{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T16:48:46Z","timestamp":1782406126378,"version":"3.54.5"},"reference-count":25,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neonatal-Perinatal Medicine"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lung recruitment maneuvers (LRM) during high-frequency oscillatory ventilation (HFOV) lack bedside standardized monitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>\n                      To evaluate the efficacy and safety of FiO\n                      <jats:sub>2<\/jats:sub>\n                      -guided LRM in preterm infants with moderate-to-severe respiratory-distress syndrome (RDS) using integrated functional echocardiography (FE) and lung ultrasound (LUS). Also, we hypothesized that a standardized LUS score can accurately guide successful recruitment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This a prospective, single-arm, protocol-driven cohort study that was conducted at a tertiary NICU (Alexandria University), and 70 preterm infants (GA 32\u201337 weeks) requiring HFOV within 24\u00a0h of life were included. Integrated LUS and FE were performed at three phases: pre-initiation, maintenance pressure (opening), and pre-weaning. Lung aeration was quantified using a standardized 12-zone LUS protocol (0\u20133 points per zone) based on international consensus. Hemodynamics were assessed via tricuspid regurgitation (TR) gradient, superior vena cava (SVC) flow, and right ventricular myocardial performance index (RV-MPI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      LRM led to significant improvements in oxygenation and lung aeration. Mean LUS scores decreased significantly from 23.13 \u00b1 1.33 (pre-initiation) to 19.94 \u00b1 1.67 (maintenance) and 3.70 \u00b1 2.49 (pre-weaning) (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). FE demonstrated a significant reduction in TR gradient (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), while SVC flow and RV-MPI remained stable, indicating preserved myocardial function. Pre-weaning LUS scores were significantly associated with weaning success from HFOV.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      FiO\n                      <jats:sub>2<\/jats:sub>\n                      -guided LRM is effective and safe in late-preterm infants with RDS. Integrated bedside imaging confirms that recruitment improves lung aeration without compromising hemodynamics. A standardized LUS score is a reliable tool for identifying optimal lung opening and guiding the weaning process.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19345798261461225","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T19:24:18Z","timestamp":1782156258000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrated echocardiography and lung ultrasound assessment of lung recruitment in preterm infants using high frequency ventilation: A prospective, single-arm, protocol-driven cohort study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0426-9018","authenticated-orcid":false,"given":"Marwa Mohammed","family":"Farag","sequence":"first","affiliation":[{"name":"Alexandria University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Hazem","family":"Gouda","sequence":"additional","affiliation":[{"name":"Alexandria University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aly Mohamed","family":"Abdel-Mohsen","sequence":"additional","affiliation":[{"name":"Alexandria University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Hany","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Alexandria University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"issue":"6","key":"e_1_3_4_2_2","first-page":"465","article-title":"Lung injury in preterm infants on mechanical ventilation: mechanisms and prevention","volume":"6","author":"Clark RH","year":"2018","unstructured":"Clark RH, Gerstmann DR, Jobe AH, et al. 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