Phentolamine continuous infusion in a pediatric patient with uncontrolled hypertension.
Am J Health Syst Pharm
; 78(13): 1195-1199, 2021 06 23.
Article
in English
| MEDLINE | ID: covidwho-1153110
ABSTRACT
PURPOSE:
A case of uncontrolled hypertension nonresponsive to traditional pharmacologic management in a pediatric patient with a ventricular assist device awaiting a heart transplant is reported.SUMMARY:
A 4-month-old male in heart failure was experiencing uncontrolled hypertension. Because of a lack of hemodynamic stability, he was unable to be listed as a heart transplant candidate. He received multiple antihypertensive agents (calcium channel blockers, ß-blockers, and direct-acting vasodilators) as both intermittent and continuous infusions over the course of several days without achieving normotension. The decision was then made to administer intravenous phentolamine as a continuous infusion to pursue a different mechanism than with traditional antihypertensive agents to achieve hemodynamic stability. Within 8 hours of initiation of the continuous phentolamine infusion, the patient became normotensive and was listed for a heart transplant. The continuous phentolamine infusion was administered over the next 4 days to maintain normotension, and on day 4 the patient underwent successful orthotopic heart transplantation.CONCLUSION:
A 4-month-old male in heart failure with a ventricular assist device, experiencing uncontrolled hypertension nonresponsive to traditional pharmacologic management, was successfully treated with a continuous intravenous infusion of phentolamine.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Heart-Assist Devices
/
Heart Transplantation
/
Heart Failure
/
Hypertension
Type of study:
Case report
/
Prognostic study
Limits:
Child
/
Humans
/
Infant
/
Male
Language:
English
Journal:
Am J Health Syst Pharm
Journal subject:
Pharmacy
/
Hospitals
Year:
2021
Document Type:
Article
Affiliation country:
Ajhp
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