Effect of modern technologies on ICU resource management in disasters: a systematic review

Abstract

During disasters, Intensive Care Units (ICUs) face immense strain due to a surge in critically ill patients, resource scarcity, and potential infrastructure damage. These conditions often lead to overwhelming operational challenges, difficult triage decisions, and complex patient evacuations. However, the role and effectiveness of modern technologies in ICU disaster scenarios remain systematically underexplored. This study systematically identified and mapped the technologies applied to ICU resource management during disasters and the phases in which they were used. This systematic review was conducted in accordance with the PRISMA guideline. A comprehensive search was performed in PubMed, Web of Science, Scopus, and IEEE databases. The search included all publications available up to May 2025, without date restrictions, and combined four main concepts—ICU, resource management, technologies, and disasters—along with their related keywords. A total of 2,244 relevant citations were retrieved. Of these, 71 full-text publications were assessed, and finally 25 studies met all inclusion criteria. Most of the studies focused on software solutions (e.g., machine learning and deep learning), while some addressed hardware solutions (e.g., low-cost or portable ventilators). The main objectives of these innovations were to increase capacity and availability (24%), support forecasting and demand prediction (20%), optimize resource allocation (20%), and improve efficiency and management (20%). The vast majority of solutions were scalable, targeted the response phase, and 96% were assessed as having high or moderate feasibility for implementation in low- and middle-income countries. This study showed that most technology solutions were primarily reactive, with a strong focus on the response phase in disasters. Most studies focused on software-based interventions with a smaller proportion emphasizing hardware solutions. Most solutions have the potential to be used in low- and middle-income countries to increase capacity and accessibility in line with equity goals. However, future efforts must pivot from proof-of-concept studies to rigorous, real-world implementation research that actively tests the recovery-phase utility of these technologies and their capacity to fundamentally strengthen healthcare systems for all future disasters. Not applicable.