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Hypovolemia in Infants

Hi-po-vo-lee-me-ah

Definition

Hypovolemia is a low level of blood in the body. Lower levels of blood make it difficult to get nutrients and oxygen to the entire body. Hypovolemia will affect the entire body but certain organs are at higher risk of damage. Organs that are very active like the heart, kidney, brain, and liver may be affected the most.

Cardiopulmonary System


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This condition is serious. Your baby will need care right away.

Causes

Hypovolemia may be caused by:

  • Blood loss–from an injury or illness
  • Dehydration which may be caused by:
    • Problems absorbing fluids in the digestive tract
    • Trouble feeding
    • Illness with vomiting or diarrhea.
Risk Factors

Factors that increase your baby’s risk of getting hypovolemia include:

  • Trauma, including complications at birth
  • Trauma with excessive bleeding
  • Vomiting
  • Diarrhea
  • A severe burn
  • Certain medications
  • Surgery
  • Infection
  • Illness of intestines or stomach
Symptoms

Symptoms may include:

  • Restlessness
  • Irritability
  • Cool, clammy skin
  • Rapid heart beat
  • Weakness
  • Abnormal drowsiness
  • Dry mouth
  • Absence of tears
  • Reduced urine output
  • Changes in breathing
Diagnosis

You will be asked about your baby’s symptoms and medical history. A physical exam will be done.

Your doctor may check your baby’s blood flow by putting pressure on a nail bed.

Treatment

Talk with your baby’s doctor about the best treatment plan.

Options include:

Replacing Fluids and Improving Blood Flow

Your baby may have:

  • Rehydration therapy—fluids and electrolytes may be given by mouth, feeding tube, or IV
  • Packed red blood cells—blood given from a donor; may be needed if large amounts of blood have been lost

Your baby’s legs may also be elevated. This will increase the amount of blood going to the heart and brain.

Fluid Replacement


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Managing the Underlying Cause

Additional treatment will depend on the cause of hypovolemia:

  • Medication may be needed to help manage diarrhea, vomiting, or blood pressure in severe cases
  • Your baby may also need an IV or feeding tube for the duration of the illness. These will deliver fluids until your baby can feed again.
  • Any bleeding will also need to be managed. Surgery and/or stitches may be needed to repair injuries.
Prevention

There is no known way to prevent hypovolemia. It is important to notice signs of dehydration and begin treatment right away.

RESOURCES:

Healthy Children—American Academy of Pediatrics
http://www.healthychildren.org

National Heart Lung and Blood Institute
http://www.nhlbi.nih.gov

CANADIAN RESOURCES:

Canadian Pediatric Society
http://www.cps.ca

Sick Kids—The Hospital for Sick Children
http://www.sickkids.ca

References:

Day R, Paul P, Williams B. Textbook of Canadian Medical-Surgical Nursing. 2nd ed. Lippincott Williams & Wilkins; 2009. Available at: http://books.google.com/books?id=SB_-CRXvZPYC&dq=hypovolemic+shock+risk+factors&source=gbs_navlinks_s. Accessed September 30, 2014.

Dehydration and hypovolemia in infants and children. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 4, 2013. Accessed September 30, 2014.

Hypovolemic shock. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 19, 2014. Accessed September 30, 2014.



Last reviewed August 2014 by Kari Kassir, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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