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Treatment of Post-Coarctectomy Hypertension With Labetalol-A 9-Year Single-Center Experience
Carolien Siersma1, Carole N M Brouwer1, Vladimir Sojak2
1Pediatric Intensive Care Unit, 4501Leiden University Medical Center, Leiden, the Netherlands.
Insights
Intravenous labetalol effectively treats post-coarctectomy hypertension in children. This beta-blocker is safe, fast-acting, and easily transitioned to oral medication if needed.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Clinical Pharmacology
Background:
- Post-coarctectomy hypertension is a known complication.
- Beta-blockers are theoretically effective but clinical experience with labetalol is limited.
Purpose of the Study:
- To evaluate the efficacy and safety of intravenous labetalol for managing post-coarctectomy hypertension in young children.
Main Methods:
- Retrospective analysis of data from children aged 6 years or younger undergoing coarctation repair.
- Comparison of outcomes between patients treated with intravenous labetalol and a control group.
Main Results:
- 45 patients received intravenous labetalol; 51 did not.
- Labetalol was effective in controlling hypertension, with no need for additional antihypertensives in treated patients.
- 48% of patients on IV labetalol were switched to oral therapy at discharge.
Conclusions:
- Intravenous labetalol is a safe, effective, and rapid treatment for hypertension after aortic coarctation repair.
- Labetalol facilitates easy conversion to oral therapy for continued management.
Background:
Although considering the pathophysiology of post-coarctectomy hypertension, β-blockers should be effective, experience with labetalol for treatment is limited in the literature.
Methods:
Retrospective collection and analysis of data in children aged ≤6 years following coarctectomy in our tertiary care university medical center between January 2009 and June 2018.
Results:
96 patients were included, 45 were treated with intravenous labetalol and 51 received no treatment. Median time to maximum dose received (median 1.1 mg/kg/h) was 2.7 h, and median time to the reduction of labetalol dose was 8.3 h. No antihypertensives had to be added. In one child, labetalol was switched to nitroprusside due to bronchoconstriction. Of patients receiving intravenous labetalol, 48% had been switched to oral labetalol at discharge.
Conclusions:
Intravenous labetalol is a fast, effective, and safe drug to treat hypertension following aortic coarctation repair. Labetalol is easily converted to oral therapy when the continuation of treatment is considered necessary.
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