Lung ultrasound assessment of pulmonary effects of large patent ductus arteriosus in extremely preterm infants beyond the transitional period
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Bibliographic record
Abstract
BACKGROUND: Several studies have suggested a positive association between elevated lung ultrasound scores (LUS) and large patent ductus arteriosus (L-PDA), although findings remain inconsistent. Lung ultrasound score, a semi-quantitative measure of pulmonary aeration loss, has been proposed as a surrogate marker of excessive lung fluid, which may reflect the hemodynamic burden of a significant PDA. The aim of this study was to assess the association between LUS and L-PDA in preterm neonates beyond the initial transitional period and examine its correlations with echocardiographic measures of ductal shunting. This is a cohort retrospective study that included preterm infants born at < 29 weeks' gestation who underwent LUS within 24 h of targeted neonatal echocardiography. Infants were categorized as having L-PDA (diameter ≥ 1.5 mm, left-to-right shunt) or no/small PDA (< 1.5 mm). Clinical characteristics, LUS, and echocardiographic parameters including PDA diameter, left atrial-to-aortic root (LA: Ao) ratio, and left ventricular output (LVO) were compared. Statistical analyses included univariate, multivariate, and correlation assessments. RESULTS: Among 119 infants included in the analysis, 56 (47%) had L-PDA, and 63 (53%) had no or small PDA. Infants with L-PDA had significantly lower gestational age and higher rates of invasive ventilation. LUS, LA: Ao ratio, and LVO were significantly elevated in the L-PDA group (all p < 0.001). LUS correlated with PDA diameter (r = 0.27, p = 0.003) and respiratory severity score (r = 0.49, p < 0.001). Furthermore, LUS was found to be independently predictive for L-PDA (adjusted OR 1.5; 95% CI: 1.1-1.9). Each 1-point increase in LUS was associated with a 0.14 mm increase in PDA diameter. Inter-rater reliability for LUS was strong (IRR = 0.86). CONCLUSION: Beyond the transitional period, LUS was significantly associated with PDA size and independently predicted L-PDA in extremely preterm infants.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it