· Tele-ICU services are provided either by existing staff within the network to smaller centers, or outsourced to larger networks or independent firms
· The impact of tele-ICU adoption can result in a decrease in ICU mortality as large as 32%
· The impact of tele-ICU adoption of length of stay is mixed, with some studies reporting a significant decrease, while others report a small, but statistically insignificant decrease
· The degree of impact of tele-ICU adoption is linked to several factors such as yearly admission rates, location (urban vs. rural) and level of authority given to the tele-ICU team leading to increased positive impacts.
Badea, A; Groot, G; Reeder, B; Young, C; Ellsworth, C; Howell-Spooner, B. How to deliver remote ICU care for COVID-19 patients to avoid/prevent transfer from smaller communities to tertiary care hospitals. 2021 Apr 6; Document no.: CC210301 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 13p. (CEST rapid review report)
Overall, data are insufficient to recommend for or against the use of ECMO in patients with COVID-19 and refractory hypoxemia.
The best available evidence points to an overall combined mortality rate of 46% among COVID-19 patients placed on ECMO (n=331). This rate is similar to the overall 40% mortality rate for extracorporeal life support in pulmonary failure. However, mortality rates among COVID-19 patients on ECMO range widely due to patient factors, site specific factors, and small sample sizes in available studies.
Recommendations for strategies and patient indications/contraindications are available to help guide centres intending to offer ECMO to COVID-19 patients.
Vanstone, J; Groot, G; Dalidowicz, M; Young, C. What are the outcomes of ECMO and COVID, particularly in small centers? 2021 Jan 13; Document no.: EOC011101 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 7 p. (CEST rapid review report)
