{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:53:01Z","timestamp":1790009581483,"version":"4.0.1"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Lung ultrasound (LUS) offers a safe, repeatable, radiation-free tool in management of respiratory distress in neonates. Despite wide use, limited data exists on optimal scoring approaches.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methodology<\/jats:title><jats:p>A prospective observational study was conducted over 6 months in a tertiary neonatal intensive care unit (NICU) enrolling neonates with respiratory distress within 2\u2005h of admission after consent. LUS was performed using both 6-area and 12-area scanning approaches. Scores were assigned per Brat's criteria. Primary outcome was prediction of need for invasive ventilation within 72\u2005h. Secondary outcomes included optimal cut-off scores, correlation with clinical outcomes and procedural safety.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 73 neonates enrolled, the 6-area LUS score (cut-off \u22655) predicted invasive mechanical ventilation within 72\u2005h with 75% sensitivity and 67% specificity (AUC\u2009=\u20090.76). The 12-area score (cut-off \u226513) had similar accuracy (sensitivity 75%, specificity 73%; AUC\u2009=\u20090.77). Both 6-area and 12-area scores performed better in neonates &amp;lt;34 weeks (AUCs: 0.83 vs. 0.86). In neonates presenting after 24\u2005h of life (<jats:italic>n<\/jats:italic>\u2009=\u200919), both scores maintained good accuracy (AUCs: 0.80 for 6-area, 0.83 for 12-area). Multivariate analysis identified partial pressure of carbon dioxide (pCO<jats:sub>2<\/jats:sub>) and duration of stay as independent predictors. The 12-area score required reattempts (in 9% cases) unlike the 6-area score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In neonates presenting with respiratory distress, 6-area and 12-area LUS scores done within 2\u2005h of admission show good and comparable predictive value regarding need for invasive ventilation by 72\u2005h.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2025.1638936","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T05:35:24Z","timestamp":1755063324000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Neonatal evaluation by extended (12 area) vs. traditional (6 area) lung ultrasound scoring (NEXT-LUS): a prospective observational 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