-3476(75)80314-3

Cited by 50 publications

(6 citation statements)

References 13 publications

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“…This drug has been used for many years in the treatment of hypertensive crisis in children [68]. The dose can be titrated effectively and rapidly.…”

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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“…This drug has been used for many years in the treatment of hypertensive crisis in children [68]. The dose can be titrated effectively and rapidly.…”

Section: Management Of Hypertensive Crisismentioning

confidence: 99%

Hypertensive crisis in children

Chandar

Zilleruelo

2011

Pediatr Nephrol

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“…Older case studies and series suggest rapid response with improved BP and a low incidence of complications. 50 , 51 Extended use and use with concomitant renal or liver dysfunction is generally avoided due to the risk for toxic metabolite accumulation, particularly cyanide and thiocyanate. Encouragingly, recent studies have evaluated nitroprusside use in children in a more rigorous manner.…”

Section: Medicationsmentioning

confidence: 99%

Evaluation and treatment of hypertensive crises in children

Stein

Ferguson

2016

IBPC

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Hypertensive crises in children are medical emergencies that must be identified, evaluated, and treated promptly and appropriately to prevent end-organ injury and even death. Treatment in the acute setting typically includes continuous intravenous antihypertensive medications with monitoring in the intensive care unit setting. Medications commonly used to treat severe hypertension have been poorly studied in children. Dosing guidelines are available, although few pediatric-specific trials have been conducted to facilitate evidence-based therapy. Regardless of what medication is used, blood pressure should be lowered gradually to allow for accommodation of autoregulatory mechanisms and to prevent cerebral ischemia. Determining the underlying cause of the blood pressure elevation may be helpful in guiding therapy.

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“…Its offset is equally as rapid as BP returns to baseline values generally within 3–5 minutes following discontinuation of the infusion. In many centers, SNP remains the time-honored therapy for the rapid control of acute hypertension in the pediatric population [6]. However, given the paucity of data regarding the use of this agent in children and the lack of safety and pharmacokinetic information, it may be that SNP popularity merely relates to introduction in 1955 when there were limited options for the pharmacologic control of BP.…”

Section: Agents For Blood Pressure Controlmentioning

confidence: 99%

Clevidipine for Perioperative Blood Pressure Control in Infants and Children

2013

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Various pharmacologic agents have been used for perioperative BP control in pediatric patients, including sodium nitroprusside, nitroglycerin, β-adrenergic antagonists, fenoldopam, and calcium channel antagonists. Of the calcium antagonists, the majority of the clinical experience remains with the dihydropyridine nicardipine. Clevidipine is a short-acting, intravenous calcium channel antagonist of the dihydropyridine class. It undergoes rapid metabolism by non-specific blood and tissue esterases with a half-life of less than 1 minute. As a dihydropyridine, its cellular and end-organ effects parallel those of nicardipine. The clevidipine trials in the adult population have demonstrated efficacy in rapidly controlling BP in various clinical scenarios with a favorable adverse effect profile similar to nicardipine. Data from large clinical trials regarding the safety and efficacy of clevidipine in children is lacking. This manuscript aims to review the commonly used pharmacologic agents for perioperative BP control in children, discuss the role of calcium channel antagonists such as nicardipine, and outline the preliminary data regarding clevidipine in the pediatric population.

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Sodium nitroprusside treatment of severe arterial hypertension in children

Cited by 50 publications

References 13 publications

Hypertensive crisis in children

Hypertensive crisis in children

Evaluation and treatment of hypertensive crises in children

Clevidipine for Perioperative Blood Pressure Control in Infants and Children

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