Usefulness of eICU system in pediatric critical care consultation

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[SUMMARY] Background : The complexity of pediatric intensive care unit（PICU） support has increased due to advances in surgical interventions and treatment modalities. The need for the PICU is increasing, but the current number of pediatric intensive care physicians is inadequate to meet the demand. Intensive care unit telemedicine（tele-ICU/eICU） was developed to address the increasing complexity of patient care and the inadequate number of intensivists. Methods : The first eICU system was installed in Tokyo Metropolitan Children’s Medical Center （TMCMC） in 2010. This eICU network was developed as a collaborative effort between TMCMC and Tama-Hokubu Medical Center（THMC）. A video conference unit was installed in the PICU at TMCMC, and a mobile, pole-mounted telemedicine unit was placed in the pediatric ward at THMC. We analyzed case backgrounds, purpose of usage and efficacy of this eICU system. Also we herein describe the typical case of one patient whose treatment clearly demonstrated the effectiveness of this eICU system. Results : 15 cases（22 events） used eICU were observed during this project period（2011-2013）. 6 cases were consultation only, however, 7 cases required inter-hospital transfer, and 4 cases were transferred in emergent fashion. 6 events were used for follow up rounds after discharge. In the typical case, the referral decision was expedited, critical care management improved, and the time required for treatment generally shortened. The improvement in overall critical care management was remarkable. Conclusion : This is the first report describing the usefulness of the eICU system in pediatric critical care field. Network security and privacy protection are foreseen as major obstacles to the use of this program and should be resolved to expand the use of the telemedicine/eICU system throughout Japan.

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