PMID: 9576226May 12, 1998Paper

Esmolol for the management of pediatric hypertension after cardiac operations

The Journal of Thoracic and Cardiovascular Surgery
Donald B WiestR M Sade

Abstract

Hypertension frequently occurs during the immediate postoperative period in children after repair of aortic coarctation but may also occur after repair of other congenital heart defects. Nitroprusside has often been used to control blood pressure in this setting. Because hypertension after coarctation repair is frequently associated with elevations in catecholamines, esmolol, a short-acting beta-blocking agent, may be an effective alternative. Therefore we undertook the first systematic investigation to determine the efficacy and disposition of esmolol in pediatric patients with acute hypertension after cardiac operations. Twenty patients aged 1 month to 12 years (median 25.6 months) with acute hypertension after cardiac operations received esmolol in an opened-labeled trial. Esmolol was titrated to a blood pressure less than or equal to the 90th percentile for age. Ten patients had coarctation repair and the remaining patients underwent repair of other congenital heart defects. On final esmolol dose (mean +/- standard deviation dosage 700 +/- 232 microg/kg/min) there was a significant percent decrease in heart rate and systolic and diastolic blood pressures from postoperative values. Esmolol dose was significantly associated w...Continue Reading

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Related Concepts

Esmolol hydrochloride
Adrenergic beta-Antagonists
Coarctation of Aorta Dominant
Dose-Response Relationship, Drug
Congenital Heart Defects
Hypertensive Disease
Postoperative Complications
Propanolamines

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