气候变化领域集成服务门户(CCPortal): A call for immediate climate action in anesthesiology: routine use of minimal or metabolic fresh gas flow reduces our ecological footprint

CCPortal

DOI	10.1007/s12630-022-02393-z
	A call for immediate climate action in anesthesiology: routine use of minimal or metabolic fresh gas flow reduces our ecological footprint
	Ruebsam, Marie-Luise; Kruse, Philippe; Dietzler, Yvonne; Kropf, Miriam; Bette, Birgit; Zarbock, Alexander; Kim, Se-Chan; Hoenemann, Christian
发表日期	2023
ISSN	0832-610X
EISSN	1496-8975
起始页码	301
结束页码	312
卷号	70 期号:3
英文摘要	PurposeClimate change is a global threat, and inhalational anesthetics contribute to global warming by altering the photophysical properties of the atmosphere. On a global perspective, there is a fundamental need to reduce perioperative morbidity and mortality and to provide safe anesthesia. Thus, inhalational anesthetics will remain a significant source of emissions in the foreseeable future. It is, therefore, necessary to develop and implement strategies to minimize the consumption of inhalational anesthetics to reduce the ecological footprint of inhalational anesthesia.SourceWe have integrated recent findings concerning climate change, characteristics of established inhalational anesthetics, complex simulative calculations, and clinical expertise to propose a practical and safe strategy to practice ecologically responsible anesthesia using inhalational anesthetics.Principal findingsComparing the global warming potential of inhalational anesthetics, desflurane is about 20 times more potent than sevoflurane and five times more potent than isoflurane. Balanced anesthesia using low or minimal fresh gas flow (<= 1 L center dot min(-1)) during the wash-in period and metabolic fresh gas flow (0.35 L center dot min(-1)) during steady-state maintenance reduces CO2 emissions and costs by approximately 50%. Total intravenous anesthesia and locoregional anesthesia represent further options for lowering greenhouse gas emissions.ConclusionResponsible anesthetic management choices should prioritize patient safety and consider all available options. If inhalational anesthesia is chosen, the use of minimal or metabolic fresh gas flow reduces the consumption of inhalational anesthetics significantly. Nitrous oxide should be avoided entirely as it contributes to depletion of the ozone layer, and desflurane should only be used in justified exceptional cases.
英文关键词	climate change; green anesthesia; greenhouse gas emission; inhalational anesthetics; low-flow anesthesia; nitrous oxide
语种	英语
WOS研究方向	Anesthesiology
WOS类目	Science Citation Index Expanded (SCI-EXPANDED)
WOS记录号	WOS:000937076800003
来源期刊	CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE
文献类型	期刊论文
条目标识符	http://gcip.llas.ac.cn/handle/2XKMVOVA/281185
作者单位	Greifswald Medical School; University of Bonn; University of Munster
推荐引用方式 GB/T 7714	Ruebsam, Marie-Luise,Kruse, Philippe,Dietzler, Yvonne,et al. A call for immediate climate action in anesthesiology: routine use of minimal or metabolic fresh gas flow reduces our ecological footprint[J],2023,70(3).
APA	Ruebsam, Marie-Luise.,Kruse, Philippe.,Dietzler, Yvonne.,Kropf, Miriam.,Bette, Birgit.,...&Hoenemann, Christian.(2023).A call for immediate climate action in anesthesiology: routine use of minimal or metabolic fresh gas flow reduces our ecological footprint.CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE,70(3).
MLA	Ruebsam, Marie-Luise,et al."A call for immediate climate action in anesthesiology: routine use of minimal or metabolic fresh gas flow reduces our ecological footprint".CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE 70.3(2023).