Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
Department of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil.
J Crit Care. 2021 Feb;61:241-246. doi: 10.1016/j.jcrc.2020.09.036. Epub 2020 Nov 3.
The high demand for intensive care, which is predicted to further increase in the future, is contrasted by a shortage of trained intensivists and specialized nurses. Telemedicine has been heralded as a promising solution. Yet, there is considerable heterogeneity in tele-critical care when it comes to measurable effects. However, the focus has been on telemedical solutions substituting on-site intensivist functions, and outcome measures have primarily been mortality and length of stay. In a new model of telemedicine for the ICU, telemedicine could be used to increase adherence to best practice guidelines and indicators of process quality. Further, indicators of process quality, functional outcomes and quality of life measures should be incorporated in the evaluation of outcomes, as patients frequently value those higher than mere survival.
对重症监护的高度需求预计未来还会进一步增加，但重症监护专家和专业护士的短缺却与之形成鲜明对比。远程医疗被誉为一种很有前途的解决方案。然而，在可衡量的效果方面，远程重症监护存在着相当大的异质性。然而，重点一直放在远程医疗解决方案替代现场重症监护医生的功能上，并且衡量的结果主要是死亡率和住院时间。在重症监护室远程医疗的新模式中，可以使用远程医疗来提高对最佳实践指南和流程质量指标的遵循程度。此外，应该将流程质量、功能结果和生活质量指标纳入结果评估，因为患者通常比单纯的生存更看重这些指标。
