Environmental stewardship, the greenhouse effect, global warming, and climate change are common phrases that have been increasingly used over the past few decades, promoting change in society. Carbon footprints in healthcare are increasing at an alarming rate, with intensive care wastes contributing a significant percentage. Therefore, it is crucial to implement measures that promote environmental sustainability in these units. A literature search for articles/publications was conducted using keywords such as “green intensive care unit (ICU),” “environmental sustainability in the ICU,” and “carbon footprints of intensive care” in the PubMed database. This review paper discusses opportunities for critical care medicine to reduce its environmental hazards and implement sustainable practices in the intensive care unit.
Haines A, Ebi K. The imperative for climate action to protect health. New Engl J Med 2019;380(3):263–273. DOI: 10.1056/nejmra1807873
Rockström J, Steffen W, Noone K, et al. A safe operating space for humanity. Nature 2009;461(7263):472–475. DOI: 10.1038/461472a
Landrigan PJ, Raps H, Cropper M, et al. The Minderoo-Monaco commission on plastics and human health. Ann Glob Health 2023;89(1):23. DOI: 10.5334/aogh.4056
Lenzen M, Malik A, Li M, et al. The environmental footprint of health care: a global assessment. Lancet Planet Health 2020;4(7):e271–e279. DOI: 10.1016/s2542-5196(20)30121-2
McGain F, Burnham JP, Lau R, et al. The carbon footprint of treating patients with septic shock in the intensive care unit. Crit CareResus 2018;20(4):304–312. DOI: 10.1016/S1441-2772(23)00970-5
Hunfeld N, Diehl JC, Timmermann M, et al. Circular material flow in the intensive care unit—environmental effects and identification of hotspots. Intensive Care Med 2022;49(1):65–74. DOI: 10.1007/s00134-022-06940-6
Gasparrini A, Guo Y, Sera F, et al. Projections of temperature-related excess mortality under climate change scenarios. Lancet Planet Health 2017;1(9):e360–e367. DOI: 10.1016/s2542-5196(17)30156-0
Burnett R, Chen H, Szyszkowicz M, et al. Global estimates of mortality associated with long-term exposure to outdoor fine particulate matter. Proc Nat Acad Sci 2018;115(38):9592–9597. DOI: 10.1073/pnas.1803222115
Barratt A, McGain F. Overdiagnosis is increasing the carbon footprint of healthcare. BMJ 2021;375:n2407. DOI: 10.1136/bmj.n2407
Hjortsø CJ, Møller MH, Perner A, et al. Routine versus on-demand blood sampling in critically ill patients: a systematic review. Crit Care Med 2023;51(6):717–730. DOI: 10.1097/ccm.0000000000005852
Anstey MH, Maxwell N, Rickard CM, et al. How often are infusion sets for central venous catheters changed in Australian and New Zealand intensive care units? A point prevalence survey. Austr Crit Care 2024;37(3):495–498. DOI: 10.1016/j.aucc.2023.05.004
Teng R, Ding Y, See KC. Use of robots in critical care: systematic review. J Med Int Res 2022;24(5):e33380. DOI: 10.2196/33380
McAlister S, McGain F, Petersen M, et al. The carbon footprint of hospital diagnostic imaging in Australia. Lancet Reg Health West Pac 2022;24:100459. DOI: 10.1016/j.lanwpc.2022.100459
Janson C, Henderson R, Löfdahl M, et al. Carbon footprint impact of the choice of inhalers for asthma and COPD. Thorax 2020;75(1):82–84. DOI: 10.1136/thoraxjnl-2019-213744
Hemberg L, Wessberg N, Leire C, et al. Environmental impact of single-use and reusable items in central venous catheter insertion kits: a life cycle assessment. Intensive Care Med 2023;49(6):662–664. DOI: 10.1007/s00134-023-07078-9
Unger S, Campion N, Bilec MM. Evaluating quantifiable metrics for hospital green checklists. J Cleaner Product 2016;127:134–142. DOI: 10.1016/j.jclepro.2016.03.167
Blom IM, Rupp I, de Graaf IM, et al. Putting planetary health at the core of the medical curriculum in Amsterdam. Lancet Planet Health 2023;7(1):e15–e17. DOI: 10.1016/s2542-5196(22)00316-3
Thoma B, Abbott C, Snell L. The future of the CanMEDS physician competency framework. Can Med Educ J 2023;14(1):1–3. DOI: 10.36834/cmej.77098
Gepp S, Jung L, Wabnitz K, et al. The Planetary Health Academy—a virtual lecture series for transformative education in Germany. Lancet Planet Health 2023;7(1):e68–e76. DOI: 10.1016/s2542-5196(22)00253-4
See KC. Collaborative intelligence for intensive care units. Crit Care 2021;25(1):426. DOI: 10.1186/s13054-021-03852-7
