The following is a summary of “Telemedicine critical care availability and outcomes among mechanically ventilated patients,” published in the March 2024 issue of Critical Care by Graves et al.

Telemedicine Critical Care (TCC) enhances compliance with evidence-based protocols, which are linked to improved mortality rates among patients undergoing invasive mechanical ventilation (IMV).

Researchers conducted a retrospective study to investigate whether hospital availability of TCC impacted outcomes for patients on IMV, considering prior evidence suggesting TCC improves adherence to protocols and lowers mortality rates.

They involved 66,522 adult patients in 318 non-federal hospitals who underwent IMV for non-postoperative acute respiratory failure in New York, Massachusetts, Maryland, and Florida (2018). The data on hospital-level TCC was sourced from the 2018  American Hospital Association Annual Survey. The study’s primary outcome was in-hospital mortality, while secondary outcomes included a composite measure of tracheostomy or reintubation and the duration of IMV. Two hierarchical multivariable regression models were employed to examine the relationship between TCC availability and the outcomes.

The result showed no significant association between hospital availability of TCC and patient outcomes. Specifically, in-hospital mortality (OR 0.94, 99% CI 0.84-1.05), the combined occurrence of tracheostomy or re-intubation (OR 0.95, CI 0.82-1.11), and duration of IMV (OR 0.95, CI 0.83-1.09) were not significantly impacted by TCC availability. The patients with Acute Respiratory Distress Syndrome (ARDS) did not experience a significant difference in outcomes based on hospital availability of TCC.

Investigators concluded that no significant association was observed between the hospital availability of TCC and outcomes for patients with IMV.  

Source: sciencedirect.com/science/article/abs/pii/S0883944124002697