The pressure in children. Norma table by age: intracranial, blood. Normal, increased symptoms as measured by up to one year and older child. Diagnosis and treatment

Blood pressure in children - the value indicating the overall condition of the body, the activity of internal organs and systems. Inconsistency generally accepted medical standards suggesting a neurological dysfunction, endocrine, renal or cardiovascular nature, require immediate medical adjustments.

What is blood pressure, types

Blood pressure - this process of squeezing the walls of capillaries, arteries, veins appearing when moving blood fluid.

Depends on:

• Age human characteristics. Ideal performance for adults is considered to be 130-110 / 70-80 mm Hg In young children, this figure is not constant, varies in proportion to the age of the kids.
• Paul. For men and women medical characteristics are almost identical. In the period from 6 to 17 years of age in girls found higher values ​​of blood pressure than boys.
• The presence of stressful situations. These processes are characterized by strong palpitations, increased heart rate, heat. Blood pressure is automatically increased. At constant contact at critical moments may cause resistant hypertension.
• Chronic diseases of the endocrine, cardiovascular, nervous system and kidneys.
• The presence of excess body weight. Obesity is often accompanied by severe hypertension.
• The time of day. In the morning blood pressure is lower than at bedtime.
• Implementation of the physiological exercises.

Blood pressure is characterized by two components:

1. upper (systolic) - shows the blood pressure at the maximum compression of the heart muscle;
2. lower (diastolic) - reports on the movement of blood fluids during the most relaxed heart.

Methods for measuring blood pressure

Digital data are measured:

• Direct (invasive) method - is carried out in a hospital when the need for constant monitoring of blood circulation and condition of the patient. It consists in the introduction of the catheter needle into the lumen of the radial artery. instrument cord is connected to a pressure gauge, locking data.
• Indirect (invasive) methods:
  • Auditory - the most common. Pressure is measured with a tonometer hand cuff, into which air is pumped. When opening the valve the oxygen leaves the instrument, giving the opportunity to listen to heart beats of the indicator dial.
  • oscillometric - measurement of blood pressure using a mechanical device. No manual air intake. Indicators displayed on the electronic display.

Terms of blood pressure measurement:

• It is carried out in a lying or sitting position, with full relaxation of the patient, in complete silence.
• An hour before the measurement to exclude the consumption of food.
• It carried on both hands. Upper limb should be placed next to the heart palm up.
• Oxygen is pumped into the cuff smoothly, without sudden movements.
• Clothing sleeves should not squeeze his hand and arteries.

Algorithm and a BP measurement technique in a child

Pressure in Children (standard indicators are calculated according to the formula, depending on the age of children):

• rather only the pressure measured by tonometer for newborns, the lower rate is from 1/2 to 2/3 of the former.
• In infants - systolic calculated using equation 76+ 2n, where n - the value component of the months of baby's life. Diastolic is in the range of 1/2 - 2/3 of the upper.
• Year-olds and older: Top 90 + 2n, the lower 60 + 2n, where n - the value of full years baby.

Before the procedure, the legal representatives of a minor explained the process and procedure of measurement. If a child jumping, actively playing, noisy, measurements are carried out not earlier than after 25 minutes. Silence.

Measurements:

1. Pediatrician cleans hands and stethoscope. Selects the cuff - it should be 2/3 overlap shoulder. The diameter of the device is chosen depending on age: up to a year - 3.5 - 7 cm.; 2-4 years - 4 - 9 cm.; 5-7 years - 6.5 -13 cm.; to 10 years - 8.5 - 15 cm.; 11 years of age may use an adult cuff.
2. Little patient is required to seat, placing his left hand on the table, turned the palm upwards.
3. Positioning cuff at 2.5 cm from the elbow. Cutaneous clearance should be about 1.6 cm.
4. Pediatrician groping fingers pulsing on the upper limbs. Located at the seat pushes stethoscope fixes. It is necessary to avoid strong pressure.
5. Smooth movements cuff is inflated until the termination of the pulsating beats.
6. The valve device opens slowly releasing air smoothly.
   
7. When listening to the heart pushes the doctor fixes the numbers of blood pressure, following the indications of the tonometer.

Norma AD in the child table by age

Pressure in Children (normal, depending on age) has the following characteristics:

Age	top	lower
Max.	min.	Max.	min.
up to 2-3 weeks	62	98	45	55
3-5 weeks	85	113	42	76
3-12 months	85	115	55	76
2-3,5 years	105	114	55	77
4-6 years	102	118	65	80
7-9.5 years	105	126	64	79
10-13 years	115	128	71	83
14-16 years	114	137	73	87

Indicators are defined individually for each child. During the day you can watch the small size of the jump is not considered pathological. From 5 to 14 years in girls there is a tendency to higher values ​​of blood pressure as compared to boys.

methods of diagnosis

blood pressure numbers are determined at the time of medical examination in schools or kindergartens. During routine examination, the doctor can diagnose increased or decreased blood pressure parameters.

The reasons for holding the extraordinary dimensions are children's complaints of severe pain in the head, reinforced by a minor anxiety, poor sleep, unreasonable refusal to eat. When receiving quantities of blood pressure using a sphygmomanometer cuff that differ by 95% of the tabulated values ​​established for the child's age and sex, it is assumed pathology.

The study of pathology is accompanied by:

• Repeated measurements. BP establishment procedure is carried out twice in a standing position, and sitting with an interval of 4 min. for the removal of the child possible stress that manifests itself when you visit the doctor's office.
• Anamnesis. Pediatrician polls the parents of the baby inherited hyper- or hypotonic diseases. It draws attention to the appearance of the physique, the baby's growth. Checks for the presence of chronic diseases of the endocrine, cardiovascular, nervous system, the kidneys, the use of additional laboratory tests.
• Daily monitoring of blood pressure. The method consists in continuous (after 3-4 h) measuring blood pressure on both hands of a child. It allows you to determine the time and duration of the pressure surge. In severe cases, a hospital inpatient invasive way.

Comprehensive laboratory and diagnostic examination, consisting of:

• advanced blood tests and urine tests;
• determining glucose tolerance;
• setting the level and the amount of hormones in the blood fluid;
• Ultrasound, ECG, echocardiography;
  
• vascular radiography;
• Fundus examination;
• MRI, CT for suspected neoplasm development.

Causes and symptoms of high blood pressure

Pressure in Children (rate may vary in a big way in the presence of dysfunction of the heart, blood vessels, thyroid diseases renal, neurological problems, during the rebuilding of the body age in adolescence) often increased.

Precipitating factors of hypertension:

• genetic predisposition kid;
• overweight, obesity;
• high intracranial pressure resulting from birth trauma;
• diabetes;
• kidney disease;
• feohromartsitoma;
• coarctation of the aorta;
• puberty;
• large amount of adrenaline in blood fluid;
• protein in the urine;
• vascular dystonia;
• traumatic injuries.

Symptoms, which give reason to assume high blood pressure are different, depending on age.

For infants, pre-school children:

• dyspnea;
• small weight gain or lack of it;
• the lag in development;
• strong crying, anxiety;
• wanton frequent regurgitation after feeding, in the absence of gastrointestinal pathologies; milky coffee stains on the skin;
• tachycardia;
• thyroid enlargement;
• lunate shape of the face;
• folds on the neck Prikrilova form;
• volume formation in the stomach;
• nipples, located at a great distance from each other;
• epigastric noise.

For children from 2 to 12 years:

• tinnitus;
• extraneous sounds and pain in the area of ​​the heart muscle;
• irritability;
• severe migraine;
• constant fatigue and unfounded;
• poor health and sleep;
  
• feeling the heat.

After 12 years:

• hormonal changes in the body by puberty;
• difficult process of falling asleep;
• frequent migraine;
• fatigue;
• irritation, nervousness;
• extraneous sounds in the ears;
• pain in the heart;
• tachycardia.

Upon detection of these symptoms should consult a doctor and expose the child to a full medical examination.

Increased blood pressure during puberty is not pathology extends as they mature minor body. The main danger of high blood pressure lies in hypertensive crisis, causing a sharp jump in performance, characterized by severe pain in the heart, loss of consciousness. Without immediate medical care possible onset of death.

Causes and symptoms of low blood pressure

Low blood pressure occurs quite often, especially in female adolescents. Just pathology exposed infants who were born with intrauterine infection, during heavy labor.

Causes of hypotension:

• intrauterine infection;
• premature birth;
• early discharge of water;
• placental abruption;
• frail physique;
• teenage years;
• hereditary pathologic condition;
• excessive mental and physiological stress;
  
• frequent stressful situations.

Hypoxia can indicate the presence of disease:

• kidney;
• heart;
• vessels;
• problems in the adrenal glands, associated with hormonal changes in the body;
• infectious diseases;
• high quantity of dextrose in blood fluid;
• hydrocephalus.

Signs, making it possible to assume a reduced pressure for babies:

• decreased muscle tone (the baby is not able to independently straighten the arm or leg);
• problems with swallowing and sucking reflex;
• very long sleep;
• lack of tears while awake;
• developmental delays.

Children from 2 to 10 years:

• dizziness, showing when changing the sitting position;
• severe mood swings;
• nosebleed;
• bouts of palpitations;
• sweating, fever;
• pain in the muscles and joints;
• migraine in the occipital region occurring upon waking;
• shortness of breath, a feeling of suffocation.

The pressure in boys and girls is a little different. And 17 years in males shows a tendency to lower rates, which is not critical.

Causes and symptoms of intracranial pressure

Pressure in children (intracranial circulation rate indices different from BP) determines the ratio of the size of the brain, blood and cerebrospinal fluid. If you have poor circulation outflow violation occurs, the loss of cerebrovascular ischemic stroke occurs.

Danae pathology is not determined independently. Conclusion on the presence of the ICP gives doctor after conducting sonography, EEG, MRI, neurosonography (used in infants up to overgrown fontanelle).

Norma indicators ICP:

• from 0 to 12 months - 1,4-7 mm Hg .;
• from 1 to 15 years - 3-8 mm Hg .;
• to reach the age of 16 - 4-17 mm Hg

During the day the figures are subject to change up or down. This process is not considered a pathology, if not of a permanent nature, as there is under stress or amplified physiological, mental training.

Stably exhibiting deviations from tabulated values ​​indicate:

• traumatic lesions of the head and brain;
  
• reactions to medication;
• complications arising during pregnancy: a strong toxicosis, placental abruption, preterm delivery, intrauterine infection of the fetus;
• problems encountered during labor;
• hydrocephalus;
• tumors of different etymology in the brain;
• early overgrown fontanelle.

Symptoms suggestive of intracranial hypertensionBaby equipment:

• limbs cramp;
• swelling of the fontanelle;
• divergence of cranial bones;
• involuntary deviation eyeballs down (Graefe's syndrome);
• frequent and severe vomiting;
• refusal to supply;
• problems with laying the baby;
• constant irrational crying;
• weakened muscle tone.

In older children:

• severe pain in the head;
• dark circles under the eyes, do not pass after the holidays;
• convulsions;
• impotence, the absence of loads.

The presence of these signs - a good reason to refer to the pediatrician.

Treatment of high blood pressure in children

Normalizing the process of increasing performance pressure in children consists of a set of measures aimed at eliminating the causes of disease. The goal of therapy - a cure major diseases that provoke high blood pressure indicators.

When vegetative-vascular dystonia are assigned:

1. elenium - drug with sedative, anticonvulsant, sedative and relaxing effect. The dosage for children by age: 4-7 years - 5-9,5 mg / day.; 8-14 years - 10-19,5 mg / day.; 15-18 years - 25-35 mg / day. Drink 3-4 times a day.
2. Bromine with valerian. Made in medicine, it recommended for newborns and infants. Calms, normalizes the process of sleep, relaxes the smooth muscles. Accept required 1 h. l. three times a day for at least 10 days.
3. Seduksen. Tranquilizer with myorelaxant activity. Not approved for use in infants because of the unformed enzyme system. It registers 1 time in 24 h, 500 mg by intramuscular injection. Coursework therapy is chosen individually.

With an increase in systolic pressure appointed andrenoblokatory eliminating tachycardia, angina, lowering of blood pressure:

• obzidan - by 19.5 mg three times per day
• Inderal - 25 mg twice per 24 hours.

The treatment process is controlled by doctor-pediatrician. Taken alone these drugs to children is strictly prohibited. Treatment is prescribed for a short time, until the decline.

High upper and lower pressure, the tablets:

1. Reunatin, The treatment regimen:

• 1 day - 1/4 tablets at night;
• Day 2 1/4 capsule in the fed-dy 2 a day;
• Day 3 1/4 tablets 3-hole after a meal.

The maximum dose of 1 capsule. The preparation takes about 3 h weeks.

2. Rauvazan, Therapy process:

• 1 day 1/4 capsule before bedtime;
• Day 2 1/3 tablets after meals, divided into 2 doses;
• 3 capsules per day 1/2 3 rows after a meal.

The biggest daily intake of the drug is not more than 1 capsule, broken into 3-4 times. treatment time between 3 to 5 weeks.

3. Reserpine - appointed by 0,2-0,5,5 mg. Four times a day on a full stomach. The treatment duration of 2 weeks. Furthermore medicaments must daily walk in air, to define a child in sports activities, particularly shows swimming, athletics.

Perhaps the use of grass fitonastoev elecampane, oats with honey. Parents of young patient pediatrician strongly advise you to reconsider the diet of preschoolers, to limit the consumption of foods that cause obesity, contributing to an increase in blood pressure.

When hypertension is strictly prohibited:

• carbonated lemonade;
• sweet pastry;
• smoked products;
  
• Sausages;
• salted salmon;
• meat and canned fish;
• any fried and fatty food;
• pasta, except made from wheat flour;
• burgers, chips, popcorn;
• strong black tea;
• coffee drinks.

Treatment of low blood pressure

Stabilization of the lower figure is based on the establishment and strict observance of the regime of sleep and rest, taking herbal tinctures, use of products that contain caffeine.

The process of reducing and maintaining normal blood pressure in children who are prone to hypotension:

• Establishment and adherence of the day. Elimination of high stress, frequent rest (at least 15 minutes. after 2 h).
• Refusal of films, causing a strong nervous excitability, computer games.
• Everyday Promenade Street consisting of not less than 3 hours.
• Frequent meals keep your blood sugar;
• Physical exercise. Particularly useful are swimming, walking, dancing.
• Dieting.

Recommended use:

• milk;
• cottage cheese;
• sauerkraut;
• pickles and tomatoes;
• spices;
• cocoa, strong tea with herbs and lemon;
• dark chocolate, candy, marshmallows.

Of the drugs are assigned:

• tincture Schisandra - 10 drops 3 times per 24 h for 15 min. before a meal. Therapy is 2 weeks;
  
• tincture of Eleutherococcus - 20 Cap. 3 rows per day for 30 days 10 min. before a meal;
• tsinarizin drug - dilates blood vessels, located in the brain, normalizes sleep, eliminates a strong nervous excitability and headaches. Appoint 1 tab. three times a day for 30 days.

Hypotension is dangerous for small children at least a high pressure. Under the influence of low levels body poorly oxygenated, possible fainting, severe headaches, delayed development.

General principles of treatment of intracranial pressure

Normalization of intracranial pressure is a long process aimed at eliminating the causes of inflated figures.

General principles of therapy:

• Surgical treatment - is to eliminate tumors, blocking the outflow of the cerebrospinal fluid and blood.
• Drug correction. In the treatment of encephalitis, meningitis carried out antibacterial treatment.
• Bypass, designed to eliminate the increased secretion of cerebrospinal fluid.
• Receiving drugs that reduce CSF production: diuretics; hormones; diakarb; neuroprotective agents; furosemide.
• Vnutrikulyarnaya puncture to reduce CSF volume in areas of the brain.
• Complete elimination of salt from food intake.
• Manual therapy. A good result in the treatment given physiotherapy, massage.

Means for treatment of intracranial pressure

Drug therapy of intracranial hypertension drugs held complex. diuretic drugsEliminating liquorodynamic violations by reducing excessive production of cerebrospinal fluid.

Golon vessels operate in the brain:

• Diakarb. Assigned 250 mg. 7-10 hours. Early treatment is applied daily. While improving the state dose reduced to 250 mg. once a day.
  
• Glycerol. It registers one-time, to facilitate the patient's condition. Reduces intracranial pressure and hypertension fundus. Used as a medicine or rectal suppository. Applied after 15 min. at the end of the meal.
• furosemide - a daily dose of 1-2 g / day.. Job permitted to consume no more than 6 mg.

Treatment is carried out strictly under the supervision of a physician.

Vasodilator drugs, increases the flow of blood to the brain fluid:

• cavinton;
• cinnarizine;
• Sermion.

Any of the tablet means guzzle up to 3 months, 1 capsule three times per day.

Antibiotics for infection with meningitis, encephalitis:

• amoxicillin;
• Tsefuronsim;
• ketoconazole;
• Cephalosporin.

Drank away until the complete disappearance of symptoms, course of 14 days. The daily dose of the 1st (in severe cases 2.5) tablets thrice daily after meals strictly. Treatment is carried out only in a hospital.

Neuroprotective drugs, help improve memory, attention, mental activity:

• fenotropil - 0,5 capsule twice to 14:00. Later intake prevents full sleep.
• piracetam - 30-50 mg / kg / day. 2-3, at least 3 weeks.
  
• nootropil - 3.2 g twice a day on a full stomach.
• Glycine - 1 tablet under the tongue three times a day.

Medicaments containing amino acids, relieving stress brain involved in the production of enzymes, proteins, chemical organism acids.

Other agents for the treatment of pressure:

1. vitamin complexes, Having in its composition of vitamins, antioxidants.
2. antispasmodics, Strong pain relieving: Ketonal; Nimesil. Guzzle on 1 tab. when a severe pain. Used for pediatric purposes. Uncontrolled reception destabilizes the state of the heart muscle.
3. Traditional medicines used only as a complex therapy. Self-treatment consisting only of herbal infusions can degrade the condition of the child.

pressure indicators in children - an important health factor, giving the opportunity to judge the activities of vessels, heart, thyroid, nervous system and kidneys. In case of deviations from normal values ​​should be carried out a full examination of the child, the timely elimination of the factors that provoke pathology.

Registration of the article: Lozinski Oleg

Videos about pressure in children

Features, symptoms and treatment of blood pressure in children: