JMIR Publications

ABSTRACT

Background:

While robotic presence is prevalent in the surgical setting, its role in critical care has not been well established.

Objective:

We aim to examine the uses and limitations of robots for critically ill patients.

Methods:

This systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. MEDLINE and EMBASE were searched from inception to 26 October 2020. Included studies involved patients requiring critical care, both in intensive care units (ICUs) or high-dependency units, or in settings that required critical care procedures (e.g. intubation and cardiopulmonary resuscitation). Randomised trials and observational studies were included.

Results:

30 studies were included. The greatest application of robots in the ICU was in the field of telepresence, where robots proved advantageous in providing reduced response time, earlier intervention and lower mortality rates. Challenges of telepresence included regulatory and financial barriers. In therapy and stroke rehabilitation, robots were able to achieve superior clinical outcomes safely. Robotic use in patient evaluation and assessment was mainly through ultrasound evaluation, obtaining satisfactory-to-superior results with added benefits of remote assessment, time savings, and increased efficiency. Drug-dispensing robots were able to increase efficiency and generate cost savings. All robots had technological limitations and hidden costs.

Conclusions:

Overall, our results show that robotic use in critical care settings is a beneficial, effective, and well-received intervention that delivered significant patient, staff, and hospital benefits. Looking ahead, it is necessary to form strong ethical and legislative frameworks, and to overcome various regulatory and financial barriers.