78 - Acute severe hypertension

Abstract

Acute severe hypertension is a potential medical emergency that needs to be addressed immediately. This chapter outlines the approach to such patients in the pediatric intensive care unit. After a brief evaluation of the possible etiology, antihypertensive treatment should be initiated. This is mostly done with intravenous agents, of which a number of options exist, albeit many not well studied in children. The intensivist needs a heightened awareness for factors that predispose children to severe hypertensive events as well as an understanding of the clinical symptoms that may reflect end-organ damage from critically high blood pressure.