Treatment Strategies for Paradoxical Hypertension Following Surgical Correction of Coarctation of the Aorta in Children

World Journal for Pediatric & Congenital Heart Surgery
Peter P Roeleveld, Eline G Zwijsen

Abstract

Paradoxical hypertension after repair of coarctation of the aorta is a well-known phenomenon. The pathogenesis involves the activation of the sympathetic nervous system (first phase) and renin-angiotensin system (second phase). Only a limited number of different treatment strategies have been published in the literature, without any comparative studies. Our aim was to describe the current international practice variation surrounding pharmacological treatment currently being employed to treat paradoxical hypertension following the repair of coarctation of the aorta in children. We performed an online survey among 197 members of the Pediatric Cardiac Intensive Care Society. We also conducted a systematic review of the literature regarding the treatment of paradoxical hypertension. Eighty-eight people (45%), from 62 different centers, responded and answered the questions regarding blood pressure control. Nitroprusside is the first drug of choice for initial blood pressure control in 66% of respondents, esmolol in 11%, labetalol in 11%, and angiotensin-converting enzyme inhibitors (ACEIs) are used by 3% of respondents. For oral blood pressure control after discharge from the pediatric intensive care unit, 75% of respondents use ACE...Continue Reading

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Citations

Oct 2, 2019·Pediatrics International : Official Journal of the Japan Pediatric Society·Vishal R KaleyJoseph J Vettukattil
Dec 1, 2020·Journal of Vascular Surgery Cases and Innovative Techniques·Fei JintaoMa Wei

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Methods Mentioned

BETA
sedation

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