Patent Ductus Arteriosus and Hypotension in a Preterm Infant: Fluids or Furosemide?

Author(s): Shabih Manzar

Abstract

Hypotension is common in preterm infants. A gestational age-based BP range has been published but the definition of “normal” blood pressure (BP) in preterm infant has not been established. The use of gestational age as surrogate of mean arterial BP is discouraged. Preterm infants are at risk of low blood flow and low BP due to many factors. Patent ductus arteriosus (PDA) is one of the factor that leads to diastolic hypotension because of the diastolic run off of blood flow into the pulmonary vascular system from left-to-right shunt. Hypotension with is often difficult to treat. The dilemma is restricting versus liberalizing fluids. At one end we have fluid overload on left atrium while at the other end we have pulmonary edema. We present a case in brief, followed by the discussion on how one should approach such a situation.

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