• A large cluster randomized trial (TELESCOPE) across 30 Brazilian ICUs evaluated the impact of tele-ICU on critically ill patients.
• The tele-ICU intervention included multidisciplinary rounds led by remote intensivists, monthly audit meetings, and evidence-based protocols.
• The study found no significant reduction in ICU length of stay or in-hospital mortality with the tele-ICU intervention compared to usual care.
• The findings suggest that the effectiveness of tele-ICU is context-specific and requires customization based on local needs and resources.