Whether it's the skull, heart, abdomen, or lungs, the range of ultrasound applications is hardly as extensive as it is in pediatrics and adolescent medicine. For this reason, St. Marien Children's Hospital in Landshut purchased three high-end ultrasound systems Resona I9 from Mindray in 2023. The Resona I9, with its versatility and extensive probe options, is capable of fulfilling the stringent diagnostic requirements in pediatric care, suitable for patients ranging from 500-gram preterm infants to 80-kilogram teenagers.
How Pediatric Ultrasound is Different from Adult Ultrasound
In pediatric medicine, many things differ from adult medicine, explains the Medical Director and Chief Physician of St. Marien Children's Hospital, Karl F. Schettler: "A significant difference is that our young patients are often in motion. You can't just tell a child to 'stay still and lie down.' This makes certain examinations more difficult and is, in addition to radiation protection, an important reason why ultrasound is firmly anchored in our field. In our clinic, the fact that the previous chief physician, Dr. Reinhard Herterich, is a leading expert in ultrasound in Germany also adds to this. Therefore, this method has a long tradition here and has always been an integral part of specialist further education in St. Marien."
Schettler himself comes from neonatology, which brings its own peculiarities. Thus, the brain is the organ he most frequently examines with ultrasound in newborns - a field that does not exist in adult sonography in this form. "For infants, we can easily scan the entire brain through the still open fontanelle to detect, for example, bleeding, infections, or malformations early on and treat them specifically." After the skull, the heart (echocardiography) and the abdomen are the second and third most frequently examined body areas with ultrasound in neonatology.
Resona I9: The Quick Helper in Emergency
Since the fall of 2023, St. Marien Children's Hospital has installed three Resona I9 ultrasound devices, including one in the regular pediatric intensive care unit and one in the neonatal intensive care unit, where approximately 60 extremely preterm and vulnerable infants weighing less than 1500 grams are cared for annually. The wireless design, long battery life, and rapid system startup time of the Resona I9 convinced the doctors of the children's hospital during the selection process, as these features create ideal conditions for being able to react quickly in an emergency.
Applications in Lung Ultrasound
The Resona I9 offers the pediatrician and his team versatile applications, for example, in assessing lung anomalies and diseases. Lung ultrasound is gaining importance worldwide, especially in neonatology and intensive medicine. It is a relatively young discipline that differs significantly from other ultrasound procedures, as it is not based on the observation of organs as usual, but on the analysis of artifacts. "This unusual approach has contributed to the lung ultrasound being less known and researched for a long time," explains Schettler. "However, in recent years, numerous studies have shown how lung ultrasound can be used to obtain diagnoses that are just as precise and safe as with conventional X-rays."
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The lung ultrasound is not only used in acute respiratory events but is also excellent for closely monitoring general lung function, adds Schettler: "A lung ultrasound is quickly done, and since we already regularly perform ultrasound examinations in the neonatal intensive care unit, such as on the head, it naturally follows to also ultrasound the lungs. This way, we can monitor disease progression where an additional X-ray would not be justified due to radiation exposure."
Variety of Probes for All Weights
Another reason why Schettler chose the Resona I9 is the wide range of ultrasound probes. These are available in different shapes and high-resolution frequencies, covering a broad spectrum of clinical applications and patients - which is often less in focus in adult medicine but is crucial in pediatric medicine, he emphasizes: "For a 500-gram baby, we need a probe that works with high frequencies and is suitable for low penetration depth. With larger patients, such as an 80-kilogram teenager, this would not work, as these frequencies do not penetrate deep enough into the body. Therefore, we need a wide range of ultrasound probes to achieve optimal image quality in all weight classes."
The standard equipment of the Resona I9 in Landshut includes five different types of probes: a small probe specially designed for newborns; a probe for larger patients that images deeper structures in older children and adolescents; an abdominal probe; a linear probe, and a hockey-stick probe, which is ideal for functional and targeted applications. Therefore, pediatricians are well prepared for any diagnostic challenge in their daily clinic routine. With the Resona I9, they have found a solution that flexibly adapts to the individual requirements in pediatrics.
About St. Marien Children's Hospital
Founded by the Catholic religious community of the Solanus sisters, St. Marien Children's Hospital looks back on a history of over a hundred years. Today, it is one of the leading institutions for pediatric care in Bavaria, Germany and covers almost all areas of neonatal, pediatric, and adolescent medicine, including diabetology, rheumatology, gastroenterology, neurology, and much more. In the future, the hospital will also be part of the new Medical Campus Niederbayerns and contribute to the training of young doctors as an academic training site.
About Karl Schettler
Karl F. Schettler is a specialist in pediatric and adolescent medicine with comprehensive specializations in neonatology, pediatric cardiology, pediatric intensive medicine, and diabetology. He is qualified in sonography (trainer/DEGUM 1) and is active internationally as the elected president of the European Society for Pediatric Intensive Medicine and Neonatology (ESPNIC). At the turn of the year 2023/2024, he took over from Dr. Reinhard Herterich as Medical Director and Chief Physician at St. Marien Children's Hospital in Landshut. He had previously held the deputy position for many years.
Reference:
[1] https://healthcare-in-europe.com/de/news/mindray-resona-i9-kinderkrankenhaus-st-marien.html
