Butterfly IQ Ultrasound in a low-resource neonatal ward.

[Philip]

I am a neonatologist working in a low-income country in a hospital with 6000 + births a year. The hospital also functions as the only neonatal referral center for a region that has 17,000 births a year. Due to being a public institution the mothers of our newborns are mostly from extremely low-income households thus we have high rates of congenital malformations and premature births with the corresponding elevated rates of morbidity and mortality. We are interested in implementing Point of Care Echocardiagram for monitoring pulmonary pressure, cardiac function and PAD as well as implementing Point of Care Ultrasound for pleural effusions, line placement, and to perform transfontanellar ultrasound. On of the cheaper options I found was the Butterfly IQ Ultrasound which connects to iphones and Ipads. While i have talked to other medical practitioners in other countries about their positives experiences in pediatric patients using the Butterfly IQ,  I have not come across someone with experience using the Butterfly IQ in neonatal patients. I would welcome any feedback pertaining to this topic and welcome other affordable solutions of POCUS that can be used in the neonatal population.  

[Tamimi]

I have contacted the company before. They said it's not designed or licensed for newborns and I have not come across anyone that have used it before.

 

[Stefan Johansson]

A colleague of mine has one such probe and said she would let me try it ( after New years). Will report back!

[Stefan Johansson]

Finally... my colleague brought the Butterfly probe and and Ipad, and I took some brain images and echocardiography views. The probe has a large surface and lot of gel is needed to avoid artefacts.

Naturally, the quality is not comparable to our real machine. On the other hand, I think that the quality was surprisingly good, almost like the XP128 (back in the days...  ) . Looking at the AV valves with color doppler also worked reasonably well.

I did not go into any details in the software, but similar to a "real" machine, adjusted settings could probably increase the image quality.

I attach two photos and a long axis echo-view (VLBW infant)

 

[felipeym]

On 1/24/2020 at 9:08 AM, Stefan Johansson said:

Finally... my colleague brought the Butterfly probe and and Ipad, and I took some brain images and echocardiography views. The probe has a large surface and lot of gel is needed to avoid artefacts.

Naturally, the quality is not comparable to our real machine. On the other hand, I think that the quality was surprisingly good, almost like the XP128 (back in the days...  ) . Looking at the AV valves with color doppler also worked reasonably well.

I did not go into any details in the software, but similar to a "real" machine, adjusted settings could probably increase the image quality.

I attach two photos and a long axis echo-view (VLBW infant)

 

Good images! Thanks. Sounds promising
do you think that the probe is too large to use on a newborn? What do you think about extreme preterm infants with birth weight <1000g?

Greetings

[Stefan Johansson]

@felipeym thanks, I think this portable technology will be the future also in high-income settings.

And yes, I think the probe was too large, not the handle as such but the "imaging surface" was like 2x3 cm, so practically too large for convex surfaces like the skull or chest in a small baby.

But, this should be possible to solve. I think that the probe size is choosen by the company to fit a the targeted user base of staff working with larger children and/or adults.

[felipeym]

On 2/1/2020 at 4:33 AM, Stefan Johansson said:

@felipeym thanks, I think this portable technology will be the future also in high-income settings.

And yes, I think the probe was too large, not the handle as such but the "imaging surface" was like 2x3 cm, so practically too large for convex surfaces like the skull or chest in a small baby.

But, this should be possible to solve. I think that the probe size is choosen by the company to fit a the targeted user base of staff working with larger children and/or adults.

Thanks for the feedback!
I think I will give it a try and buy 1, since where I work there is no echocardiogram every day.
I hope it can be useful for premature babies

[mfsamc]

I am a neonatologist in Pakistan. Recently bought this machine. According to the company this machine is not yet approved for transcranial ultrasound of neonates. Rest it works pretty good. We are doing lung ultrasound and echo most commonly.

[Marcie]

Hello - what preset did you use on the butterfly for the cranial ultrasound?

Thanks,

Marcie

[Stefan Johansson]

1 hour ago, Marcie said:

Hello - what preset did you use on the butterfly for the cranial ultrasound?

Thanks,

Marcie

am sorry but I don’t remember... I had the machine only for an hour and just made a quick test run