• Postgraduate medicine · Aug 2024

    Randomized Controlled Trial Multicenter Study

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

    • Gabriela de Oliveira Laguna Silva, Emanuele König Klever, Jacqueline Castro da Rocha, Mariana Motta Dias da Silva, Jerusa da Rosa de Amorim, Vanessa Cristina Jacovas, Bárbara Marina Simionato, Luciane Gomes da Cunha, Ana Paula Berni Zaupa, Mafalda KrauzerJoão RonaldoJR0000-0002-1802-6175Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, Brasil., Aristóteles de Almeida Pires, Cezar CabralFelipeF0000-0003-4648-1228Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, Brasil., Taís de Campos Moreira, and Hilda Maria Rodrigues Moleda Constant.
    • Responsabilidade Social, Hospital Moinhos de Vento, Porto Alegre, Brasil.
    • Postgrad Med. 2024 Aug 1; 136 (6): 633640633-640.

    IntroductionTelemedicine 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).MethodsAn 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.ResultsA 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.ConclusionDespite 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 RegistrationClinicalTrials.gov NCT05260710 and ReBEC - RBR-7×j4wyp.

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