Eight preterm infants were given intravenous nicardipine, a calcium channel blocker, to treat systemic hypertension (renal artery thrombosis (n=3); dexamethasone for management of bronchopulmonary dysplasia (n=2); unexplained (n=3)). Nicardipine doses ranged from 0.5 to 2.0 µg/kg/min and were given for three to 36 days (mean (SD) 15.9 (10.3) days). Systolic blood pressure had significantly decreased after 12 and 24 hours of nicardipine treatment (-17 (17)% and -21 (10) %, respectively). Diastolic blood pressure significantly decreased after 24 hours of treatment (-22 ± 16%). The decrease in blood pressure remained significant over the subsequent days of treatment. No hypotension or other clinical side eVects were observed.It is concluded that intravenous nicardipine could be a first line treatment for hypertension in preterm infants. (Arch Dis Child 1997;76:F126-F127) Keywords: nicardipine; hypertension; blood pressure.The incidence of neonatal hypertension in neonatal intensive care units is reported to be between 0.7 to 3.2%.1 Data on the use of antihypertensive drugs in neonates, particularly preterm infants, are scarce. The most eYcacious antihypertensive drugs, such as diazoxide, sodium nitroprusside, blockers and angiotensin-converting enzyme inhibitors, may all induce severe side eVects.1-3 Moreover, the eYcacy and safety of these drugs have not been systematically reported in preterm infants who may be particularly sensitive to antihypertensive agents as has been observed with angiotensinconverting enzyme inhibitors. established that continuous infusion of nicardipine (1 µg/kg/min) was eVective and safe in 14 hypertensive children including seven term neonates (personal communication). To our knowledge, no other data on the use of nicardipine in hypertensive newborn infants have been published. We therefore report our experience of nicardipine administration in eight hypertensive preterm infants. MethodsEight preterm infants were given intravenous nicardipine. For all patients, systolic and/or diastolic blood pressures were above the mean + 2 standard deviations for gestational age and postnatal age, according to normative values of blood pressure.1 Arterial hypertension was the result of renal artery thrombosis (n=3), dexamethasone administration for management of bronchopulmonary dysplasia (n=2), or remained unexplained (n=3).Blood pressure and cardiac frequency were measured using an automatic oscillometric blood pressure monitoring device (Dinamap, Critikon Inc. Tampa, Florida) when the newborn infants were quiet or asleep. These variables were recorded at least four times daily over the two days before the onset of treatment and every day throughout the treatment period. Moreover, these variables were recorded in the hour preceding the onset of nicardipine infusion and at three, six, 12 and 24 hours after treatment had started.The initial infusion rate of nicardipine was 0.5 µg/kg/min (n=2) or 1.7 µg/kg/min (n=6). The infusion rate was modified according to therapeutic response (that is, ...

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