Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2025;95(2):138-142.
doi: 10.24875/ACM.24000070.

Telemedicine in critical care: collaborative experience in postoperative pediatric cardiac care

María Althabe  1 , Paula Martínez-Da Bove  1 , Celeste Arancibia  2 , Mercedes Montonati  1 , Sandra Chuchuy  2 , Doris Flores  2 , Noelia De Maio  1 , Mariana Fenoy  1 , Edgardo Rodríguez  3 , Laura Selvatici  3
Affiliations
Multicenter Study

Telemedicine in critical care: collaborative experience in postoperative pediatric cardiac care

María Althabe et al. Arch Cardiol Mex. 2025.

Abstract
in English, Spanish

Objectives: Telehealth applied to the perioperative care of pediatric patients with congenital heart disease facilitates sharing experiences and provides valuable support to institutions initiating cardiac surgery programs, improving the quality of patient care. The primary goal of this study is to describe the implementation and initial results of a collaborative telehealth program between two cardiac centers with different complexity.

Method: Three teleconsultations per patient were programed, one preoperative to identify risks and discuss postoperative strategies, the second immediate after admission, and the last on day 2 pop. Demographic data, diagnosis, and surgical procedures (RACHS-1 scale) were recorded. A satisfaction survey was completed at the end of the process for each patient. A descriptive analysis was performed (Stata®).

Results: One hundred and twenty-three patients were consulted in 154 connections, with an average of 25 min consultation. Diagnoses included ventricular septal defect, atrial septal defect, and aortic coartation. The proportion of patients undergoing more complex procedures (RACHS-1 ≥ 3) increased from 9.5 to 35%. Survey results indicated that teleconsultation significantly contributed to problem-solving and understanding (100%), suggested new studies (18.6%), or new diagnoses (16.3%), modifications in therapeutic proposals (37.2%), and follow-up protocols (49%). Connectivity issues (41.8%) and challenges in coordinating consultation schedules (42%) were identified as the main difficulties.

Conclusions: Throughout the program, the complexity of RACHS-1 ≥ 3 procedures increased from 9.5 to 35%. Teleconsultation demonstrated notable enhancements in understanding and problem-solving capabilities, despite challenges in connectivity and scheduling coordination.

Objectives: La telesalud aplicada al cuidado perioperatorio del niño con cardiopatía congénita permite compartir experiencias y ofrecer apoyo a centros que inician sus programas de cirugía cardiaca para generar mejoras en la calidad de la atención. El objetivo de este trabajo es describir la implementación y resultados de un programa de colaboración entre dos centros de diferente complejidad.

Método: Se realizaron mínimo dos consultas por paciente para planificación y seguimiento conjunto de la recuperación cardiovascular, por medio de diferentes plataformas de videoconsulta. Se registraron datos demográficos, del diagnóstico y procedimiento quirúrgico con escala de RACHS-1. Por cada paciente se completó una encuesta de satisfacción sobre el proceso. Se realizó un análisis descriptivo de los datos.

Resultados: Se consultaron 123 pacientes, en 154 conexiones, de 25 min promedio. Los diagnósticos más frecuentes fueron comunicación interventricular, comunicación interauricular y coartación de aorta. La proporción de pacientes con mayor complejidad de procedimientos (RACHS-1 ≥ 3) se incrementó del 9.5 al 35%. Según las encuestas la teleconsulta permitió: mejorar la capacidad de resolución y la comprensión (100%), indicar nuevos estudios (18.6%), formular nuevos diagnósticos (16.3%), modificar la propuesta terapéutica (37.2%) y planificar pautas de seguimiento (49%). Las principales dificultades se encontraron en la conectividad (41.8%) y en coordinar los horarios de consulta (42%).

Conclusiones: La complejidad de los procedimientos RACHS-1 ≥ 3 se incrementó del 9.5 al 35% a lo largo del programa. La teleconsulta mejoró la comprensión y la capacidad de resolución de los casos.

Keywords: Cirugía de cardiopatía congénita; Congenital heart disease; Cuidados intensivos cardiovasculares; Pediatric cardiac intensive care; Telehealth; Telemedicina.

PubMed Disclaimer

Conflict of interest statement

Los autores declaran no tener conflicto de intereses.

Figures

Figura 1
Figura 1
Dispositivo móvil de teleconsulta.
Figura 2
Figura 2
Diagnósticos en orden de frecuencia. IAA: interrupción de arco aórtico; EP: estenosis pulmonar; AP/SI: atresia pulmonar con septum íntegro; APRV: anomalía parcial de retorno venoso pulmonar; ATRV: anomalía total de retorno venoso pulmonar; AP c/CIV: atresia pulmonar con CIV; CAV: canal auriculoventricular; VU: ventrículo único; DAP: ductus arterioso persistente; CIA: comunicación interauricular; CIV: comunicación interventricular.
Figura 3
Figura 3
Complejidad de la cirugía cardiovascular por año por escala de RACHS-1. A partir del inicio del programa en 2018 se incrementó el porcentaje de pacientes de mayor complejidad (RACHS ≥ 3).
See this image and copyright information in PMC

References

    1. Gaies M, Pasquali SK, Banerjee M, Dimick JB, Birkmeyer J, Zhang W, et al. Improvement in pediatric cardiac surgical outcomes through interhospital collaboration. J Am Coll Cardiol. 2019;74:2786–95. - PMC - PubMed
    1. Gaies M, Anderson J, Kipps A, Lorts A, Madsen N, Marino B, et al. Cardiac Networks United:an integrated paediatric and congenital cardiovascular research and improvement network. Cardiol Young. 2019;29(2):111–8. - PubMed
    1. Kipps AK, Cassidy SC, Strohacker CM, Graupe M, Bates KE, McLellan MC, et al. Collective quality improvement in the paediatric cardiology acute care unit:establishment of the Pediatric Acute Care Cardiology Collaborative (PAC3) Cardiol Young. 2018;28:1019–23. - PubMed
    1. Gaies M, Cooper DS, Tabbutt S, Schwartz SM, Ghanayem M, Chanani NK, et al. Collaborative quality improvement in the cardiac intensive care unit:development of the Paediatric Cardiac Critical Care Consortium (PC4) Cardiol Young. 2015;25:951–7. - PMC - PubMed
    1. Wilcox ME, Adhikari NKJ. The effect of telemedicine in critically ill patients:systematic review and meta-analysis. Crit Care. 2012;16:R127. - PMC - PubMed

Publication types

LinkOut - more resources