Abstract
To determine the efficacy and safety of intravenous (IV) labetalol in the management of hypertensive crisis in children. A retrospective chart review of 56 consecutive children (age > 1 mo to ≤12 y) with hypertensive crisis admitted to a pediatric intensive care unit (PICU) from July 2009 to 2019. The proportion of children attaining the primary endpoint (target 95th percentile in >12 to ≤48h) was significantly more in the group receiving labetalol as first-line or add-on (n = 23) as compared to those not receiving labetalol (n = 33) (62% vs. 30.3%, p = 0.03). Higher proportion of neurological recovery was seen in the labetalol group (56.2% vs. 18.7%, p = 0.02). The proportion of children with hypotension before 12h was similar in both treatment groups (13% vs. 15%, p = 0.82). The practice variations between two periods of 5y each (2009-2013 and 2014-2019) showed significantly more use of labetalol in the latter cohort (53% for 2014-2019 vs. 25% for 2009-2013, p = 0.03). Labetalol, when used alone or as an add-on drug, was more efficacious than IV nitroprusside/nitroglycerine in attaining the primary endpoint in children up to ≤12 y of age with hypertensive crisis. Labetalol was safe and associated with higher neurological recovery.
Published Version
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