McGain Forbes, Burnham Jason P, Lau Ron, Aye Lu, Kollef Marin H, McAlister Scott
Departments of Anaesthesia and Intensive Care Medicine, Western Health, Melbourne, Vic, Australia.
Department of Internal Medicine, Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA.
Crit Care Resusc. 2018 Dec;20(4):304-312.
To use life cycle assessment to determine the environmental footprint of the care of patients with septic shock in the intensive care unit (ICU).
DESIGN, SETTING AND PARTICIPANTS: Prospective, observational life cycle assessment examining the use of energy for heating, ventilation and air conditioning; lighting; machines; and all consumables and waste associated with treating ten patients with septic shock in the ICU at BarnesJewish Hospital, St. Louis, MO, United States (US-ICU) and ten patients at Footscray Hospital, Melbourne, Vic, Australia (Aus-ICU).
Environmental footprint, particularly greenhouse gas emissions.
Energy use per patient averaged 272 kWh/day for the US-ICU and 143 kWh/day for the Aus-ICU. The average daily amount of single-use materials per patient was 3.4 kg (range, 1.0-6.3 kg) for the US-ICU and 3.4 kg (range, 1.2-8.7 kg) for the Aus-ICU. The average daily particularly greenhouse gas emissions arising from treating patients in the US-ICU was 178 kg carbon dioxide equivalent (CO-e) emissions (range, 165-228 kg CO-e), while for the Aus-ICU the carbon footprint was 88 kg CO-e (range, 77-107 kg CO-e). Energy accounted for 155 kg CO-e in the US-ICU (87%) and 67 kg CO-e in the Aus-ICU (76%). The daily treatment of one patient with septic shock in the US-ICU was equivalent to the total daily carbon footprint of 3.5 Americans' CO-e emissions, and for the Aus-ICU, it was equivalent to the emissions of 1.5 Australians.
The carbon footprints of the ICUs were dominated by the energy use for heating, ventilation and air conditioning; consumables were relatively less important, with limited effect of intensity of patient care. There is large opportunity for reducing the ICUs' carbon footprint by improving the energy efficiency of buildings and increasing the use of renewable energy sources.
运用生命周期评估法来确定重症监护病房(ICU)中感染性休克患者护理的环境足迹。
设计、地点与参与者:前瞻性观察性生命周期评估,研究美国密苏里州圣路易斯市巴恩斯犹太医院(美国ICU)和澳大利亚维多利亚州墨尔本弗斯克雷医院(澳大利亚ICU)对10例感染性休克患者进行治疗时,供暖、通风与空调、照明、机器以及所有消耗品和废物处理所消耗的能源。
环境足迹,尤其是温室气体排放。
美国ICU每位患者的平均能源消耗为每天272千瓦时,澳大利亚ICU为每天143千瓦时。美国ICU每位患者每天的一次性材料平均用量为3.4千克(范围为1.0 - 6.3千克),澳大利亚ICU为3.4千克(范围为1.2 - 8.7千克)。美国ICU治疗患者产生的平均每日温室气体排放量为178千克二氧化碳当量(CO-e)(范围为165 - 228千克CO-e),而澳大利亚ICU的碳足迹为88千克CO-e(范围为77 - 107千克CO-e)。在美国ICU,能源占155千克CO-e(87%),在澳大利亚ICU占67千克CO-e(76%)。在美国ICU,每天治疗一名感染性休克患者相当于3.5个美国人的每日总碳足迹排放量,而在澳大利亚ICU,相当于1.5个澳大利亚人的排放量。
ICU的碳足迹主要由供暖、通风与空调的能源消耗主导;消耗品相对不太重要,患者护理强度的影响有限。通过提高建筑能源效率和增加可再生能源的使用,有很大机会减少ICU的碳足迹。