Vasodilators and hypertensive encephalopathy following scorpion envenomation in children
Chest
|January 1, 1990
Insights
Severe hypertension in children after scorpion stings is common. Most cases resolve with sedatives, but severe instances benefit from prompt antihypertensive therapy with hydralazine and nifedipine.
Area of Science:
- Pediatric Intensive Care
- Toxicology
- Cardiovascular Pharmacology
Background:
- Scorpion envenomation frequently causes severe hypertension in pediatric patients.
- Hypertension management in pediatric intensive care units (PICUs) requires specific protocols.
Purpose of the Study:
- To evaluate the efficacy of analgesics, sedatives, and specific antihypertensive agents in managing severe hypertension secondary to scorpion envenomation in children.
- To determine the safety and effectiveness of hydralazine and nifedipine in treating refractory hypertension in pediatric scorpion sting cases.
Main Methods:
- Retrospective analysis of 23 children admitted to a PICU for scorpion envenomation with severe hypertension.
- Assessment of response to initial treatment with analgesics and sedatives.
- Evaluation of outcomes following administration of intravenous hydralazine and sublingual nifedipine in non-responsive cases.
Main Results:
- Fifteen out of 23 children (65%) experienced hypertension that responded to analgesics and sedatives.
- The remaining eight children required specific antihypertensive therapy.
- Intravenous hydralazine and sublingual nifedipine effectively controlled hypertension in these eight children, with one instance of rebound hypertension.
Conclusions:
- Hypertension is a significant and frequent complication of scorpion stings in the pediatric population.
- Specific antihypertensive therapy, including hydralazine and nifedipine, is indicated and effective for severe cases of hypertension following scorpion envenomation in children.
- Hydralazine and nifedipine demonstrate a favorable safety profile in this pediatric cohort.
Abstract:
Twenty-three children were admitted to a pediatric intensive care unit for scorpion envenomation with severe hypertension. The hypertension responded to analgesics and sedatives in 15 (65 percent) of the 23. The remaining eight children required specific antihypertensive therapy, and their condition promptly responded to intravenous hydralazine and sublingual nifedipine; rebound hypertension was observed in one. Hypertension is a frequent complication of a scorpion's sting in children, and specific antihypertensive therapy is indicated in severe cases. Hydralazine and nifedipine are effective and safe in such instances.
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