Birmingham and Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
Birmingham and Midland Eye Centre, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
Am J Ophthalmol. 2022 Mar;235:271-279. doi: 10.1016/j.ajo.2021.09.020. Epub 2021 Sep 26.
To investigate the direct contribution to carbon emissions of fluorinated gases used in all vitreoretinal (VR) procedures utilizing gas tamponade and assess the respective carbon footprint of the three different gas delivery systems.
A multicenter, retrospective, environmental impact study.
All VR procedures using fluorinated gases between 2017 to 2020 at the Manchester Royal Eye Hospital (MREH) and Birmingham and Midland Eye Centre (BMEC) (the second and third largest VR centers in the UK), and between 2019 to 2020 at the University Hospitals Coventry and Warwickshire (UHCW) were included. CO equivalent mass (COEM) was calculated from the mass of each gas used, according to the Intergovernmental Panel on Climate Change.
A total of 4877 (1883 SF [38.6%], 2096 CF [43.0%], and 897 CF [18.4%]) procedures were analyzed. UHCW and BMEC utilized single-use 30 mL and 75 mL cannisters, respectively. MREH used four cylinders of each gas over 4 years (2 kg SF, 1 kg CF, 1 kg CF). Mean COEM per patient was: MREH 111.8 kg, BMEC 7.5 kg, and UHCW 2.7 kg. For MREH and BMEC, the COEM was 73.4 metric tons annually (if all cases were performed with i) 30 mL: 3.7 tons and ii) cylinders: 148.0 tons, x 40-fold difference), equating to 599,400 (30,500-1.2 million) km travelled by a passenger car. The current use of SF in VR surgery accounts for 0.11% of total SF6 use; if 30 mL cylinders were exclusively used in the UK, this could be lowered to 0.01%.
This study highlights the significant waste associated with large gas cylinders and demonstrated that 30 mL cannisters can lead to a marked reduction in carbon emissions, even after accounting for the increased carbon footprint involved in their manufacture and disposal.
研究所有玻璃体视网膜（VR）手术中使用的含氟气体对碳排放的直接贡献，并评估三种不同气体输送系统的各自碳足迹。
多中心、回顾性、环境影响研究。
纳入了 2017 年至 2020 年期间在曼彻斯特皇家眼科医院（MREH）和伯明翰和米德兰眼科中心（BMEC）（英国第二大和第三大 VR 中心）以及 2019 年至 2020 年期间在考文垂和沃里克郡大学医院（UHCW）进行的所有使用含氟气体的 VR 手术。CO 等效质量（COEM）根据政府间气候变化专门委员会（IPCC），根据使用的每种气体的质量进行计算。
共分析了 4877 例（SF[38.6%]1883 例、CF[43.0%]2096 例和 CF[18.4%]897 例）手术。UHCW 和 BMEC 分别使用一次性 30 毫升和 75 毫升安瓿。MREH 在四年内使用了每种气体的四个气瓶（SF2 公斤、CF1 公斤、CF1 公斤）。每位患者的平均 COEM 为：MREH111.8 公斤、BMEC7.5 公斤和 UHCW2.7 公斤。对于 MREH 和 BMEC，COEM 每年为 73.4 公吨（如果所有病例均采用 i）30 毫升：3.7 吨和 ii）气瓶：148.0 吨，相差 40 倍），相当于一辆乘用车行驶 599400（30500-120 万）公里。目前 VR 手术中 SF 的使用占 SF6 总用量的 0.11%；如果仅在英国使用 30 毫升安瓿，这一比例可降至 0.01%。
本研究强调了大气瓶相关的大量浪费，并表明即使考虑到制造和处置过程中增加的碳足迹，30 毫升安瓿仍可显著减少碳排放。
