In neonatal hypotension management, albumin may impair gas exchange and be associated with increased mortality; isotonic saline has been shown to be as effective in increasing blood pressure.

• A. Both statements are true
• B. Albumin is superior to saline
• C. Isotonic saline is less effective
• D. Neither statement is true

Answer: (A)

The main idea is how fluid choice affects both oxygenation and outcomes in treating neonatal hypotension. In this setting, albumin, a colloid, does not provide a proven advantage over isotonic saline for raising blood pressure, and it may worsen gas exchange and be linked with higher mortality in some neonates. Albumin can leak from the vascular space into the interstitial and alveolar compartments during illness, which can impair gas exchange in fragile neonatal lungs and contribute to less favorable outcomes. In contrast, isotonic saline effectively expands intravascular volume and increases blood pressure with a safety profile supported by evidence in neonates, making it a reliable first-line option for volume resuscitation. Because there is no demonstrated mortality benefit with albumin and there are potential risks to oxygenation, the two statements align: albumin may impair gas exchange and be associated with higher mortality, while isotonic saline is at least as effective in increasing blood pressure.