{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T12:13:22Z","timestamp":1793276002005,"version":"4.5.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2021,6,1]],"date-time":"2021-06-01T00:00:00Z","timestamp":1622505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":["www.atsjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Lung ultrasound is useful in critically ill patients with acute respiratory failure. Given its characteristics, it could also be useful in extremely preterm infants with evolving chronic respiratory failure, as we lack accurate imaging tools to monitor them.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To verify if lung ultrasound can monitor lung aeration and function and has good reliability to predict bronchopulmonary dysplasia in extremely preterm neonates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicenter, international, prospective, longitudinal, cohort, diagnostic accuracy study consecutively enrolling inborn neonates with gestational age 30+6 weeks or younger. Lung ultrasound was performed on the 1, 7, 14, and 28 days of life, and lung ultrasound scores were calculated and correlated with simultaneous blood gases and work of breathing score. Gestational age\u2013adjusted lung ultrasound scores were created, verified in multivariate models, and subjected to receiver operator characteristics (ROC) analyses to predict bronchopulmonary dysplasia at 36 weeks postmenstrual age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Mean lung ultrasound scores are different between infants developing (n\u2009=\u200972) or not developing (n\u2009=\u200975) bronchopulmonary dysplasia (P\u2009&amp;lt;\u20090.001 at any time point). Lung ultrasound scores significantly correlate with oxygenation metrics and work of breathing at any time point (P always\u2009&amp;lt;\u20090.0001). Gestational age\u2013adjusted lung ultrasound scores significantly predict bronchopulmonary dysplasia at 7 (area under ROC curve, 0.826\u20130.833; P\u2009&amp;lt;\u20090.0001) and 14 (area under ROC curve, 0.834\u20130.858; P\u2009&amp;lt;\u20090.0001) days of life. Bronchopulmonary dysplasia severity and gestational age\u2013adjusted lung ultrasound scores are significantly correlated at 7 and 14 days (P always\u2009&amp;lt;\u20090.0001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Lung ultrasound scores allow monitoring of lung aeration and function in extremely preterm infants. Gestational age\u2013adjusted scores significantly predict the occurrence of bronchopulmonary dysplasia, starting from the seventh day of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.202008-3131oc","type":"journal-article","created":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T18:59:06Z","timestamp":1608663546000},"page":"1398-1409","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":147,"title":["Lung Ultrasound to Monitor Extremely Preterm Infants and Predict Bronchopulmonary Dysplasia. A Multicenter Longitudinal Cohort Study"],"prefix":"10.1093","volume":"203","author":[{"given":"Barbara","family":"Loi","sequence":"first","affiliation":[{"name":"Division of Pediatrics and Neonatal Critical Care, A.B\u00e9cl\u00e8re Medical Center, Paris Saclay University Hospitals, APHP, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Vigo","sequence":"additional","affiliation":[{"name":"Division of Pediatrics and Neonatal Critical Care, A.B\u00e9cl\u00e8re Medical Center, Paris Saclay University Hospitals, APHP, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eugenio","family":"Baraldi","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, Neonatal ICU, Padova University Hospital, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Raimondi","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Science, Neonatal ICU, Federico II University, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virgilio P.","family":"Carnielli","sequence":"additional","affiliation":[{"name":"Division of Neonatology, G. Salesi Women and Children Hospital, Polytechnical University of Marche, Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Mosca","sequence":"additional","affiliation":[{"name":"Neonatal ICU, \u201cCa\u2019 Granda Ospedale Maggiore Policlinico,\u201d IRCCS Foundation, University of Milan, Milan, Italy; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3846-4834","authenticated-orcid":false,"given":"Daniele","family":"De Luca","sequence":"additional","affiliation":[{"name":"Division of Pediatrics and Neonatal Critical Care, A.B\u00e9cl\u00e8re Medical Center, Paris Saclay University Hospitals, APHP, Paris, France"},{"name":"Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris Saclay University, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,6,1]]},"reference":[{"key":"2026030503474538200_B1","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1007\/s00134-019-05725-8","article-title":"Thoracic ultrasonography: a narrative review","volume":"45","author":"Mayo","year":"2019","journal-title":"Intensive Care Med"},{"key":"2026030503474538200_B2","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1159\/000113059","article-title":"Lung ultrasound in respiratory distress syndrome: a useful tool for early diagnosis","volume":"94","author":"Copetti","year":"2008","journal-title":"Neonatology"},{"key":"2026030503474538200_B3","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.jpeds.2016.04.018","article-title":"Lung ultrasound for diagnosing pneumothorax in the critically ill neonate","volume":"175","author":"Raimondi","year":"2016","journal-title":"J Pediatr"},{"key":"2026030503474538200_B4","doi-asserted-by":"crossref","first-page":"S41","DOI":"10.1016\/S0378-3782(14)50011-4","article-title":"Lung ultrasound findings in meconium aspiration syndrome","volume":"90","author":"Piastra","year":"2014","journal-title":"Early Hum Dev"},{"key":"2026030503474538200_B5","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1159\/000495911","article-title":"A multicenter lung ultrasound study on transient tachypnea of the neonate","volume":"115","author":"Raimondi","year":"2019","journal-title":"Neonatology"},{"key":"2026030503474538200_B6","doi-asserted-by":"crossref","first-page":"e1089","DOI":"10.1542\/peds.2013-3924","article-title":"Use of neonatal chest ultrasound to predict noninvasive ventilation failure","volume":"134","author":"Raimondi","year":"2014","journal-title":"Pediatrics"},{"key":"2026030503474538200_B7","doi-asserted-by":"crossref","first-page":"e20180463","DOI":"10.1542\/peds.2018-0463","article-title":"Lung ultrasound score predicts surfactant need in extremely preterm neonates","volume":"142","author":"De Martino","year":"2018","journal-title":"Pediatrics"},{"key":"2026030503474538200_B8","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.jpeds.2019.04.020","article-title":"Echography-guided surfactant therapy to improve timeliness of surfactant replacement: a quality improvement project","volume":"212","author":"Raschetti","year":"2019","journal-title":"J Pediatr"},{"key":"2026030503474538200_B9","first-page":"1","article-title":"Point-of-care lung ultrasound in neonatology: classification into descriptive and functional applications","volume":"84","author":"Raimondi","year":"2018","journal-title":"Pediatr Res"},{"key":"2026030503474538200_B10","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1186\/s13054-020-2787-9","article-title":"International evidence-based guidelines on Point of Care Ultrasound (POCUS) for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)","volume":"24","author":"Singh","year":"2020","journal-title":"Crit Care"},{"key":"2026030503474538200_B11","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1164\/ajrccm.163.7.2011060","article-title":"Bronchopulmonary dysplasia","volume":"163","author":"Jobe","year":"2001","journal-title":"Am J Respir Crit Care Med"},{"key":"2026030503474538200_B12","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.jpeds.2017.08.006","article-title":"Chronic pulmonary insufficiency of prematurity: developing optimal endpoints for drug development","volume":"191","author":"Steinhorn","year":"2017","journal-title":"J Pediatr"},{"key":"2026030503474538200_B13","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1002\/jum.15195","article-title":"Semiquantititative lung ultrasound scores are accurate and useful in critical care, irrespective of patients\u2019 ages: the power of data over opinions","volume":"39","author":"De Luca","year":"2020","journal-title":"J Ultrasound Med"},{"key":"2026030503474538200_B14","doi-asserted-by":"crossref","first-page":"1404","DOI":"10.1002\/ppul.24410","article-title":"Lung ultrasound score as early predictor of bronchopulmonary dysplasia in very low birth weight infants","volume":"54","author":"Alonso-Ojembarrena","year":"2019","journal-title":"Pediatr Pulmonol"},{"key":"2026030503474538200_B15","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1159\/000499361","article-title":"European consensus guidelines on the management of respiratory distress syndrome - 2019 update","volume":"115","author":"Sweet","year":"2019","journal-title":"Neonatology"},{"key":"2026030503474538200_B16","doi-asserted-by":"crossref","first-page":"S120","DOI":"10.1542\/peds.2015-3373D","article-title":"Part 7: neonatal resuscitation: 2015 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations (reprint)","volume":"136","author":"Perlman","year":"2015","journal-title":"Pediatrics"},{"key":"2026030503474538200_B17","doi-asserted-by":"crossref","first-page":"e151797","DOI":"10.1001\/jamapediatrics.2015.1797","article-title":"Lung ultrasonography score to evaluate oxygenation and surfactant need in neonates treated with continuous positive airway pressure","volume":"169","author":"Brat","year":"2015","journal-title":"JAMA Pediatr"},{"key":"2026030503474538200_B18","first-page":"1282","article-title":"Lung ultrasound in the ICU: from diagnostic instrument to respiratory monitoring tool","volume":"78","author":"Via","year":"2012","journal-title":"Minerva Anestesiol"},{"key":"2026030503474538200_B19","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1016\/j.chest.2019.11.013","article-title":"Effect of different probes and expertise on the interpretation reliability of point-of-care lung ultrasound","volume":"157","author":"Gomond-Le Goff","year":"2020","journal-title":"Chest"},{"key":"2026030503474538200_B20","first-page":"1","article-title":"A controlled clinical trial of effects of water mist on obstructive respiratory signs, death rate and necropsy findings among premature infants","volume":"17","author":"Silverman","year":"1956","journal-title":"Pediatrics"},{"key":"2026030503474538200_B21","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1038\/s41372-018-0049-3","article-title":"Performance of the Silverman Andersen Respiratory Severity Score in predicting Pco2 and respiratory support in newborns: a prospective cohort study","volume":"38","author":"Hedstrom","year":"2018","journal-title":"J Perinatol"},{"key":"2026030503474538200_B22","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/S2213-2600(17)30214-X","article-title":"The Montreux definition of neonatal ARDS: biological and clinical background behind the description of a new entity","volume":"5","author":"De Luca","year":"2017","journal-title":"Lancet Respir Med"},{"key":"2026030503474538200_B23","doi-asserted-by":"crossref","first-page":"1955","DOI":"10.4187\/respcare.02011","article-title":"AARC clinical practice guideline: transcutaneous monitoring of carbon dioxide and oxygen: 2012","volume":"57","author":"Restrepo","year":"2012","journal-title":"Respir Care"},{"key":"2026030503474538200_B24","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1038\/s41372-017-0009-3","article-title":"Continuous positive airway pressure delivery during less invasive surfactant administration: a physiologic study","volume":"38","author":"Jourdain","year":"2018","journal-title":"J Perinatol"},{"key":"2026030503474538200_B25","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1001\/jamapediatrics.2014.3351","article-title":"Survival and morbidity of preterm children born at 22 through 34 weeks\u2019 gestation in France in 2011: results of the EPIPAGE-2 cohort study","volume":"169","author":"Ancel","year":"2015","journal-title":"JAMA Pediatr"},{"key":"2026030503474538200_B26","doi-asserted-by":"crossref","first-page":"837","DOI":"10.2307\/2531595","article-title":"Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach","volume":"44","author":"DeLong","year":"1988","journal-title":"Biometrics"},{"key":"2026030503474538200_B27","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1136\/eb-2013-101243","article-title":"The two-step Fagan\u2019s nomogram: ad hoc interpretation of a diagnostic test result without calculation","volume":"18","author":"Caraguel","year":"2013","journal-title":"Evid Based Med"},{"key":"2026030503474538200_B28","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.jpeds.2018.10.033","article-title":"rhIGF-1\/rhIGFBP-3 in preterm infants: a phase 2 randomized controlled trial","volume":"206","author":"Ley","year":"2019","journal-title":"J Pediatr"},{"key":"2026030503474538200_B29","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.jpeds.2017.02.061","article-title":"Two-year follow-up outcomes of premature infants enrolled in the phase I trial of mesenchymal stem cells transplantation for bronchopulmonary dysplasia","volume":"185","author":"Ahn","year":"2017","journal-title":"J Pediatr"},{"key":"2026030503474538200_B30","doi-asserted-by":"crossref","first-page":"119387","DOI":"10.1016\/j.ijpharm.2020.119387","article-title":"SP-D loaded PLGA nanoparticles as drug delivery system for prevention and treatment of premature infant\u2019s lung diseases","volume":"585","author":"Attias Cohen","year":"2020","journal-title":"Int J Pharm"},{"key":"2026030503474538200_B31","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1002\/ppul.23696","article-title":"Structural and functional ventilatory impairment in infants with severe bronchopulmonary dysplasia","volume":"52","author":"van Mastrigt","year":"2017","journal-title":"Pediatr Pulmonol"},{"key":"2026030503474538200_B32","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1164\/rccm.202001-0213OC","article-title":"Magentic resonance imaging evaluation of regional lung Vts in severe neonatal bronchopulmonary dysplasia","volume":"202","author":"Gouwens","year":"2020","journal-title":"Am J Respir Crit Care Med"},{"key":"2026030503474538200_B33","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.1055\/s-0038-1676975","article-title":"A lung ultrasound severity score predicts chronic lung disease in preterm infants","volume":"36","author":"Abdelmawla","year":"2019","journal-title":"Am J Perinatol"},{"key":"2026030503474538200_B34","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1164\/ajrccm.163.1.2005029","article-title":"Endogenous surfactant turnover in preterm infants with respiratory distress syndrome studied with stable isotope lipids","volume":"163","author":"Cavicchioli","year":"2001","journal-title":"Am J Respir Crit Care Med"},{"key":"2026030503474538200_B35","doi-asserted-by":"crossref","first-page":"e0164211","DOI":"10.1371\/journal.pone.0164211","article-title":"Untargeted metabolomic analysis of amniotic fluid in the prediction of preterm delivery and bronchopulmonary dysplasia","volume":"11","author":"Baraldi","year":"2016","journal-title":"PLoS One"},{"key":"2026030503474538200_B36","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.7863\/ultra.15.14.08016","article-title":"Neonatal lung sonography: interobserver agreement between physician interpreters with varying levels of experience","volume":"34","author":"Brusa","year":"2015","journal-title":"J Ultrasound Med"},{"key":"2026030503474538200_B37","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1159\/000493001","article-title":"Lung ultrasound for the differential diagnosis of respiratory distress in neonates","volume":"115","author":"Corsini","year":"2019","journal-title":"Neonatology"},{"key":"2026030503474538200_B38","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1164\/rccm.201101-0055OC","article-title":"Prediction of bronchopulmonary dysplasia by postnatal age in extremely premature infants","volume":"183","author":"Laughon","year":"2011","journal-title":"Am J Respir Crit Care Med"},{"key":"2026030503474538200_B39","doi-asserted-by":"crossref","first-page":"678","DOI":"10.1183\/09031936.00024910","article-title":"Intrapulmonary drug administration in neonatal and paediatric critical care: a comprehensive review","volume":"37","author":"De Luca","year":"2011","journal-title":"Eur Respir J"},{"key":"2026030503474538200_B40","doi-asserted-by":"crossref","first-page":"e0202397","DOI":"10.1371\/journal.pone.0202397","article-title":"Visual assessment versus computer-assisted gray scale analysis in the ultrasound evaluation of neonatal respiratory status","volume":"13","author":"Raimondi","year":"2018","journal-title":"PLoS One"},{"key":"2026030503474538200_B41","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1164\/rccm.201003-0369OC","article-title":"Bedside ultrasound assessment of positive end-expiratory pressure-induced lung recruitment","volume":"183","author":"Bouhemad","year":"2011","journal-title":"Am J Respir Crit Care Med"},{"key":"2026030503474538200_B42","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.chest.2016.08.1465","article-title":"Effectiveness of a critical care ultrasonography course","volume":"151","author":"Greenstein","year":"2017","journal-title":"Chest"},{"key":"2026030503474538200_B43","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1007\/s00431-020-03603-w","article-title":"Introduction of point-of-care neonatal lung ultrasound in a developing country","volume":"179","author":"Mazmanyan","year":"2020","journal-title":"Eur J Pediatr"},{"key":"2026030503474538200_B44","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.jpeds.2018.01.043","article-title":"Bronchopulmonary dysplasia: executive summary of a workshop","volume":"197","author":"Higgins","year":"2018","journal-title":"J Pediatr"},{"key":"2026030503474538200_B45","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1164\/rccm.201810-2037OC","article-title":"Physiology and predictors of impaired gas exchange in infants with bronchopulmonary dysplasia","volume":"200","author":"Svedenkrans","year":"2019","journal-title":"Am J Respir Crit Care Med"},{"key":"2026030503474538200_B46","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1164\/rccm.201812-2348OC","article-title":"The diagnosis of bronchopulmonary dysplasia in very preterm infants: an evidence-based approach","volume":"200","author":"Jensen","year":"2019","journal-title":"Am J Respir Crit Care Med"}],"container-title":["American Journal of Respiratory and Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/203\/11\/1398\/67235698\/ajrccm_203_11_1398.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/203\/11\/1398\/67235698\/ajrccm_203_11_1398.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T08:48:46Z","timestamp":1772700526000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajrccm\/article\/203\/11\/1398\/8490906"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,1]]},"references-count":46,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,6,1]]},"published-print":{"date-parts":[[2021,6,1]]}},"URL":"https:\/\/doi.org\/10.1164\/rccm.202008-3131oc","relation":{},"ISSN":["1073-449X","1535-4970"],"issn-type":[{"value":"1073-449X","type":"print"},{"value":"1535-4970","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,6]]},"published":{"date-parts":[[2021,6,1]]},"assertion":[{"value":"2020-08-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}