| Telemedicine outcome of mechanically ventilated children
in Brazilian pediatric intensive care units |
Aristóteles Almeida Pires1 
, Luciano Remião Guerra1
, Luciane Gomes da Cunha1
, João Ronaldo Mafalda Krauzer1
, Mariana Motta Dias da Silva1
, Vanessa Cristina Jacovas1
, Hilda Maria Rodrigues Moleda1
, Tais de Campos Moreira1
, Paulo Márcio Pitrez2
, Felipe Cezar Cabral1
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1Hospital Moinhos de Vento, Porto Alegre, Brazil
2Federal University of Health Sciences of Porto Alegre - UFCSPA , Porto Alegre, Brazil |
Correspondence:
Aristóteles Almeida Pires, Email: aristoteles.pires@hmv.org.br
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Received: 7 June 2025 • Revised: 6 August 2025 • Accepted: 30 August 2025 |
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| Abstract |
Background
Pediatric intensive care units (PICUs) have
undergone significant evolution, resulting in a reduction
in patient morbidity and mortality rates. Telemedicine has
emerged as a valuable resource for services that optimize
the care processes in PICUs. Despite growing interest
in telemedicine for pediatric critical care, its impact on
mechanically ventilated (MV) children in public health
settings in Brazil remains underexplored.
Purpose
This study aimed to evaluate the effect of telemedicine
on the care of MV patients in 2 public PICUs in
Brazil.
Methods
This prospective pre–post interventional study
was conducted in 2 public PICUs in the Northern and
Northeastern regions of Brazil. Patients aged 0–18 years
who received ventilatory support between January 1, 2019,
and December 31, 2021, were included. The intervention
consisted of daily synchronous telerounds conducted by
pediatric intensivists from Hospital Moinhos de Vento
who provided clinical consultation and ensured protocol
adherence. The primary evaluated outcomes included
mortality, ventilator-free days (VFD), and MV duration.
Results
A total of 790 patients were analyzed: 261 in the
pretelemedicine period and 529 in the posttelemedicine
period. The overall mortality rate decreased significantly
from 20.7% to 10.4% (P<0.001). In center A, mortality
decreased from 25.96% to 9.86% (P<0.001); in center B,
mortality decreased from 17.2% to 11.06% (P=0.11). The
overall VFD increased significantly from 3 days (interquartile
range, 0–7) to 4 days (interquartile range, 2–8)
(P<0.001). No significant differences were noted in total
MV duration in the general analysis.
Conclusion
The implementation of telemedicine in
public PICUs significantly reduced mortality and increased
VFD among MV patients. These findings support
telemedicine as a viable and promising strategy for enhancing pediatric critical care in public health systems,
thereby contributing to improved patient outcomes. |
| Key Words:
Telemedicine, eHealth, Pediatric intensive
care unit, Mechanical ventilation, Ventilator-free days |
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