• Hypovolemia in Infants

    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 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 medicines
    • 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

    Your doctor will ask 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 amount 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

    American Academy of Pediatrics http://www.healthychildren.org

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

    Nemours http://kidshealth.org

    CANADIAN RESOURCES

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

    Caring for Kids http://www.caringforkids.cps.ca

    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%5F-CRXvZPYC&dq=hypovolemic+shock+risk+factors&source=gbs%5Fnavlinks%5Fs . Accessed January 11, 2013.

    Dehydration and hypovolemia. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated January 25, 2012. Accessed January 11, 2013.

    Hypovolemic shock. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us . Updated December 3, 2012. Accessed January 11, 2013.

    Revision Information

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