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Pharmacologic Control of Blood Pressure in Infants and Children

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Abstract

Alterations in blood pressure are common during the perioperative period in infants and children. Perioperative hypertension may be the result of renal failure, volume overload, or activation of the sympathetic nervous system. Concerns regarding end-organ effects or postoperative bleeding may mandate regulation of blood pressure. During the perioperative period, various pharmacologic agents have been used for blood pressure control including sodium nitroprusside, nitroglycerin, β-adrenergic antagonists, fenoldopam, and calcium channel antagonists. The following manuscript outlines the commonly used pharmacologic agents for perioperative BP including dosing regimens and adverse effect profiles. Previously published clinical trials are discussed and efficacy in the perioperative period reviewed.

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Abbreviations

BP:

Blood pressure

CH:

Controlled hypotension

CHD:

Congenital heart disease

CN:

Cyanide

CNS:

Central nervous system

CPB:

Cardiopulmonary bypass

CV:

Cardiovascular

GMP:

Guanosine 3′,5′-cyclic monophosphate

HPV:

Hypoxic-pulmonary vasoconstriction

HR:

Heart rate

ICP:

Intracranial pressure

ICU:

Intensive care unit

MAP:

Mean arterial pressure

NO:

Nitric oxide

NTG:

Nitroglycerin

SNP:

Sodium nitroprusside

SVR:

Systemic vascular resistance

TBI:

Traumatic brain injury

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Authors and Affiliations

  1. Departments of Anesthesiology & Pain Medicine, Nationwide Children’s Hospital and The Ohio State University, 700 Children’s Drive, Columbus, OH, 43205, USA

    Joseph D. Tobias & Aymen Naguib

  2. Department of Pediatrics and Division of Pediatric Cardiology, Nationwide Children’s Hospital and The Ohio State University, Columbus, OH, USA

    Janet Simsic & Catherine D. Krawczeski

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  1. Joseph D. Tobias
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Tobias, J.D., Naguib, A., Simsic, J. et al. Pharmacologic Control of Blood Pressure in Infants and Children. Pediatr Cardiol 41, 1301–1318 (2020). https://doi.org/10.1007/s00246-020-02448-2

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  • DOI: https://doi.org/10.1007/s00246-020-02448-2

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