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Left ventricle mass index in paediatric intensive care unit acquired hypertension

Published online by Cambridge University Press:  12 May 2023

Mostafa Mekki ,
HebatAllah Fadel Algebaly Open the ORCID record for HebatAllah Fadel Algebaly [Opens in a new window] ,
Hend Aly Sabry ,
Mohamed Samir  and
Hanaa Rady
Mostafa Mekki
Affiliation:
Department of Pediatric and Pediatric Intensive Care Unit, Cairo University, Cairo, Egypt
HebatAllah Fadel Algebaly*
Affiliation:
Department of Pediatric and Pediatric Intensive Care Unit, Cairo University, Cairo, Egypt
Hend Aly Sabry
Affiliation:
Department of Public Health, Cairo University, Cairo, Egypt
Mohamed Samir
Affiliation:
Department of Pediatric and Pediatric Cardiology Unit, Cairo University, Cairo, Egypt
Hanaa Rady
Affiliation:
Department of Pediatric and Pediatric Intensive Care Unit, Cairo University, Cairo, Egypt
*
Corresponding author: HebatAllah Fadel Algebaly, 11 Ali Basha Street, Manail, Egypt. E-mail: HebatAlah.gebaly@kasralainy.edu.eg
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Abstract

Background:

Hypertension acquired in paediatric critical patients is a recognised challenge, with variable reported frequency. Pain, agitation, and/or medications such as beta stimulants and corticosteroids are well-known risk factors. Sympathomimetics in septic patients can cause high blood pressure, especially with unobserved haemodynamic monitors. Beyond haemodynamic factors, several endocrinal-metabolic factors – including catecholamines, insulin, renin, angiotensin, the aldosterone system, and sodium consumption – may contribute to the left ventricular growth. It is well known that the sympathetic tone has a trophic effect on the heart muscle.

Method:

A prospective cohort study was conducted during the year 2021. The children were divided into two groups: those who were critically ill with paediatric intensive care unit-acquired hypertension (n = 59) and those without paediatric intensive care unit-acquired hypertension (n = 62). We used the American Academy of Pediatrics’ 2017 definition of hypertension to diagnose paediatric intensive care unit-acquired hypertension. Measurement of cardiac output and systemic vascular resistance was performed by cardiometry. Left ventricular myocardial performance and left ventricular mass index were measured by bedside echocardiography at the onset of hypertension diagnosis.

Results:

Critically ill children with acquired hypertension had a higher cardiac index (p = 0.0001), systemic vascular resistance index (<0.0001), myocardial performance (0.037), and left ventricular mass index (0.009). The longer duration of stay observed in the hypertension group had no observable effect on mortality (<0.0001).

Conclusion:

Both myocardial performance and left ventricle mass index increased in critically ill children with paediatric intensive care unit-acquired hypertension.

Keywords

PICUleft ventriclehypertentionn
Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 1 , January 2024 , pp. 56 - 61
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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