Houston hospital taps new tech to provide more accurate COVID-19 diagnostics and treatment

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CHI St. Luke's Health has invested in around 40 of the Butterfly iQ devices that can be used to provide accurate and portable ultrasonography on COVID-19 patients. Photo courtesy of CHI St. Luke's

With such a dynamic virus like COVID-19 that affects patients with different levels of severity, the first challenge doctors face when treating infected patients is assessing the situation. CHI St. Luke's Health has been implementing a new technology that allows its physicians better access to that initial diagnosis.

Dr. Jose Diaz-Gomez, an anesthesiologist at CHI St. Luke's Health and ultrasonography expert, says the Butterfly iQ's portable ultrasonography technology has been a key tool in his team's point of care for COVID-19 patients. Over the past few years, ultrasonography equipment has been evolving to be more portable and more accurate. That's what the Butterfly iQ technology provides, and Diaz-Gomez says his team was quick to realize how the technology can help in diagnostics and treatment of coronavirus patients.

A traditional approach to examining a patient's lungs would mean radiography, but Diaz-Gomez says his team saw the opportunity ultrasonography and these new, portable devices had on providing more accurate and timely diagnostics.

"In conditions that are dynamic, you want to have a diagnostic tool that, over time as you're treating a patient, you can see meaningful changes — good or bad," Diaz-Gomez says. "The pandemic has enabled us to use — from the initial care to when they are on the ventilator — ultrasonography to see the changes in the patient's' lungs."

Jose Diaz-Gomez is an anesthesiologist at CHI St. Luke's. Photo courtesy of CHI St. Luke's

The Butterfly iQ device is different from its ultrasound predecessors in that it's built to be more accurate, portable, easy to use, and low cost (even being made available for commercial purchase). According to Diaz-Gomez, he could train someone on the device in just a few hours.

Ahead of the pandemic, CHI St. Luke's had 20 of these devices and now has doubled that initial fleet. Along with the other non-Butterfly iQ ultrasonography devices, Diaz-Gomez's team has access to 70 ultrasonography devices — 80 percent of which are dedicated to COVID-19 patients.

"Our institution was very supportive of bringing a very robust roll-out program for point-of-care ultrasonography during the pandemic," Diaz-Gomez says. "We were able to incorporate 40 ultrasound devices — the Butterfly system. Not only that, we actually implemented a very rigorous infection control process to make sure we do it in a safe manner. You don't want to bring tools that will be another source of transmission from patient to patient."

While this new technology is continuing to make a difference in St. Luke's COVID units, Diaz-Gomez is already looking forward to the difference the devices will make post pandemic.

"Whatever we will face after the pandemic, many physicians will be able to predict more objectively when a patient is deteriorating from acute respiratory failure," he says. "Without this innovation, we wouldn't have been able to be at higher standards with ultrasonography."

The device, with its portability, low cost, and ease of use, also has an application for telemedicine and at-home health, and that's something that's exciting for Diaz-Gomez. However, both in his COVID units or in the home setting, the device is only as good as the clinician who's interpreting the images paired with the other diagnostics.

"The integration of ultrasonography with the clinical practice itself — it has to go hand in hand," Diaz-Gomez says. "The clinical decision will depend on that integration."

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Rice University lands $18M to revolutionize lymphatic disease detection

fresh funding

An arm of the U.S. Department of Health and Human Services has awarded $18 million to scientists at Rice University for research that has the potential to revolutionize how lymphatic diseases are detected and help increase survivability.

The lymphatic system is the network of vessels all over the body that help eliminate waste, absorb fat and maintain fluid balance. Diseases in this system are often difficult to detect early due to the small size of the vessels and the invasiveness of biopsy testing. Though survival rates of lymph disease have skyrocketed in the United States over the last five years, it still claims around 200,000 people in the country annually.

Early detection of complex lymphatic anomalies (CLAs) and lymphedema is essential in increasing successful treatment rates. That’s where Rice University’s SynthX Center, directed by Han Xiao and Lei Li, an assistant professor of electrical and computer engineering, comes in.

Aided by researchers from Texas Children’s Hospital, Baylor College of Medicine, the University of Texas at Dallas and the University of Texas Southwestern Medical Center, the center is pioneering two technologies: the Visual Imaging System for Tracing and Analyzing Lymphatics with Photoacoustics (VISTA-LYMPH) and Digital Plasmonic Nanobubble Detection for Protein (DIAMOND-P).

Simply put, VISTA-LYMPH uses photoacoustic tomography (PAT), a combination of light and sound, to more accurately map the tiny vessels of the lymphatic system. The process is more effective than diagnostic tools that use only light or sound, independent of one another. The research award is through the Advanced Research Projects Agency for Health (ARPA-H) Lymphatic Imaging, Genomics and pHenotyping Technologies (LIGHT) program, part of the U.S. HHS, which saw the potential of VISTA-LYMPH in animal tests that produced finely detailed diagnostic maps.

“Thanks to ARPA-H’s award, we will build the most advanced PAT system to image the body’s lymphatic network with unprecedented resolution and speed, enabling earlier and more accurate diagnosis,” Li said in a news release.

Meanwhile, DIAMOND-P could replace the older, less exact immunoassay. It uses laser-heated vapors of plasmonic nanoparticles to detect viruses without having to separate or amplify, and at room temperature, greatly simplifying the process. This is an important part of greater diagnosis because even with VISTA-LYMPH’s greater imaging accuracy, many lymphatic diseases still do not appear. Detecting biological markers is still necessary.

According to Rice, the efforts will help address lymphatic disorders, including Gorham-Stout disease, kaposiform lymphangiomatosis and generalized lymphatic anomaly. They also could help manage conditions associated with lymphatic dysfunction, including cancer metastasis, cardiovascular disease and neurodegeneration.

“By validating VISTA-LYMPH and DIAMOND-P in both preclinical and clinical settings, the team aims to establish a comprehensive diagnostic pipeline for lymphatic diseases and potentially beyond,” Xiao added in the release.

The ARPA-H award funds the project for up to five years.

Houston doctor wins NIH grant to test virtual reality for ICU delirium

Virtual healing

Think of it like a reverse version of The Matrix. A person wakes up in a hospital bed and gets plugged into a virtual reality game world in order to heal.

While it may sound far-fetched, Dr. Hina Faisal, a Houston Methodist critical care specialist in the Department of Surgery, was recently awarded a $242,000 grant from the National Institute of Health to test the effects of VR games on patients coming out of major surgery in the intensive care unit (ICU).

The five-year study will focus on older patients using mental stimulation techniques to reduce incidences of delirium. The award comes courtesy of the National Institute on Aging K76 Paul B. Beeson Emerging Leaders Career Development Award in Aging.

“As the population of older adults continues to grow, the need for effective, scalable interventions to prevent postoperative complications like delirium is more important than ever,” Faisal said in a news release.

ICU delirium is a serious condition that can lead to major complications and even death. Roughly 87 percent of patients who undergo major surgery involving intubation will experience some form of delirium coming out of anesthesia. Causes can range from infection to drug reactions. While many cases are mild, prolonged ICU delirium may prevent a patient from following medical advice or even cause them to hurt themselves.

Using VR games to treat delirium is a rapidly emerging and exciting branch of medicine. Studies show that VR games can help promote mental activity, memory and cognitive function. However, the full benefits are currently unknown as studies have been hampered by small patient populations.

Faisal believes that half of all ICU delirium cases are preventable through VR treatment. Currently, a general lack of knowledge and resources has been holding back the advancement of the treatment.

Hopefully, the work of Faisal in one of the busiest medical cities in the world can alleviate that problem as she spends the next half-decade plugging patients into games to aid in their healing.

New accelerator joins the Ion and more Houston innovation news to know

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