Klugman Darren, Goswami Elizabeth S, Berger John T
1Department of Critical Care Medicine and Cardiology, Children's National Medical Center, Washington, DC. 2Department of Pharmacy, Riley Hospital for Children, Indianapolis, IN. 3Department of Pediatrics, Children's National Medical Center, Washington, DC.
Pediatr Crit Care Med. 2016 Mar;17(3 Suppl 1):S101-8. doi: 10.1097/PCC.0000000000000621.
Hypertension remains a common condition in pediatric cardiac intensive care. The physiologic effects of hypertension in this population are complex and are impacted by patient age, comorbidities, and primary cardiac disease. The objective of this study is to review current pharmacotherapies for the management of systemic hypertension in the pediatric cardiac ICU.
Relevant literature to the treatment of systemic hypertension in children was included. Specific focus was given to literature studying the use of therapies in critically ill children and those with heart disease. Reference textbooks and drug packaging inserts were used for drug-specific pediatric guidelines.
A search of MEDLINE, PubMed, and the Cochrane Database was performed to find literature about the management of hypertension in children. Metaanalyses and pediatric-specific studies were primarily considered and cross-referenced. Pertinent adult studies were included.
Once the studies for inclusion were finalized, priority for data extraction was given to pediatric-specific studies that focused on children with heart disease and critical illness.
Systemic hypertension is common, and there is significant heterogeneity in the patient population with critical heart disease. There are limited large, prospective analyses of safety and efficacy for pediatric drug antihypertensive agents. Despite patient heterogeneity, most pharmacotherapies are safe and efficacious.
高血压在小儿心脏重症监护中仍然是一种常见病症。高血压在该人群中的生理影响较为复杂，且受患者年龄、合并症及原发性心脏病的影响。本研究的目的是回顾小儿心脏重症监护病房中系统性高血压管理的当前药物治疗方法。
纳入了与儿童系统性高血压治疗相关的文献。特别关注研究在危重症儿童和患有心脏病儿童中使用治疗方法的文献。参考教科书和药品包装说明书用于特定药物的儿科指南。
对MEDLINE、PubMed和Cochrane数据库进行检索，以查找有关儿童高血压管理的文献。主要考虑并交叉引用荟萃分析和儿科特异性研究。纳入相关的成人研究。
一旦确定纳入研究，数据提取的重点是针对患有心脏病和危重症的儿童的儿科特异性研究。
系统性高血压很常见，患有严重心脏病的患者群体存在显著异质性。关于儿科抗高血压药物安全性和有效性的大型前瞻性分析有限。尽管患者存在异质性，但大多数药物治疗是安全有效的。
