Telemed J E Health - Telemedicine in pediatric cardiac critical care.

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Resumo

JECTIVE: To describe our international telemedicine experience in pediatric cardiac critical care.MATERIALS AND METHODS: This is a case series of pediatric patients teleassisted from the Cardiac Intensive Care Unit (CICU) at Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, Pittsburgh, PA, to the CICU at Hospital Valle del Lili, Cali, Valle, Colombia, between March and December 2010. An attending intensivist from the CICU in Pittsburgh reviewed cases, monitored real-time vital signs, and gave formal medical advice as requested by the attending physician in Cali. The network connection is a Cisco (San Jose, CA)-based Secure Sockets Layer virtual private network via the Internet that allows access to the web-based interface of the Dr?ger(?) (L?beck, Germany) physiological monitor system. The videoconferencing equipment consists of a standard component on a custom-made mobile cart that uses an APC(?) (West Kingston, RI) uninterruptible power supply for portable power and 3Com(?) (Hewlett-Packard, Palo Alto, CA) for wireless connectivity. A post-intervention survey regarding satisfaction with the telemedicine service was conducted.RESULTS: Seventy-one recommendations were given regarding 53 patients. Median age and weight were 10 months and 7.1 kg, respectively. Ventricular septal defect, transposition of the great vessels, and single ventricle accounted for most cases. The most frequent recommendations were related to surgical conduct, management of arrhythmias, and performance of cardiac catheterization studies. No technical difficulties were experienced during the monitoring of the patients. Satisfaction rates were equally high for technical and medical aspects of telemedicine service.CONCLUSIONS: Telemedicine is a feasible option for pediatric intensivists seeking experienced assistance in the management of complex cardiac patients. Real-time remote assistance may improve the medical care of pediatric cardiac patients treated in developing countries.

Resumo Limpo

jectiv describ intern telemedicin experi pediatr cardiac critic caremateri method case seri pediatr patient teleassist cardiac intens care unit cicu children hospit pittsburgh univers pittsburgh medic center pittsburgh pa cicu hospit vall del lili cali vall colombia march decemb attend intensivist cicu pittsburgh review case monitor realtim vital sign gave formal medic advic request attend physician cali network connect cisco san jose cabas secur socket layer virtual privat network via internet allow access webbas interfac drger lbeck germani physiolog monitor system videoconferenc equip consist standard compon custommad mobil cart use apc west kingston ri uninterrupt power suppli portabl power com hewlettpackard palo alto ca wireless connect postintervent survey regard satisfact telemedicin servic conductedresult seventyon recommend given regard patient median age weight month kg respect ventricular septal defect transposit great vessel singl ventricl account case frequent recommend relat surgic conduct manag arrhythmia perform cardiac catheter studi technic difficulti experienc monitor patient satisfact rate equal high technic medic aspect telemedicin serviceconclus telemedicin feasibl option pediatr intensivist seek experienc assist manag complex cardiac patient realtim remot assist may improv medic care pediatr cardiac patient treat develop countri

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