Department of Critical Care Medicine, Division of Pediatric Cardiac Critical Care, Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15224, USA.
Telemed J E Health. 2012 Mar;18(2):132-6. doi: 10.1089/tmj.2011.0090. Epub 2012 Jan 27.
To describe our international telemedicine experience in pediatric cardiac critical care.
This is a case series of pediatric patients teleassisted from the Cardiac Intensive Care Unit (CICU) at Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA, to the CICU at Hospital Valle del Lili, Cali, Valle, Colombia, between March and December 2010. An attending intensivist from the CICU in Pittsburgh reviewed cases, monitored real-time vital signs, and gave formal medical advice as requested by the attending physician in Cali. The network connection is a Cisco (San Jose, CA)-based Secure Sockets Layer virtual private network via the Internet that allows access to the web-based interface of the Dräger(®) (Lübeck, Germany) physiological monitor system. The videoconferencing equipment consists of a standard component on a custom-made mobile cart that uses an APC(®) (West Kingston, RI) uninterruptible power supply for portable power and 3Com(®) (Hewlett-Packard, Palo Alto, CA) for wireless connectivity. A post-intervention survey regarding satisfaction with the telemedicine service was conducted.
Seventy-one recommendations were given regarding 53 patients. Median age and weight were 10 months and 7.1 kg, respectively. Ventricular septal defect, transposition of the great vessels, and single ventricle accounted for most cases. The most frequent recommendations were related to surgical conduct, management of arrhythmias, and performance of cardiac catheterization studies. No technical difficulties were experienced during the monitoring of the patients. Satisfaction rates were equally high for technical and medical aspects of telemedicine service.
Telemedicine is a feasible option for pediatric intensivists seeking experienced assistance in the management of complex cardiac patients. Real-time remote assistance may improve the medical care of pediatric cardiac patients treated in developing countries.
描述我们在儿科心脏危重病学方面的国际远程医疗经验。
这是一组病例系列，涉及匹兹堡大学医学中心匹兹堡儿童医院心脏重症监护病房（CICU）向哥伦比亚卡利 Valle del Lili 医院 CICU 远程协助的儿科患者，时间为 2010 年 3 月至 12 月。匹兹堡 CICU 的主治重症监护医生审查病例、监测实时生命体征，并根据卡利主治医生的要求提供正式的医疗建议。网络连接是通过互联网使用基于思科（加利福尼亚州圣何塞）的安全套接字层虚拟专用网络，允许访问 Dräger（®）（吕贝克，德国）生理监测系统的基于网络的界面。视频会议设备由一个标准组件组成，位于定制的移动推车上，使用 APC（®）（金斯敦，RI）不间断电源提供便携式电源，3Com（®）（惠普，帕洛阿尔托，CA）提供无线连接。在干预后，对远程医疗服务的满意度进行了调查。
对 53 名患者提出了 71 条建议。中位数年龄和体重分别为 10 个月和 7.1 公斤。室间隔缺损、大动脉转位和单心室占大多数病例。最常见的建议与手术管理、心律失常管理和心导管检查的实施有关。在监测患者期间，未遇到任何技术困难。远程医疗服务的技术和医疗方面的满意度同样高。
对于寻求在复杂心脏患者管理方面寻求经验协助的儿科重症监护医生来说，远程医疗是一种可行的选择。实时远程协助可能会提高发展中国家治疗的儿科心脏患者的医疗护理水平。
