{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T08:06:21Z","timestamp":1782201981577,"version":"3.54.5"},"reference-count":29,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T00:00:00Z","timestamp":1657584000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>This study investigated the effectiveness of an original Lung UltraSound Targeted Recruitment (LUSTR) protocol to improve the success of lung recruitment maneuvers (LRMs), which are performed as a rescue approach in critically ill neonates. All the LUSTR maneuvers, performed on infants with an oxygen saturation\/fraction of inspired oxygen (S\/F) ratio below 200, were included in this case\u2212control study (LUSTR-group). The LUSTR-group was matched by the initial S\/F ratio and underlying respiratory disease with a control group of lung recruitments performed following the standard oxygenation-guided procedure (Ox-group). The primary outcome was the improvement of the S\/F ratio (Delta S\/F) throughout the LRM. Secondary outcomes included the rate of air leaks. Each group was comprised of fourteen LRMs. As compared to the standard approach, the LUSTR protocol was associated with a higher success of the procedure in terms of Delta S\/F (110 \u00b1 47.3 vs. 64.1 \u00b1 54.6, p = 0.02). This result remained significant after adjusting for confounding variables through multiple linear regressions. The incidence of pneumothorax was lower, although not reaching statistical significance, in the LUSTR-group (0 vs. 14.3%, p = 0.15). The LUSTR protocol may be a more effective and safer option than the oxygenation-based procedure to guide open lung ventilation in neonates, potentially improving ventilation and reducing the impact of ventilator-induced lung injury.<\/jats:p>","DOI":"10.3390\/children9071035","type":"journal-article","created":{"date-parts":[[2022,7,12]],"date-time":"2022-07-12T20:52:41Z","timestamp":1657659161000},"page":"1035","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Lung UltraSound Targeted Recruitment (LUSTR): A Novel Protocol to Optimize Open Lung Ventilation in Critically Ill Neonates"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4101-9982","authenticated-orcid":false,"given":"Roberto","family":"Chioma","sequence":"first","affiliation":[{"name":"Dipartimento Universitario Scienze della Vita e Sanit\u00e0 Pubblica, Unit\u00e0 Operativa Complessa di Neonatologia, Fondazione Policlinico Universitario A Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Amabili","sequence":"additional","affiliation":[{"name":"Bernoulli Institute for Mathematics, Computer Science and Artificial Intelligence, University of Groningen, 9712 CP Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Ciarmoli","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, ASST Vimercate, Vimercate Hospital, 20871 Vimercate, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Copetti","sequence":"additional","affiliation":[{"name":"Emergency Department, Latisana General Hospital, 33053 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier Giorgio","family":"Villani","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Maggiore Hospital, 26100 Cremona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miria","family":"Natile","sequence":"additional","affiliation":[{"name":"Neonatal Intensive Care Unit, Azienda Sanitaria Romagna, Infermi Hospital Rimini, 47923 Rimini, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Vento","sequence":"additional","affiliation":[{"name":"Dipartimento Universitario Scienze della Vita e Sanit\u00e0 Pubblica, Unit\u00e0 Operativa Complessa di Neonatologia, Fondazione Policlinico Universitario A Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7525-162X","authenticated-orcid":false,"given":"Enrico","family":"Storti","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Maggiore Hospital, 26100 Cremona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5451-6702","authenticated-orcid":false,"given":"Maria","family":"Pierro","sequence":"additional","affiliation":[{"name":"Neonatal and Paediatric Intensive Care Unit, M. Bufalini Hospital, AUSL Romagna, 47521 Cesena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s13089-017-0073-0","article-title":"Postural lung recruitment assessed by lung ultrasound in mechanically ventilated children","volume":"9","author":"Tusman","year":"2017","journal-title":"Crit. Ultrasound J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s13089-016-0045-9","article-title":"Ultrasonography for the assessment of lung recruitment maneuvers","volume":"8","author":"Tusman","year":"2016","journal-title":"Crit. Ultrasound J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/j.jpeds.2009.01.059","article-title":"Lung recruitment for ventilation: Does it work, and is it safe?","volume":"154","author":"Jobe","year":"2009","journal-title":"J. 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