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A 28-week infant has hypotension, bounding pulses, and low diastolic pressure with increasing ventilator settings. Which PDA physiology explains the clinical picture?
Right-to-left ductal shunting caused by fixed pulmonary atresia.
Closure of the ductus causing increased systemic diastolic runoff.
Atrial-level mixing as the primary cause of low diastolic pressure.
Systemic steal and pulmonary overcirculation from left-to-right ductal shunting.
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