• Journal of critical care · Aug 2024

    Telemedicine critical care availability and outcomes among mechanically ventilated patients.

    • Jonah M Graves, James G Krings, Joanna L Buss, Dorina Kallogjeri, and Uchenna R Ofoma.
    • Division of Pulmonary and Critical Care Medicine, Department of Medicine, Washington University in St. Louis School of Medicine, United States of America. Electronic address: graves.jonah@wustl.edu.
    • J Crit Care. 2024 Aug 1; 82: 154782154782.

    PurposeTelemedicine Critical Care (TCC) improves adherence to evidence based protocols associated with improved mortality among patients receiving invasive mechanical ventilation (IMV). We sought to evaluate the relationship between hospital availability of TCC and outcomes among patients receiving IMV.Materials And MethodsWe performed a cross-sectional study of 66,522 adults who received IMV for non-postoperative acute respiratory failure at 318 non-federal hospitals in New York, Massachusetts, Maryland, and Florida in 2018. Hospital-level TCC availability was ascertained from the 2018 American Hospital Association Annual Survey. The primary outcome was in-hospital mortality. Secondary outcomes included the composite of tracheostomy or reintubation and duration of IMV. We used two-level hierarchical multivariable regression models to investigate the association between TCC availability and outcomes.Results20,270 (30.5%) patients were admitted into 89 TCC-available hospitals. There was no difference between TCC and non-TCC-available hospitals in mortality (odds ratio [OR] 0.94, 99% confidence interval [CI] 0.84-1.05), composite of tracheostomy or reintubation (OR 0.95 [0.82-1.11], or duration of IMV (OR 0.95 [0.83-1.09]). There was no difference in outcomes among the subgroup of patients with acute respiratory distress syndrome.ConclusionsHospital TCC availability was not associated with improved outcomes among patients receiving IMV.Copyright © 2024 Elsevier Inc. All rights reserved.

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