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Hypotension In Infants

What is hypotension in infants?

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.

What causes hypotension in infants?

  • Adrenal gland problems: Your child's adrenal glands may not make enough of a hormone called cortisol. He may also have low cortisol if you received steroid medicine before giving birth.

  • Blood loss: Blood loss during birth, or from injury or other medical problems can cause hypotension.

  • Heart problems: A heart infection, abnormal heartbeats, or patent ductus arteriosis (PDA) may cause hypotension.

  • Medicines: Infants born with high BP may be given medicines to lower the pressure. The medicines can lead to hypotension.

  • Sepsis: This is an infection in the blood that can lead to hypotension.

What increases my infant's risk for hypotension?

  • Low birth weight and preterm infants: The highest risk is for infants who weigh less than 1,000 grams (2.2 pounds) at birth.

  • Medical conditions: These include necrotizing enterocolitis (dead bowel tissue) or an electrolyte imbalance.

  • Ventilator use: A ventilator is a machine that breathes for your infant when he cannot breathe well on his own. The ventilator may cause increased pressure in your infant's chest, leading to hypotension.

What are the signs and symptoms of hypotension in infants?

  • Breathing faster than normal

  • Cold arms, hands, legs, and feet

  • A heartbeat that is faster or slower than it should be

  • Pale or mottled (spotted with different colors) skin

  • Urinating very little or not at all

How is hypotension in infants diagnosed?

Your infant's caregiver may check and monitor your infant's BP. To check your infant's BP at certain times, a BP cuff is placed on his arm or leg. The BP cuff is attached to a machine and will tighten on your infant's arm or leg. The caregiver may also insert a catheter into your infant's artery (blood vessel) to monitor his BP constantly. Your infant's caregiver will also check your infant's heart and how well blood is flowing through his body.

What tests may help find the cause of my infant's hypotension?

Many times, hypotension is a symptom of another condition. Your infant may need any of the following tests to find the cause of his hypotension:

  • 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.

  • 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.

How is hypotension in infants treated?

Caregivers will watch your infant closely for signs of poor organ blood flow. Your infant may need any of the following to treat the cause of hypotension:

  • 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 BP and improve the blood flow to his organs.

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

  • 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.

What are the risks of hypotension in infants?

  • 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.

When should I contact my infant's caregiver?

Contact your infant's caregiver if:

  • Your infant has a fever.

  • Your infant is sick, vomiting, or has diarrhea.

  • You have questions or concerns about your infant's condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • Your infant has trouble breathing, or breathes faster than his caregiver says he should.

  • Your infant has trouble, or is not able to, breastfeed or drink from a bottle.

  • Your infant urinates very little or not at all.

  • Your infant's arms, hands, legs, or feet feel cold.

  • Your infant's heart beats faster than caregivers say it should.

  • Your infant's skin is pale or mottled.

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. 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.

© 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.

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