Acute, severe hypertension will require careful monitoring in a paediatric ICU and treatment with drugs shown in Table 11.8.
Dosing schedules of many hypertensive drugs have not been evaluated in children. The favoured combination is a beta-adrenergic blocker with a vasodilator. A diuretic can be used if BP is still not controlled. ACE inhibi-tors should be avoided if renal artery stenosis is suspected but are useful for renin-mediated hypertension. Phentolamine is used if catecholamine-induced hypertension is suspected, e.g. phaeochromocytoma.