ArticleClinical and experimental pediatrics2026
Telemedicine outcome of mechanically ventilated children in Brazilian pediatric intensive care units.
Article in Clinical and experimental pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPediatric 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.
methodsThis 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.
resultsA 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.
conclusionThe 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.
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