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Labetalol infusion for refractory hypertension causing severe hypotension and bradycardia: an issue of patient safety

Incremental doses of intravenous labetalol are safe and effective and, at times, such therapy may need to be augmented by a continuous infusion of labetalol to control severe hypertension. Continuous infusions of labetalol may exceed the recommended maximum daily dose of 300 mg on occasion. We repor...

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Detalles Bibliográficos
Autores principales: Fahed, Samir, Grum, Daniel F, Papadimos, Thomas J
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2429901/
https://www.ncbi.nlm.nih.gov/pubmed/18505576
http://dx.doi.org/10.1186/1754-9493-2-13
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author Fahed, Samir
Grum, Daniel F
Papadimos, Thomas J
author_facet Fahed, Samir
Grum, Daniel F
Papadimos, Thomas J
author_sort Fahed, Samir
collection PubMed
description Incremental doses of intravenous labetalol are safe and effective and, at times, such therapy may need to be augmented by a continuous infusion of labetalol to control severe hypertension. Continuous infusions of labetalol may exceed the recommended maximum daily dose of 300 mg on occasion. We report a case in which hypertension occurring after an abdominal aortic aneurysm repair, initially responsive to intermittent intravenous beta-blockade, became resistant to this therapy leading to the choice of an intravenous labetalol infusion as the therapeutic option. The labetalol infusion resulted in a profound cardiovascular compromise in this postoperative critically ill patient. While infusions of labetalol have successfully been used, prolonged administration in the intensive care unit requires vigilance and the establishment of a therapeutic rationale/policy for interventions, such as the ready availability of glucagon, β-agonists, phosphodiesterase inhibitors, insulin, and vasopressin when severe cardiovascular depression occurs.
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spelling pubmed-24299012008-06-14 Labetalol infusion for refractory hypertension causing severe hypotension and bradycardia: an issue of patient safety Fahed, Samir Grum, Daniel F Papadimos, Thomas J Patient Saf Surg Case Report Incremental doses of intravenous labetalol are safe and effective and, at times, such therapy may need to be augmented by a continuous infusion of labetalol to control severe hypertension. Continuous infusions of labetalol may exceed the recommended maximum daily dose of 300 mg on occasion. We report a case in which hypertension occurring after an abdominal aortic aneurysm repair, initially responsive to intermittent intravenous beta-blockade, became resistant to this therapy leading to the choice of an intravenous labetalol infusion as the therapeutic option. The labetalol infusion resulted in a profound cardiovascular compromise in this postoperative critically ill patient. While infusions of labetalol have successfully been used, prolonged administration in the intensive care unit requires vigilance and the establishment of a therapeutic rationale/policy for interventions, such as the ready availability of glucagon, β-agonists, phosphodiesterase inhibitors, insulin, and vasopressin when severe cardiovascular depression occurs. BioMed Central 2008-05-27 /pmc/articles/PMC2429901/ /pubmed/18505576 http://dx.doi.org/10.1186/1754-9493-2-13 Text en Copyright © 2008 Fahed et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Fahed, Samir
Grum, Daniel F
Papadimos, Thomas J
Labetalol infusion for refractory hypertension causing severe hypotension and bradycardia: an issue of patient safety
title Labetalol infusion for refractory hypertension causing severe hypotension and bradycardia: an issue of patient safety
title_full Labetalol infusion for refractory hypertension causing severe hypotension and bradycardia: an issue of patient safety
title_fullStr Labetalol infusion for refractory hypertension causing severe hypotension and bradycardia: an issue of patient safety
title_full_unstemmed Labetalol infusion for refractory hypertension causing severe hypotension and bradycardia: an issue of patient safety
title_short Labetalol infusion for refractory hypertension causing severe hypotension and bradycardia: an issue of patient safety
title_sort labetalol infusion for refractory hypertension causing severe hypotension and bradycardia: an issue of patient safety
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2429901/
https://www.ncbi.nlm.nih.gov/pubmed/18505576
http://dx.doi.org/10.1186/1754-9493-2-13
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