Safety and efficacy of intravenous labetalol for hypertensive crisis in infants and small children
- 1 January 2011
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Pediatric Critical Care Medicine
- Vol. 12 (1), 28-32
- https://doi.org/10.1097/pcc.0b013e3181e328d8
Abstract
To determine the efficacy and safety of labetalol for hypertensive crisis in children ≤ 24 months of age. Retrospective chart review. Statistical analysis utilized analysis of variance for continuous data, chi-square tests for nominal data, and linear regression. A 737-bed pediatric teaching institution. Twenty-seven patients ≤ 24 months of age were treated with 37 intravenous infusions of labetalol, nicardipine, or nitroprusside for hypertensive crisis or hypertensive urgency. None. The primary end point consisted of time to 20% reduction in systolic blood pressure. Primary safety end points measured the prevalence of deleterious effects of labetalol. Continuous infusion of labetalol reduced mean systolic blood pressure by at least 20% in < 8 hrs. This effect was similar to nicardipine and nitroprusside infusions. The reported side effects were similar in each group. Patients receiving labetalol and presenting with ischemic or traumatic brain injury were likely to develop hypotension requiring infusion discontinuation. Continuous intravenous labetalol infusion is efficacious for treatment of hypertensive crisis in children ≤ 24 months of age. Aside from patients presenting with ischemic or traumatic brain injury, labetalol was safe to use in this population for hypertensive emergencies and had a satisfactory adverse effect profile. Labetalol may reach dose saturation at a much lower dose in young children in comparison to adults. Clinicians should use caution when initiating labetalol infusions in young patients with brain injury.Keywords
This publication has 18 references indexed in Scilit:
- Severe hypertension in children and adolescents: pathophysiology and treatmentPediatric Nephrology, 2009
- Advances in the pathogenesis and management of hypertensive crisisCurrent Opinion in Pediatrics, 2005
- Nicardipine versus Nitroprusside Infusion as Antihypertensive Therapy in Hypertensive EmergenciesJournal of International Medical Research, 2004
- Intravenous nicardipine for treatment of severe hypertension in childrenThe Journal of Pediatrics, 2001
- Intravenous nicardipine as a first-line antihypertensive drug in neonatesIntensive Care Medicine, 2000
- The Diagnosis and Management of Hypertensive CrisesSocial psychiatry. Sozialpsychiatrie. Psychiatrie sociale, 2000
- Nicardipine is a safe and effective agent in pediatric hypertensive emergenciesAmerican Journal of Kidney Diseases, 2000
- Neonatal hypertension: diagnosis and managementPediatric Nephrology, 2000
- Treatment of Pediatric HypertensionPharmacotherapy: The Journal of Human Pharmacology and Drug Therapy, 2000
- Management of hypertensive emergencies.Archives of Disease in Childhood, 1992