Ventilatory settings are critical in mechanically ventilated extremely preterm newborn infants due to the risk of ventilation induced lung injury (VILI) and subsequent development of bronchopulmonary dysplasia (BPD) [1]. The positive end-expiratory pressure (PEEP) settings usually rely on blood gases, oxygen requirement, lung auscultation, evaluation of chest radiograph, and assessment of pressure-volume curves provided by the ventilators. Studies of optimal PEEP settings in the surfactant treated preterm infant in need of mechanical ventilation are limited and evidence based clinical guidelines are sparse [2, 3]. Footnotes This manuscript has recently been accepted for publication in the European Respiratory Journal . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article. Conflict of interest: Dr. Wallstrom has nothing to disclose. Conflict of interest: Dr. Veneroni reports and My institution (Politecnico di Milano University) received research grants from Chiesi Farmaceutici Conflict of interest: Dr. Zannin has nothing to disclose. Conflict of interest: Dr. Dellaca’ reports grants from Acutronic, outside the submitted work; In addition, Dr. Dellaca’ has a patent on the detection of EFL by FOT with royalties paid to Philips Respironics and Restech srl, a patent on monitoring lung volume recruitment by FOT with royalties paid to Vyaire, and a patent on early detection of exacerbations by home monitoring of FOT with royalties paid to Restech. Conflict of interest: Dr. Sindelar has nothing to disclose.