The effect of clonidine drip in hypertensive crisis in children

H. Alatas, Huda Farida, I. G.N. Wila Wirya, T. Tambunan, Partini P. Trihono

Research output: Contribution to journalArticlepeer-review

Abstract

Clonidine drip was given to 17 patients with hypertensive crisis (9 cases showed hypertensive encephalopathy) admitted to the Department of Child Health of the Cipto Mangunkusumo Hospital during a 3-year perod (March 1990 until February 1993). Various etiologies of the hypertension were encountered: 7 cases were due to acute glomerulonephritis, 4 with chronic renal failure, 2 complicated urinary tract infection, 1 Takayasu's disease, 1 viral meningitis, 1 acute cardiac decompensation (rheumatic heart disease) and 1 of unknown etiology. Clonidine was administered by titration with an initial dose of 0.002 mg/kgBW every 8 hours in a 100 ml 5% dextrosa solution, together with furosemide 1 mg/kgBW given every 8 hours intravenously. The drip was increases every 1/2 hour until the diastolic pressure decreased to less than 100 mmHg or the mean arterial pressure (MAP) reached less than 93 mmHg. The maximal dose of clinidine was 0.006 mg/kgBW/8 hours. If no reduction in diastolic pressure was obtained until the maximal dose was reached, captopril was supplemented orally. The age of the children was between 5-13 years (mean age 9 7/12), comprising of 9 boys and 8 girls. The results of treatment showed that blood pressure decreased in 4 cases (23,5%) after 30 minutes, 5 cases (29,5%) after 1 hour, 7 cases (41.2%) after 3 hours, 11 cases (64.7%) after 6 hours, 14 cases (82.3%) after 12 hours while in 3 cases (17.6%) it decreased after 24 hours of clonidine administration. The clonidine dosage used in this study was 0,002 mg/kgBW in 3 cases (17,6%), 0,004 mg/kgBW in 4 cases (23.5%) and 0.006 mg/kgBW in 10 cases (58.9%). Captopril was added orally in only 1 case. The onset of effect upon the blood pressure was 30 minutes after clonidine administration. After 6 hours of administration the systolic blood pressure decreased 24.3% the diastolic blood pressure 27% and MAP 29.7%. Within 24 hours 14 out of 17 cases showed a decrease in diastolic blood pressure less than lOOmmHg. No obvious side effect was detected during the study. In conclusion clinidine drip showed a promising effect in the treatment of hypertensive crisis in children.

Original languageEnglish
Pages (from-to)226-230
Number of pages5
JournalMedical Journal of Indonesia
Volume3
Issue number4
DOIs
Publication statusPublished - 1 Oct 1994

Keywords

  • Clonidine drip
  • Hypertensive crisis
  • Hypertensive encephalopathy

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