Schuster Martin, Bein Thomas
Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie, RKH-Kliniken Landkreis Karlsruhe, Fürst-Stirum-Klinik Bruchsal und Rechbergklinik Bretten, Akademische Lehrkrankenhäuser der Universität Heidelberg, Gutleutstr. 1-14, 76646, Bruchsal, Deutschland.
Deutsche Allianz für Klimawandel und Gesundheit, Regensburg, Deutschland.
Anaesthesiologie. 2025 Apr;74(4):189-203. doi: 10.1007/s00101-024-01485-3. Epub 2024 Dec 12.
Intensive care medicine is an area with a particularly high consumption of resources. This review presents important new findings relating to the environmental sustainability of intensive care medicine. For example, the drugs used in intensive care medicine can end up in the environment and cause relevant ecotoxicity. The consumption of material items is very high in intensive care medicine and the increasing replacement of reusable items by disposable items is a major problem. Simple measures can reduce the ecological footprint of materials and introduce the recycling of waste in intensive care units. The high energy consumption of air conditioning, lighting and medical technology varies between facilities but in most cases is substantial and can be significantly reduced through appropriate measures. Ideally, the consumption should be measured and analyzed in detail. In the future, support from artificial intelligence is conceivable in this aspect. Sustainability must be given a much higher priority in the training, continued and advanced education in intensive care medicine than it has been to date and in intensive care research sustainability aspects should be given equal consideration alongside economic aspects when it comes to assessing otherwise equivalent treatments. It is particularly important to avoid the misuse and overuse of intensive care. It brings no benefit to patients and hinders needs-based treatment that is oriented towards the patient's well-being. In addition, misuse and overuse increases costs and drives up the consumption of resources and thus the ecological footprint. Sustainability in the intensive care unit can only be achieved as a team. Various approaches are presented on how a networked Green Team can promote sustainability in the intensive care unit.
重症医学是一个资源消耗特别高的领域。本综述介绍了与重症医学环境可持续性相关的重要新发现。例如，重症医学中使用的药物最终可能进入环境并造成相关生态毒性。重症医学中物质项目的消耗量非常高，可重复使用物品被一次性物品日益取代是一个主要问题。简单的措施可以减少材料的生态足迹，并在重症监护病房引入废物回收利用。空调、照明和医疗技术的高能耗因设施而异，但在大多数情况下都相当可观，通过适当措施可以显著降低。理想情况下，应该对消耗量进行详细测量和分析。未来，在这方面可以设想得到人工智能的支持。在重症医学的培训、继续医学教育和进阶教育中，可持续性必须比迄今为止得到更高的重视，在重症医学研究中，在评估其他方面等效的治疗方法时，可持续性方面应与经济方面得到同等考虑。避免重症监护的滥用和过度使用尤为重要。这对患者没有益处，还会阻碍以患者福祉为导向的按需治疗。此外，滥用和过度使用会增加成本，推高资源消耗，从而增加生态足迹。重症监护病房的可持续性只能通过团队合作来实现。本文介绍了各种方法，说明网络化的绿色团队如何促进重症监护病房的可持续性。
