Evaluation of the use of telemedicine in pediatric intensive care units: a cluster-randomized trial.

Autor:	de Oliveira Laguna Silva G; Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, Brasil., König Klever E; Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, Brasil., Castro da Rocha J; Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, Brasil., da Silva MMD; Instituto de Pesquisa, Hospital Moinhos de Vento - Porto Alegre (RS), Porto Alegre, Brasil., da Rosa de Amorim J; Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, Brasil., Cristina Jacovas V; Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, Brasil., Marina Simionato B; Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, Brasil., Gomes da Cunha L; Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, Brasil., Zaupa APB; Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, Brasil., Mafalda Krauzer JR; Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, Brasil., de Almeida Pires A; Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, Brasil., Cezar Cabral F; Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, Brasil., de Campos Moreira T; Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, Brasil., Rodrigues Moleda Constant HM; Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, Brasil.
Jazyk:	angličtina
Zdroj:	Postgraduate medicine [Postgrad Med] 2024 Aug; Vol. 136 (6), pp. 633-640. Date of Electronic Publication: 2024 Aug 05.
DOI:	10.1080/00325481.2024.2388023
Abstrakt:	Introduction: Telemedicine has shown promising results, allowing specialists to provide rapid and effective care in remote locations. However, to our knowledge, current evidence is not robust enough to prove the effectiveness of this tool. This cluster-randomized trial (CRT) aimed to evaluate the impact of telemedicine on clinical care indicators in pediatric intensive care units (PICUs). Methods: An open-label CRT was conducted in 16 PICUs within the Brazilian public health system. The trial took place from August 2022 to December 2023 and compared an intervention group, which received telemedicine support, with a control group, which received usual PICU care. The primary outcome was the PICU length of stay. The main secondary outcomes were mortality rate and ventilator-free days. Results: A total of 1393 participants were included, 657 in the control group and 736 in the intervention group. The mean PICU length of stay was 10.42 (SD, 10.71) days for the control group and 11.52 (SD, 10.80) days for the intervention group. The overall mean of ventilator-free days was 6.82 (SD, 7.71) days. Regarding mortality, 7.54% of participants died in total. No significant difference was found in the outcomes between the groups. Conclusion: Despite the potential benefits of telemedicine, its effective implementation in the Brazilian public health system faces considerable challenges, highlighting the continued importance of investigating and improving the role of telemedicine in pediatric critical care. Clinical Trial Registration: ClinicalTrials.gov NCT05260710 and ReBEC - RBR-7×j4wyp.
Databáze:	MEDLINE
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