Abstract
While patent ductus arteriosus, pulmonary hypertension, and systemic hypotension are key medical issues amongst neonates, there are other common biological conditions which present with distinct physiological diagnostic and therapeutic challenges. This review focuses on such hemodynamic considerations in cardiomyopathy accompanying infants of diabetic mothers, twin-to-twin transfusion syndrome, and left heart pathology in infants with severe chronic lung disease. It details the pathophysiological mechanisms, diagnostic approaches, and therapeutic strategies essential for optimizing cardiovascular stability in this fragile cohort. A regimented, protocol-driven approach may lead to an increased risk of unintended treatment side effects in patients where diagnostic precision is low. This review provides a rational basis of the management of hemodynamic instability, at the same time laying out knowledge gaps and considerations for future research.