1596 HYPERTENSION IN BABIES FOLLOWING DISCHARGE FROM NEONATAL INTENSIVE CARE UNIT (ICU)

Abstract

We followed 17 babies who were found to have elevated blood pressure (BP) at or after discharge from neonatal ICU (systolic BP > 115 mm Hg, repeated 3 times under quiet conditions); babies with hypertension during their stay were excluded. All 17 babies had nursery stays longer than 48 hr. Follow-up was 6 months to 3½ years. Five babies had the following secondary diagnoses: 2 UPJ obstruction, 1 coarctation of the aorta, 1 neuroblastoma and 1 renal artery thrombosis. Five babies had umbilical artery catheters (UAC) for more than 24 hours; three of these babies are included in the group with secondary diagnoses. Thus, 10 babies developed hypertension without obvious cause. Sex, age of gestation, type of feeding, ventilator use or antibiotic use, proved insignificant. Sixteen of 17 babies were treated with 1-2 mg/kg/day of propranolol and/or 10-20 mg/kg/day of chlorthiazide. All children older than 2 years were off medication and were normotensive.We conclude: 1) follow-up of babies discharged from neonatal ICU should include careful BP measurements; 2) high BP may develop in babies who have not had prolonged use of UAC; 3) even when no secondary cause can be elucidated, hypertension responds to medication; 4) further study is needed to determine if babies discharged from neonatal ICU are at high risk for elevated BP and to determine the natural history, prognosis and best form of treatment for these babies.