Clinical characteristics of hypertension in burned children

Although systemic arterial hypertension has been recognized as a common complication of thermal injury in children, its clinical characteristics have not been defined. This review of 987 burned children, treated over an 11-year period, documents development of hypertension in 195 patients (19.8%). The problem occurs most frequently in males and in the 7--10-year age group, but does not correlate with racial origin. Incidence increases with burn severity up to a 40% total surface burn. The incidence did not vary with the year of treatment when changes in patient population were eliminated. Fifteen of the 195 patients had hypertensive encephalopathy and seizure problems. No other complication or change in mortality could be related to hypertension. The problem could not be related to location of the burn wound, drug treatment, or differences in transfusion and fluid therapy. Comparison of the highest daily blood pressure measurements between matched hypertensive and normotensive groups demonstrated that the hypertensive and normotensive groups demonstrated that the hypertension is limited to the acute phase of burn wound treatment and that blood pressures are normal after complete autografting. The encephalopathy and seizure problems indicate the need for careful blood pressure monitoring and effective antihypertensive therapy in the treatment of burned children.