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#Volume resuscitation (usually with [[Iv colloid|crystalloid]] or [[blood product]]s)<ref name=":8" />
#Blood pressure support with a [[vasopressor]] (all seem equivalent with respect to risk of death, with [[norepinephrine]] possibly better than [[dopamine]]).<ref>{{cite journal|last1=Gamper|first1=G|last2=Havel|first2=C|last3=Arrich|first3=J|last4=Losert|first4=H|last5=Pace|first5=NL|last6=Müllner|first6=M|last7=Herkner|first7=H|title=Vasopressors for hypotensive shock.|journal=Cochrane Database of Systematic Reviews|date=15 February 2016|volume=2|pages=CD003709|pmid=26878401|doi=10.1002/14651858.CD003709.pub4|pmc=6516856}}</ref> Trying to achieve a [[mean arterial pressure]] (MAP) of greater than 70 mmHg does not appear to result in better outcomes than trying to achieve a MAP of greater than 65 mm Hg in adults.<ref name=Hy2017/>
#Ensure adequate tissue perfusion (maintain SvO2 >70 with use of blood or [[dobutamine]])<ref name=":8" />
#Address the underlying problem (i.e., antibiotic for [[septic shock|infection]], [[stent]] or [[Coronary artery bypass surgery|CABG]] (coronary artery bypass graft surgery) for [[infarction]], [[steroids]] for [[adrenal insufficiency]], etc...)<ref name=":8" />
The best way to determine if a person will benefit from fluids is by doing a [[passive leg raise]] followed by measuring the [[cardiac output|output from the heart]].<ref>{{cite journal|last1=Bentzer|first1=P|last2=Griesdale|first2=DE|last3=Boyd|first3=J|last4=MacLean|first4=K|last5=Sirounis|first5=D|last6=Ayas|first6=NT|title=Will This Hemodynamically Unstable Patient Respond to a Bolus of Intravenous Fluids?|journal=JAMA|date=27 September 2016|volume=316|issue=12|pages=1298–309|pmid=27673307|doi=10.1001/jama.2016.12310}}</ref>
=== Medication ===
Chronic hypotension sometimes requires the use of medications.<ref>{{Cite journal|last=Arnold|first=Amy C.|last2=Raj|first2=Satish R.|date=December 2017|title=Orthostatic Hypotension: A Practical Approach to Investigation and Management|url=https://www.ncbi.nlm.nih.gov/pubmed/28807522|journal=The Canadian Journal of Cardiology|volume=33|issue=12|pages=1725–1728|doi=10.1016/j.cjca.2017.05.007|issn=1916-7075|pmc=5693784|pmid=28807522}}</ref> Some medications that are commonly used include [[Fludrocortisone]], [[Erythropoietin]], and [[Sympathomimetics]] such as [[Midodrine]] and [[Norepinephrine|Noradrenaline]] and precursor ([[L-DOPS]]).<ref name="Joseph S55–S67" />
* [[Fludrocortisone]] is the first-line therapy (in the absence of heart failure) for patients with chronic hypotension or resistant orthostatic hypotension.<ref name=":6" /> It works by increasing the intravascular volume.<ref name=":6" /> * [[Midodrine]] is a therapy used for severe orthostatic hypotension, and works by increasing [[peripheral vascular resistance]].<ref name=":6" /> * [[Norepinephrine|Noradrenaline]] and its * [[Erythropoietin]] is given to patients with neurogenic orthostatic hypotension and it works through increasing vascular volume and [[viscosity]].<ref name=":6" /> == Pediatrics ==
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The clinical history provided by the caretaker is the most important part in determining the cause of hypotension in pediatric patients.<ref name=":9">{{Cite journal|last=Mendelson|first=Jenny|date=May 2018|title=Emergency Department Management of Pediatric Shock|url=https://www.ncbi.nlm.nih.gov/pubmed/29622332|journal=Emergency Medicine Clinics of North America|volume=36|issue=2|pages=427–440|doi=10.1016/j.emc.2017.12.010|issn=1558-0539|pmid=29622332}}</ref> Symptoms for children with hypotension include increased sleepiness, not using the restroom as much (or at all), having difficulty breathing or breathing rapidly, or [[Syncope (medicine)|syncope.]]<ref name=":9" /> The treatment for hypotension in pediatric patients is similar to the treatment in adults by following the four first steps listed above (see Treatment).<ref name=":8" /> Children are more likely to undergo [[intubation]] during the treatment of hypotension because their oxygen levels drop more rapidly than adults.<ref name=":9" />
==Etymology==
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