Innovations in critical care: Tele-ICU augmented ICUs in the Indian setting
Vol 5 | Issue 1 | Jan-April 2019 | page: 6-8 | Sanu Anand1, Vimohan Kumar2, Dileep Raman1, Dhruv Joshi1, Dileep Unnikrishnan1
Authors: Sanu Anand , Vimohan Kumar , Dileep Raman , Dhruv Joshi , Dileep Unnikrishnan .
 Cloudphysician Healthcare, Bangalore, India
 Prashant Memorial Charitable Hospital, Muzaffarpur, India.
Address of Correspondence
Dr. Sanu Anand,
Cloudphysician Healthcare, Bangalore, India;
Prashant Memorial Charitable Hospital, Muzaffarpur, India
Intensive care has advanced over the past few decades to find its space as a separate specialty in medicine. In addition to prompt diagnosis and timely intervention, measures such as unit staffing, observance of hand hygiene and adherence to standard protocols for common disorders result in improvements in outcome in Intensive Care Units (ICU). Presence of a specially trained intensivist in an ICU has been shown to improve mortality and length of stay in Western studies . However, due to the shortage in supply of such specialists world over, their presence at smaller ICU in low and middle-income countries (LMIC) can be prohibitively expensive for the hospitals . Tele-ICU based technologies that help increase the efficiency and reach of the specialists can be an effective way to bridge such supply-demand disparities . Here we report a case where a fourteen-year-old boy admitted with Severe Acute Respiratory Distress Syndrome (ARDS) to an ICU in Bihar which was managed successfully, with lung protective and prone ventilation utilizing a tele-ICU service.
Keywords: Tele-ICU, Critical Care, ARDS, Prone Ventilation, Global Health
1. Halpern NA, Pastores SM, Greenstein RJ. Critical care medicine in the United States 1985–2000: An analysis of bed numbers, use, and costs*. Crit Care Med. 2004;32(6):1254. doi:10.1097/01.CCM.0000128577.31689.4C
2. Pronovost PJ, Angus DC, Dorman T, Robinson KA, Dremsizov TT, Young TL. Physician Staffing Patterns and Clinical Outcomes in Critically Ill Patients: A Systematic Review. JAMA. 2002;288(17):2151-2162. doi:10.1001/jama.288.17.2151
3. Wilcox ME, Chong CAKY, Niven DJ, et al. Do intensivist staffing patterns influence hospital mortality following ICU admission? A systematic review and meta-analyses. Crit Care Med. 2013;41(10):2253-2274. doi:10.1097/CCM.0b013e318292313a
4. Yeolekar M, Mehta S. ICU Care in India – Status and Challenges. :2.
5. Marcin JP, Rimsza ME, Moskowitz WB. The Use of Telemedicine to Address Access and Physician Workforce Shortages. Pediatrics. 2015;136(1):202-209. doi:10.1542/peds.2015-1253
6. Guérin C, Reignier J, Richard J-C, et al. Prone Positioning in Severe Acute Respiratory Distress Syndrome. N Engl J Med. 2013;368(23):2159-2168. doi:10.1056/NEJMoa1214103
7. Unnikrishnan D, Raman D, Joshi D, Ajaikumar BS. Use of home telemedicine for critical illness rehabilitation: an Indian success story. BMJ Case Rep. 2019;12(2). doi:10.1136/bcr-2018-227779
8. Kumar S, Merchant S, Reynolds R. Tele-ICU: Efficacy and Cost-Effectiveness Approach of Remotely Managing the Critical Care. Open Med Inform J. 2013;7:24-29. doi:10.2174/1874431101307010024
9. Grabowski DC, O’Malley AJ. Use Of Telemedicine Can Reduce Hospitalizations Of Nursing Home Residents And Generate Savings For Medicare. Health Aff (Millwood). 2014;33(2):244-250. doi:10.1377/hlthaff.2013.0922
10. Raheja R, Unnikrishnan DC, Anand S, Joshi D, Raman D. Feasibility of Tele-ICU augmented cardiopulmonary resuscitation in a resource limited setting: A pilot study. Resuscitation. 2019;0(0). doi:10.1016/j.resuscitation.2019.02.044
11. Willmitch B, Golembeski S, Kim SS, Nelson LD, Gidel L. Clinical outcomes after telemedicine intensive care unit implementation*. Crit Care Med. 2012;40(2):450. doi:10.1097/CCM.0b013e318232d694
12. de la Torre-Díez I, López-Coronado M, Vaca C, Aguado JS, de Castro C. Cost-utility and cost-effectiveness studies of telemedicine, electronic, and mobile health systems in the literature: a systematic review. Telemed J E-Health Off J Am Telemed Assoc. 2015;21(2):81-85. doi:10.1089/tmj.2014.0053
|How to Cite this Article: Anand S, Kumar V, Raman D, Joshi D, Unnikrishnan D. Innovations in critical care: Tele-ICU augmented ICUs in the Indian setting. Journal of Anaesthesia and Critical Care Case Reports Jan-April 2019;5(1):6-8.|
ARDS, critical care, Global Health, Prone Ventilation, Tele-ICU