Evaluation of the Impact of Telemedicine in Pediatric Intensive Care Units

NCT ID: NCT05260710

Last Updated: 2022-03-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

1760 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-04-01

Study Completion Date

2023-12-31

Brief Summary

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This study will be a cluster randomized controlled trial to assess the impact of telemedicine in Pediatric Intensive Care Units (PICU), through daily tele-rounds with a board certified physician and educational activities, in improving clinical-assistance indicators, as well as reducing the length of stay in the PICU.

Detailed Description

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This is a parallel cluster randomized controlled trial in pediatric intensive care units in Brazil.

PICUs is the unit of randomization. All patients admitted to the PICUs selected to participate in the project will be included in the study allocated to the control or intervention group as their respective hospitals are randomized.

Intervention group: Tele-rounds are case discussions with remote pediatric intensive care physicians and physicians from other specialties, such as a radiologist, infectious disease specialist, for the debate on conducts based on the best scientific evidence. Additionally, concurrently with the period of application of the intervention, continuing education activities will be made available to all professionals from the teams of the participating centers. Education activities are held monthly and consist of video classes and discussions of complex cases.

Control group: This group will maintain the usual care offered by the participating centers.

Conditions

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Telemedicine Critical Care Pediatric Adolescent Intensive Care Units, Pediatric

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Allocation: Randomized Intervention Model: Parallel Assignment Masking: None (Open Label)
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Telemedicine intervention

Tele-critical care + continuing education activities

Group Type EXPERIMENTAL

Telemedicine Intervention

Intervention Type BEHAVIORAL

Tele-Critical Care: 1) establishing a diagnosis 2) guiding the therapeutic approach and 3) performing clinical follow-up. Physicians will discuss all patients in the unit, bed by bed, evaluating the specific clinical situation of each hospitalized patient, according to the protocol developed by the study.The proposal is to maintain horizontal care (the patient is monitored from the 1st day of hospitalization until discharge) for all patients in the unit.

\+

Continuing education activities: video classes and discussions of complex cases.

Usual Care

Usual Care

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Telemedicine Intervention

Tele-Critical Care: 1) establishing a diagnosis 2) guiding the therapeutic approach and 3) performing clinical follow-up. Physicians will discuss all patients in the unit, bed by bed, evaluating the specific clinical situation of each hospitalized patient, according to the protocol developed by the study.The proposal is to maintain horizontal care (the patient is monitored from the 1st day of hospitalization until discharge) for all patients in the unit.

\+

Continuing education activities: video classes and discussions of complex cases.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* All children admitted to the pediatric ICU aged ≥29 days and \<18 years
* Length of stay of more than 8 hours and, in case of death, with a length of stay of more than 24 hours

Exclusion Criteria

* Patients with incomplete medical records
* Incomplete data in the institution's database
* Patients whose guardians did not accept to participate in the study and/or who did not sign the informed consent form and the image use term.
Minimum Eligible Age

29 Days

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital Moinhos de Vento

OTHER

Sponsor Role lead

Responsible Party

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Felipe Cezar Cabral

Digital health coordinator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Felipe C Cabral

Role: PRINCIPAL_INVESTIGATOR

Hospital Moinhos de Vento

Central Contacts

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Felipe C Cabral

Role: CONTACT

+55 (51) 98464-4901

Taís C Moreira

Role: CONTACT

+55 (51) 3537-8350

References

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Agência IBGE https://agenciadenoticias.ibge.gov.br/agencia-noticias/2012-agencia-de-notíci as/27614-ibge-divulga-distribuicao-de-utis-respiradores-medicos-e-enfermeiros: Acessado em 14 de novembro de 2020.

Reference Type BACKGROUND

BRASIL. Ministério da Saúde. Diretrizes Operacionais para o Estabelecimento e o Funcionamento de Comitês de Monitoramento de Dados e de Segurança / Ministério da Saúde, Organização Mundial da Saúde. Brasília : Ministério da Saúde, 2008. 44 p.

Reference Type BACKGROUND

Campbell MK, Piaggio G, Elbourne DR, Altman DG; CONSORT Group. Consort 2010 statement: extension to cluster randomised trials. BMJ. 2012 Sep 4;345:e5661. doi: 10.1136/bmj.e5661. No abstract available.

Reference Type BACKGROUND
PMID: 22951546 (View on PubMed)

Chen J, Sun D, Yang W, Liu M, Zhang S, Peng J, Ren C. Clinical and Economic Outcomes of Telemedicine Programs in the Intensive Care Unit: A Systematic Review and Meta-Analysis. J Intensive Care Med. 2018 Jul;33(7):383-393. doi: 10.1177/0885066617726942. Epub 2017 Aug 22.

Reference Type BACKGROUND
PMID: 28826282 (View on PubMed)

DE AZEVEDO, Arimatéia Portela et al. Fatores que interferem no desempenho da utilização de leitos de unidade de terapia intensiva (UTI). Brazilian Journal of Health Review, v. 3, n. 4, p. 7421-7438, 2020.

Reference Type BACKGROUND

Garingo A, Friedlich P, Chavez T, Tesoriero L, Patil S, Jackson P, Seri I. "Tele-rounding" with a remotely controlled mobile robot in the neonatal intensive care unit. J Telemed Telecare. 2016 Mar;22(2):132-8. doi: 10.1177/1357633X15589478. Epub 2015 Jun 26.

Reference Type BACKGROUND
PMID: 26116855 (View on PubMed)

Grundy BL, Crawford P, Jones PK, Kiley ML, Reisman A, Pao YH, Wilkerson EL, Gravenstein JS. Telemedicine in critical care: an experiment in health care delivery. JACEP. 1977 Oct;6(10):439-44. doi: 10.1016/s0361-1124(77)80239-6.

Reference Type BACKGROUND
PMID: 71365 (View on PubMed)

MINISTÉRIO DA SAÚDE. Portaria n. 3.432, de 12 de agosto de 1998. Estabelece Critérios de Classificação de Unidade de Terapia Intensiva (UTI). Diário Oficial da União n. 154; Poder Executivo, 13 ago. 1998. Disponível em: <www.medicinaintensiva.com.br/portaria-3432.htm>. Acesso em: 10 jan. 2010.

Reference Type BACKGROUND

Moher D, Hopewell S, Schulz KF, Montori V, Gotzsche PC, Devereaux PJ, Elbourne D, Egger M, Altman DG; CONSORT. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. Int J Surg. 2012;10(1):28-55. doi: 10.1016/j.ijsu.2011.10.001. Epub 2011 Oct 12.

Reference Type BACKGROUND
PMID: 22036893 (View on PubMed)

PATRIDGE, Emily F.; BARDYN, Tania P. Research electronic data capture (REDCap). Journal of the Medical Library Association: JMLA, v. 106, n. 1, p. 142, 2018.

Reference Type BACKGROUND

PARK, Heesun. SAS Institute, Inc. Cary, North Carolina. Sign, v. 2, n. 4, p. 1.

Reference Type BACKGROUND

Pfrimmer DM, Roslien JJ. The Tele-ICU: a new dimension in critical care nursing education and practice. J Contin Educ Nurs. 2011 Aug;42(8):342-3. doi: 10.3928/00220124-20110722-03.

Reference Type BACKGROUND
PMID: 21800788 (View on PubMed)

Piaggio G, Elbourne DR, Pocock SJ, Evans SJ, Altman DG; CONSORT Group. Reporting of noninferiority and equivalence randomized trials: extension of the CONSORT 2010 statement. JAMA. 2012 Dec 26;308(24):2594-604. doi: 10.1001/jama.2012.87802.

Reference Type BACKGROUND
PMID: 23268518 (View on PubMed)

Jacovas VC, Chagas MEV, Constant HMRM, Alves SS, Krauzer JRM, Guerra LR, de Almeida Pires A, Gomes da Cunha L, Matte MCC, de Campos Moreira T, Cabral FC. Telemedicine in Pediatric Intensive Care Units: Perspectives From a Brazilian Experience. Curr Pediatr Rep. 2021;9(3):65-71. doi: 10.1007/s40124-021-00242-z. Epub 2021 Jul 12.

Reference Type BACKGROUND
PMID: 34277142 (View on PubMed)

de Oliveira Laguna Silva G, Konig Klever E, Castro da Rocha J, da Silva MMD, da Rosa de Amorim J, Cristina Jacovas V, Marina Simionato B, Gomes da Cunha L, Zaupa APB, Mafalda Krauzer JR, de Almeida Pires A, Cezar Cabral F, de Campos Moreira T, Rodrigues Moleda Constant HM. Evaluation of the use of telemedicine in pediatric intensive care units: a cluster-randomized trial. Postgrad Med. 2024 Aug;136(6):633-640. doi: 10.1080/00325481.2024.2388023. Epub 2024 Aug 5.

Reference Type DERIVED
PMID: 39093639 (View on PubMed)

Silva MMDD, Klever EK, Rocha JCD, Silva GOL, Amorim JDR, Dode AD, Simionato BM, Cunha LGD, Zaupa APB, Krauzer JRM, Pires AA, Cabral FC, Moreira TC, Constant HMRM. Impact of Telemedicine use on clinical care indicators of pediatric intensive care units: protocol for a cluster randomized clinical trial. Crit Care Sci. 2023 Dec 22;35(3):266-272. doi: 10.5935/2965-2774.20230223-en. eCollection 2023.

Reference Type DERIVED
PMID: 38133156 (View on PubMed)

Other Identifiers

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5.126.122

Identifier Type: -

Identifier Source: org_study_id

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