Medical School of Chinese PLA, Beijing, China.
The First Medical Centre, Chinese PLA General Hospital, Beijing, China.
J Med Internet Res. 2024 May 27;26:e54095. doi: 10.2196/54095.
In recent epochs, the field of critical medicine has experienced significant advancements due to the integration of artificial intelligence (AI). Specifically, AI robots have evolved from theoretical concepts to being actively implemented in clinical trials and applications. The intensive care unit (ICU), known for its reliance on a vast amount of medical information, presents a promising avenue for the deployment of robotic AI, anticipated to bring substantial improvements to patient care.
This review aims to comprehensively summarize the current state of AI robots in the field of critical care by searching for previous studies, developments, and applications of AI robots related to ICU wards. In addition, it seeks to address the ethical challenges arising from their use, including concerns related to safety, patient privacy, responsibility delineation, and cost-benefit analysis.
Following the scoping review framework proposed by Arksey and O'Malley and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we conducted a scoping review to delineate the breadth of research in this field of AI robots in ICU and reported the findings. The literature search was carried out on May 1, 2023, across 3 databases: PubMed, Embase, and the IEEE Xplore Digital Library. Eligible publications were initially screened based on their titles and abstracts. Publications that passed the preliminary screening underwent a comprehensive review. Various research characteristics were extracted, summarized, and analyzed from the final publications.
Of the 5908 publications screened, 77 (1.3%) underwent a full review. These studies collectively spanned 21 ICU robotics projects, encompassing their system development and testing, clinical trials, and approval processes. Upon an expert-reviewed classification framework, these were categorized into 5 main types: therapeutic assistance robots, nursing assistance robots, rehabilitation assistance robots, telepresence robots, and logistics and disinfection robots. Most of these are already widely deployed and commercialized in ICUs, although a select few remain under testing. All robotic systems and tools are engineered to deliver more personalized, convenient, and intelligent medical services to patients in the ICU, concurrently aiming to reduce the substantial workload on ICU medical staff and promote therapeutic and care procedures. This review further explored the prevailing challenges, particularly focusing on ethical and safety concerns, proposing viable solutions or methodologies, and illustrating the prospective capabilities and potential of AI-driven robotic technologies in the ICU environment. Ultimately, we foresee a pivotal role for robots in a future scenario of a fully automated continuum from admission to discharge within the ICU.
This review highlights the potential of AI robots to transform ICU care by improving patient treatment, support, and rehabilitation processes. However, it also recognizes the ethical complexities and operational challenges that come with their implementation, offering possible solutions for future development and optimization.
近年来,随着人工智能(AI)的融入,重症医学领域取得了重大进展。特别是,人工智能机器人已经从理论概念发展到积极应用于临床试验和应用中。重症监护病房(ICU)以大量医疗信息为依托,为机器人人工智能的部署提供了广阔的前景,有望为患者护理带来实质性的改善。
本综述旨在通过搜索与 ICU 病房相关的 AI 机器人的前期研究、开发和应用,全面总结 AI 机器人在重症监护领域的现状。此外,还探讨了其使用所带来的伦理挑战,包括安全性、患者隐私、责任界定和成本效益分析等方面的问题。
我们按照 Arksey 和 O'Malley 提出的范围综述框架和 PRISMA(系统评价和荟萃分析的首选报告项目)指南,进行了范围综述,以确定 ICU 中 AI 机器人研究的广度,并报告研究结果。文献检索于 2023 年 5 月 1 日在 3 个数据库(PubMed、Embase 和 IEEE Xplore 数字图书馆)进行。最初根据标题和摘要筛选合格出版物。通过初步筛选的出版物进行全面审查。从最终出版物中提取、总结和分析了各种研究特征。
在筛选的 5908 篇文献中,有 77 篇(1.3%)进行了全面审查。这些研究共涵盖了 21 个 ICU 机器人项目,包括系统开发和测试、临床试验和批准过程。根据专家评审的分类框架,这些研究被分为 5 个主要类型:治疗辅助机器人、护理辅助机器人、康复辅助机器人、远程呈现机器人和物流与消毒机器人。其中大多数已经在 ICU 中广泛部署和商业化,尽管有少数仍在测试中。所有机器人系统和工具都旨在为 ICU 中的患者提供更个性化、更便捷、更智能的医疗服务,同时旨在减轻 ICU 医护人员的大量工作量,并促进治疗和护理程序。本综述进一步探讨了当前存在的挑战,特别是关注伦理和安全问题,提出了可行的解决方案或方法,并展示了 AI 驱动的机器人技术在 ICU 环境中的预期能力和潜力。最终,我们预见到机器人在 ICU 中从入院到出院的完全自动化连续体的未来场景中发挥关键作用。
本综述强调了人工智能机器人通过改善患者治疗、支持和康复过程来改变 ICU 护理的潜力。然而,它也认识到了其实施所带来的伦理复杂性和操作挑战,为未来的发展和优化提供了可能的解决方案。