Pulmonary hypertension in newborns (PPHN) is triggered by multiple etiologies including hypoxemia and underlying parenchymal lung diseases and can potentially hinder extubation. Performing a full echocardiographic studies on all mechanically ventilated preterm infants would be exhaustive and may not consistently correlate with PPHN.

         LVEI is a quantifiable measure of the amount of distortion of ventricular septal geometry due to elevated right ventricular systolic or diastolic pressures and/or volumes. Greater degrees of LVEI have been associated with PPHN in children and adults, but have not been studied thoroughly in premature infants. LVEI has the added benefit of being easily measured from any short axis view of the mid ‐left ventricle.Increased end ‐diastolic LVEI would indicate volume overload as in hemodynamically significant PDA and increased end‐systolic LVEI may indicate right ventricular volume overload as in PPHN,.The aim of the study is to find correlation betweeen lung ultrasound score and left ventricular eccentricity index in predicting extubation readiness in preterm neonates with RDS