Knowledge Dissemination of Lung Ultrasound in Diagnosing Neonatal Respiratory Distress Syndrome: A Mixed-methods Study

Background: Semi-structured programmes are available to promote knowledge of lung ultrasound (LUS) among intensivists, and in many neonatal units, LUS is increasingly utilised in the diagnosis of Respiratory Distress Syndrome (RDS). Aims and Objectives: This study seeks to qualitatively evaluate the LUS performed by sonographers of varying experience levels, while quantitatively assessing the agreement in LUS scores between an expert and them in Neonates with RDS. Methods: This is a single-centre, mixed-methods study with 10 participants who conducted LUS scans on 61 neonates less than 34 weeks of gestation diagnosed with RDS. The LUS scans were qualitatively and quantitatively assessed by a non-participant expert using a scoring system that included six zones and a total score. Results: The mean birth weight was 1.3 ± 0.2 kg. The mean gestational age was 31.1 ± 1.6 weeks. Qualitative analysis revealed that all participants demonstrated adequate image quality in LUS imaging. The ICC between the expert and other sonographers for the total scores ranged from 0.98 to 0.99, indicating excellent reliability. The kappa values for zone-wise interrater agreement demonstrated almost perfect agreement (0.81 to 1) in 60% of measurements and substantial interrater agreement (0.61 to 0.8) in 36.66% of measurements. Conclusion: This study has demonstrated adequate quality of LUS scans conducted by sonographers of varying experience levels. This study has demonstrated that neonatal LUS is easy to learn, simple to practice, and consistent with sonographers of varying experience levels.