Work

Telemedicine outcome of mechanically ventilated children in Brazilian pediatric intensive care units

Year: 2025

Type: article

Abstract: BACKGROUND: Pediatric intensive care units (PICUs) have undergone significant evolution, resulting in a reduction in patient morbidity and mortality rates. Telemedicine has emerged as a valuable resource for services that optimize the care processes in PICUs. Despite growing interest in telemedicine for pediatric critical care, its impact on mechanically ventilated (MV) children in public health settings in Brazil remains underexplored. PURPOSE: This study aimed to evaluate the effect of telemedicine on the care of MV patients in 2 public PICUs in Brazil. METHODS: This prospective pre-post interventional study was conducted in 2 public PICUs in the Northern and Northeastern regions of Brazil. Patients aged 0-18 years who received ventilatory support between January 1, 2019, and December 31, 2021, were included. The intervention consisted of daily synchronous telerounds conducted by pediatric intensivists from Hospital Moinhos de Vento who provided clinical consultation and ensured protocol adherence. The primary evaluated outcomes included mortality, ventilator-free days (VFD), and MV duration. RESULTS: A total of 790 patients were analyzed: 261 in the pretelemedicine period and 529 in the posttelemedicine period. The overall mortality rate decreased significantly from 20.7% to 10.4% (P<0.001). In center A, mortality decreased from 25.96% to 9.86% (P<0.001); in center B, mortality decreased from 17.2% to 11.06% (P=0.11). The overall VFD increased significantly from 3 days (interquartile range, 0-7) to 4 days (interquartile range, 2-8) (P<0.001). No significant differences were noted in total MV duration in the general analysis. CONCLUSION: The implementation of telemedicine in public PICUs significantly reduced mortality and increased VFD among MV patients. These findings support telemedicine as a viable and promising strategy for enhancing pediatric critical care in public health systems, thereby contributing to improved patient outcomes.

Source: Korean Journal of Pediatrics

DOI: 10.3345/cep.2025.01270