Efficacy and Safety of Intravenous Labetalol in Acute Hypertensive Crisis in Children

Indian J Pediatr. 2022 Jan;89(1):7-12. doi: 10.1007/s12098-021-03707-7. Epub 2021 Apr 24.


Objective: To determine the efficacy and safety of intravenous (IV) labetalol in the management of hypertensive crisis in children.

Methods: A retrospective chart review of 56 consecutive children (age > 1 mo to ≤ 12 y) with hypertensive crisis admitted to a pediatric intensive care unit (PICU) from July 2009 to 2019.

Results: The proportion of children attaining the primary endpoint (target 95th percentile in > 12 to ≤ 48 h) was significantly more in the group receiving labetalol as first-line or add-on (n = 23) as compared to those not receiving labetalol (n = 33) (62% vs. 30.3%, p = 0.03). Higher proportion of neurological recovery was seen in the labetalol group (56.2% vs. 18.7%, p = 0.02). The proportion of children with hypotension before 12 h was similar in both treatment groups (13% vs. 15%, p = 0.82). The practice variations between two periods of 5 y each (2009-2013 and 2014-2019) showed significantly more use of labetalol in the latter cohort (53% for 2014-2019 vs. 25% for 2009-2013, p = 0.03).

Conclusion: Labetalol, when used alone or as an add-on drug, was more efficacious than IV nitroprusside/nitroglycerine in attaining the primary endpoint in children up to ≤ 12 y of age with hypertensive crisis. Labetalol was safe and associated with higher neurological recovery.

Keywords: Hypertensive crisis; Labetalol; Pediatric.

MeSH terms

  • Administration, Intravenous
  • Antihypertensive Agents / adverse effects
  • Blood Pressure
  • Child
  • Humans
  • Hypertension* / drug therapy
  • Labetalol* / adverse effects
  • Retrospective Studies


  • Antihypertensive Agents
  • Labetalol