Althabe María, Bove Paula Martínez-Da, Arancibia Celeste, Montonati Mercedes, Chuchuy Sandra, Flores Doris, Maio Noelia De, Fenoy Mariana, Rodríguez Edgardo, Selvatici Laura
Unidad de Cuidados Intensivos 35, Hospital de Pediatría Juan P. Garrahan, Buenos Aires.
Terapia Intensiva Pediátrica, Hospital Materno-Infantil de Salta, Salta.
Arch Cardiol Mex. 2025;95(2):138-142. doi: 10.24875/ACM.24000070.
Telehealth applied to the perioperative care of pediatric patients with congenital heart disease facilitates sharing experiences and provides valuable support to institutions initiating cardiac surgery programs, improving the quality of patient care. The primary goal of this study is to describe the implementation and initial results of a collaborative telehealth program between two cardiac centers with different complexity.
Three teleconsultations per patient were programed, one preoperative to identify risks and discuss postoperative strategies, the second immediate after admission, and the last on day 2 pop. Demographic data, diagnosis, and surgical procedures (RACHS-1 scale) were recorded. A satisfaction survey was completed at the end of the process for each patient. A descriptive analysis was performed (Stata).
One hundred and twenty-three patients were consulted in 154 connections, with an average of 25 min consultation. Diagnoses included ventricular septal defect, atrial septal defect, and aortic coartation. The proportion of patients undergoing more complex procedures (RACHS-1 ≥ 3) increased from 9.5 to 35%. Survey results indicated that teleconsultation significantly contributed to problem-solving and understanding (100%), suggested new studies (18.6%), or new diagnoses (16.3%), modifications in therapeutic proposals (37.2%), and follow-up protocols (49%). Connectivity issues (41.8%) and challenges in coordinating consultation schedules (42%) were identified as the main difficulties.
Throughout the program, the complexity of RACHS-1 ≥ 3 procedures increased from 9.5 to 35%. Teleconsultation demonstrated notable enhancements in understanding and problem-solving capabilities, despite challenges in connectivity and scheduling coordination.
远程医疗应用于先天性心脏病患儿的围手术期护理，有助于经验分享，并为启动心脏手术项目的机构提供宝贵支持，从而提高患者护理质量。本研究的主要目的是描述两个不同复杂程度的心脏中心之间合作开展的远程医疗项目的实施情况和初步结果。
为每位患者安排三次远程会诊，一次在术前以识别风险并讨论术后策略，第二次在入院后立即进行，最后一次在术后第二天进行。记录人口统计学数据、诊断结果和手术程序（RACHS-1量表）。在每个患者的会诊过程结束时完成满意度调查。进行描述性分析（使用Stata软件）。
通过154次会诊为123名患者提供了咨询，平均会诊时间为25分钟。诊断包括室间隔缺损、房间隔缺损和主动脉缩窄。接受更复杂手术（RACHS-1≥3）的患者比例从9.5%增加到35%。调查结果表明，远程会诊对解决问题和增进理解有显著帮助（100%），提出了新的研究建议（18.6%）或新的诊断（16.3%），对治疗方案进行了修改（37.2%），并对随访方案进行了调整（49%）。网络连接问题（41.8%）和协调会诊时间表方面的挑战（42%）被确定为主要困难。
在整个项目中，RACHS-1≥3手术的复杂程度从9.5%增加到35%。尽管在网络连接和时间表协调方面存在挑战，但远程会诊在理解和解决问题的能力方面有显著提高。
