Management of Hypertensive Crises in Children: A Review of the Recent Literature

Abstract

Hypertensive emergency is a life-threatening condition associated with severe hypertension and organ damage, such as neurological, renal or cardiac dysfunction. The most recent guidelines on pediatric hypertension, the 2016 European guidelines and the 2017 American guidelines, provide recommendations on the management of hypertensive emergencies, however in pediatric age robust literature is lacking and the available evidence often derives from studies conducted in adults. We reviewed PubMed and Cochrane Library from January 2017 to July 2021, using the following search terms: “hypertension” AND “treatment” AND (“emergency” OR “urgency”) to identify the studies. Five studies were analyzed, according to our including criteria. According to the articles reviewed in this work, beta-blockers seem to be safe and effective in hypertensive crises, more than sodium nitroprusside, although limited data are available. Indeed, calcium-channel blockers seem to be effective and safe, in particular the use of clevidipine during the neonatal age, although limited studies are available. However, further studies should be warranted to define a univocal approach to pediatric hypertensive emergencies.

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“…Como la HTA es por hipervolemia deben administrarse diuréticos de acción rápida como la furosemida vía endovenosa asociada a un vasodilatador si no hay respuesta. En caso de insuficiencia renal, de no presentar diuresis y de no lograrse la disminución de la PA estaría indicada la (19) diálisis . El uso del nitroprusiato de sodio está discutido y debe ser utilizado con cautela en pacientes con falla renal por la acumulación de En esta serie la EH se presentó con una alta frecuencia, dado que el 16,8% de los pacientes la presentaron.…”

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