{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:13:58Z","timestamp":1792109638569,"version":"4.4.0"},"reference-count":21,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi241052-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>A multicenter randomized clinical trial (RCT) showed a lung recruitment maneuver using high-frequency oscillatory ventilation just before surfactant administration (ie, intubate-recruit-surfactant-extubate [IN-REC-SUR-E]) improved the efficacy of treatment compared with the standard intubate-surfactant-extubate (IN-SUR-E) technique without increasing the risk of adverse neonatal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241052-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine follow-up outcomes at corrected postnatal age (cPNA) 2 years of preterm infants previously enrolled in an RCT and treated with IN-REC-SUR-E or IN-SUR-E in 35 tertiary neonatal intensive care units.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241052-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This was a follow-up study of infants recruited into the primary RCT from 2015 to 2018 at 35 tertiary neonatal intensive care units (NICUs) in Italy. Follow-up examinations included neurodevelopmental, growth, and respiratory outcomes of these children at cPNA 2 years. Participants included spontaneously breathing extremely preterm neonates (24 0\/7 to 27 6\/7 weeks\u2019 gestation) reaching failure criteria for continuous positive airway pressure within the first 24 hours of life. Data were analyzed from April 2023 to January 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241052-7\">\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Infants were randomly assigned (1:1) to IN-REC-SUR-E or IN-SUR-E and then followed up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241052-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>The primary outcome was the occurrence of death after discharge or major disability at cPNA 2 years. Secondary outcomes were neurodevelopmental outcomes (major disability, cerebral palsy, cognitive impairment, visual deficit, or auditory deficit), anthropometric measurements (weight, length, and head circumference), and recurrent respiratory infections and hospitalizations because of respiratory causes at 2y cPNA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241052-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 137 extremely preterm infants (median [IQR] gestational age, 26.5 [25.3-27.5] weeks and 75 [54.7%] female), initially enrolled in the original RCT, were followed up at cPNA 2 years, including 64 infants in the IN-SUR-E group and 73 infants in the IN-REC-SUR-E group. There were no significant differences in the occurrence of death after discharge or major disability at cPNA 2 years (IN-SUR-E: 13 children [20.3%] vs IN-REC-SUR-E: 10 children [13.7%];\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.36). There were no significant differences in incidence of disability, cerebral palsy, or cognitive impairment in the IN-REC-SUR-E group compared with the IN-SUR-E group. There were no significant differences in anthropometric measurements (weight, length, and head circumference) between groups. There were no significant differences in the incidence of recurrent respiratory infections or in hospitalizations because of respiratory causes between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi241052-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>In this RCT of lung recruitment before surfactant vs standard care there were no significant differences between the 2 groups in death, neurodevelopmental outcomes, anthropometric measurements, or recurrent respiratory infections at the 2-year follow-up. These findings can aid clinicians in decision-making for the best strategy to administer surfactant, considering long-term outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.35347","type":"journal-article","created":{"date-parts":[[2024,9,25]],"date-time":"2024-09-25T17:40:27Z","timestamp":1727286027000},"page":"e2435347","source":"Crossref","is-referenced-by-count":3,"title":["Lung Recruitment Before Surfactant Administration in Extremely Preterm Neonates"],"prefix":"10.1001","volume":"7","author":[{"given":"Francesca","family":"Gallini","sequence":"first","affiliation":[{"name":"Neonatology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy"},{"name":"Dipartimento di Scienze della Vita e Sanit\u00e0 Pubblica, Facolt\u00e0 di Medicina e Chirurgia, Universit\u00e0 Cattolica del Sacro Cuore, Rome, Italy"},{"name":"Neonatology Unit, Ospedale Isola Tiberina, Gemelli Isola, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico Umberto","family":"De Rose","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Bambino Ges\u00f9 Children\u2019s Hospital Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Iuliano","sequence":"additional","affiliation":[{"name":"Neonatology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico Marco","family":"Romeo","sequence":"additional","affiliation":[{"name":"Pediatric Neurology Unit, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milena","family":"Tana","sequence":"additional","affiliation":[{"name":"Neonatology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Paladini","sequence":"additional","affiliation":[{"name":"Neonatology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca Paola","family":"Fusco","sequence":"additional","affiliation":[{"name":"Neonatology Unit, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, 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