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COVID-19: Experts emphasis use of Tele-ICU, Telemedicine to manage critical cases

As the novel coronavirus pandemic continues to spread in the country, critical care experts are emphasising the use of telemedicine and tele-ICU in the management of serious virus cases.

The experts stated this during a recent webinar on the theme ‘The Role of Critical Care and its Challenges in the Management of Covid-19 in Nigeria’ organised by Mindray – a Chinese medical devices company.

Babaseyi Oyesola, CEC, Anesthesia Critical Care Consultant (A3C) said that the virus outbreak has shown that telemedicine, mobile ICU, and tele-ICU is efficient in the management of critically ill COVID-19 patients.

Oyesola said that knowledge sharing and patient management amongst intensivists and critical care nurses via Tele-ICU had proven to be helpful during the pandemic.

He said that Tele-ICU is an off-site internet-based audio-visual technology deployed in A3C centers in the country in which intensivists and critical care nurses are connected with the patient remote care in a remote ICU centre, to exchange health information through real-time audiovisual platform.

“Optimum management of patients in the ICU is required as such patients require constant medical attention, observation, and support,” he said.

“The patient may be unable to breathe independently and have the threat of organ failure, therefore, specialised medical equipment is often needed to take the place of these functions while the patient recovers,” Oyesola added.

The pre-eminent critical care consultant also said that the challenge of providing intensive care was not unique to Nigeria alone because intensive care was very expensive.

Oyesola highlighted some of the challenges Nigeria was facing in terms of funding, technical support, education and training, drugs, consumables, admission criteria, Blood Gas Analysis, laboratory and imaging support as well as the fear of the disease affecting patients and health workers among others.

According to him, medical equipment was in short supply as the country currently has only an Extracorporeal Membrane Oxygenation (ECMO) equipment used in pumping and oxygenate patients’ blood outside the body.

Current data on Medpage- a worldwide registry, records 370 patients with confirmed COVID-19 on ECMO across the globe, including 254 in North America. In a subset of 58 COVID-19 patients who received the treatment, 21 have been discharged alive.

Also speaking at the session was Chun Pan, chief physician of the Department of Intensive Medicine, Zhongda Hospital Southeast University, China, where the virus outbreak was first recorded, said that the pandemic Acute Respiratory Disease Syndrome (ARDS) was different from other ARDS.

Pan said that there was no antiviral drug for the disease currently, and advised that antibiotics usage must depend on the clinical sign and bacterial infection.

He suggested that Ioriginal disease control is important for COVID-19 induced ARDS with characteristics of low lung recruitability, low respiratory compliance, no airway occlusive pressure, and intrinsic PEEP.

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