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Hypotension In Infants

WHAT YOU SHOULD KNOW:

Hypotension is low blood pressure (BP) in your infant. Low blood pressure can prevent your infant's organs from getting enough blood and oxygen to work well.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

RISKS:

  • IV medicines may leak and cause skin and tissue damage. Too much IV liquid may lead to heart or lung problems. Tubes placed in your infant's blood vessels may cause a blood infection or blood clots. Blood clots can cause pain and swelling, and can stop blood from flowing where it needs to go in your infant's body. The clot may travel to your infant's heart or brain and cause life-threatening problems, such as a heart attack or stroke. Even with treatment, your infant's hypotension may not improve, causing poor blood flow to his organs. This may be life-threatening.

  • Without treatment, hypotension can decrease the blood flow to your infant's organs. Poor organ blood flow can cause the organs to stop working. Poor blood flow to your child's brain may cause brain damage. Hypotension that is not treated may be life-threatening.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.

IV:

An IV is a tiny tube placed in your infant's vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid.

Oxygen:

Your infant may need oxygen to help him breathe more easily. He may need a nasal cannula (small tubes placed in the nose) or mask. Some infants are placed in an oxygen tent or plastic hood. Do not take off your infant's oxygen without asking his caregiver first.

Monitoring:

  • Vital signs: This includes taking your infant's temperature, blood pressure, pulse (counting his heartbeat), and respirations (counting his breaths). Caregivers may listen to your infant's heart and lungs by using a stethoscope. Your infant's vital signs are taken so caregivers can see how he is doing.

  • Pulse oximeter: A pulse oximeter is a machine that tells caregivers how much oxygen is in your infant's blood. A cord with a clip or sticky strip is placed on your infant's foot, toe, hand, finger, or earlobe. The other end of the cord is hooked to a machine. Tell a caregiver if the sticky strip or clip comes off of your infant. An alarm will sound if the machine cannot read the oxygen level or if your infant needs more oxygen. Tell a caregiver if the machine is alarming. Never turn the pulse oximeter off.

  • EKG: This test records the electrical activity of your heart. It is used to check for damage or other heart problems that may be causing your hypotension.

  • Arterial line: An arterial line is a tube placed into an artery, usually in the wrist or groin. The tube may also be placed in your infant's umbilical artery (blood vessel in his umbilical cord). The arterial line is attached to tubing with liquid in it. This liquid helps keep the tubing from getting plugged. The tube may be used for measuring your infant's blood pressure or for drawing blood.

  • CVP line: A CVP line is also called a central line. It is an IV catheter put into a large blood vessel near your infant's neck, groin, or chest. The CVP line may be used to give medicines, draw blood, or to check your infant's heart. The CVP line can show if your infant has too much or too little fluid in his body.

  • Intake and output: Your infant's caregiver may need to know how much liquid your infant is getting and urinating. Caregivers may also want to know how much your infant eats and if he has a bowel movement. Save your infant's diapers so that a caregiver can weigh them.

Medicines:

  • Antibiotics: Your infant may be given this medicine if his hypotension is caused by a blood infection.

  • Heart medicines: Your infant may be given this medicine to increase blood pressure and improve the blood flow to his organs.

  • Steroids: Steroid medicine may be given to help increase your infant's blood pressure. Steroids may also be given to treat adrenal gland problems if that is what caused your infant's hypotension.

Tests:

The following tests may be needed to learn the cause of your infant's hypotension. These tests may help plan your infant's treatment:

  • Blood gases: These tests are also called arterial blood gases (ABGs). Blood is taken from one of your infant's arteries. ABGs may be done if your infant has trouble breathing or other problems caused by his illness.

  • Blood tests: Blood tests can give caregivers more information about your infant's health condition.

  • Capillary refill time: A caregiver will press an area of your infant's skin, usually a finger or toe, until it becomes white. The caregiver will let go and count how many seconds it takes for the area to turn pink. This shows how well blood is moving through his body.

  • Echocardiogram: This is a type of ultrasound, also called an echo. An ultrasound uses sound waves to show pictures of your infant's heart on a monitor. An ultrasound may be done to show how blood moves his heart when it beats. It may also show the size and shape of his heart.

Treatment:

  • IV fluids: These may be used to increase your infant's BP if hypotension is caused by blood or fluid loss. The liquids may have electrolytes and sugar in them to replace what has been lost.

  • Blood transfusion: Your infant may get whole blood, or parts of blood, through an IV.

  • Ventilator: This is a machine that can help your infant breathe. An endotracheal (ET) tube will be put into his mouth, nose, or trachea (windpipe). The ET tube is hooked to the ventilator. The ventilator can also give oxygen to your infant if he cannot breathe on his own.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Hypotension In Infants (Inpatient Care)

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