Normal Vital Signs for Infants
Heart Rate Parameters
- The European Society of Cardiology establishes specific heart rate ranges for infants 7-30 days of age at 107-182 beats per minute, with a mean of 149 bpm 1
- Heart rates below 107 bpm may indicate pathology such as central nervous system abnormalities, hypothermia, increased intracranial pressure, meningitis, or hypothyroidism in infants 1
- Heart rates above 182 bpm may indicate fever, infection, anemia, pain, dehydration, hyperthyroidism, or myocarditis in infants 1
- Critical threshold: Heart rate below 60 bpm with signs of poor perfusion requires immediate chest compressions, as recommended by the American Heart Association 2, 1
Blood Pressure Parameters
- The American College of Critical Care Medicine provides normal blood pressure ranges for neonates, which vary by gestational age and postnatal age 3
- Blood pressure assessment should be age-appropriate and interpreted in the context of perfusion status, according to the American College of Critical Care Medicine 3
- Hypotension with capillary refill >3 seconds indicates more severe shock than isolated tachycardia, as stated by the American College of Critical Care Medicine 3
Important Clinical Considerations
- Do not misinterpret transient bradycardia during feeding, sleep, or defecation as pathological, as advised by the European Society of Cardiology 1
- Using 2nd and 98th percentiles means 4% of normal infants will have values outside these ranges, as noted by the European Heart Journal 4, 1
- Heart rate <60 bpm with signs of poor perfusion requires immediate CPR, as recommended by the American Heart Association 2, 5
- Altered mental status, poor peripheral perfusion, or weak pulses warrant immediate evaluation, according to the American College of Critical Care Medicine 3
- Persistent tachycardia (>182 bpm) or bradycardia (<107 bpm) requires investigation for underlying causes, as stated by the European Society of Cardiology 1