Download 3. Global warming potential

Climate change
Anaesthesia part of the problem?
Lieven Ameye
Leen Govaers
Dr. De Buck
Outline
1.
2.
3.
4.
Introduction – The Greenhouse effect
Ozone depletion potential
Global warming potential
Strategies
a.
b.
c.
d.
Low flow anesthesia
New technologies
Xenon and future anesthetic gases
TIVA and LRA
5. Take home messages
Outline
1.
2.
3.
4.
Introduction – The Greenhouse effect
Ozone depletion potential
Global warming potential
Strategies
a.
b.
c.
d.
Low flow anesthesia
New technologies
Xenon and future anesthetic gases
TIVA and LRA
5. Take home messages
1. Introduction
• Greenhouse gas content in the atmosphere is being altered by
human activity
Global Warming
• Inhaled anesthetics = recognized greenhouse gases (GHG)
• Currently available: sevo-, des-, isoflurane
• Little in vivo metabolism
exhaled, scavenged and vented out
• Remain a long time in the atmosphere
• Contribute to two environmental problems
- Direct depletion of the ozone layer
- Infrared absorption and global warming
Outline
1.
2.
3.
4.
Introduction – The Greenhouse effect
Ozone depletion potential
Global warming potential
Strategies
a.
b.
c.
d.
Low flow anesthesia
New technologies
Xenon and future anesthetic gases
TIVA and LRA
5. Take home messages
2. Ozone depletion potential
• Relative amount of degradation to the ozone layer it
can cause
• Estimated from a given substance
• CFC’s +-1, BFC’s 5-15
Outline
1.
2.
3.
4.
Introduction – The Greenhouse effect
Ozone depletion potential
Global warming potential
Strategies
a.
b.
c.
d.
Low flow anesthesia
New technologies
Xenon and future anesthetic gases
TIVA and LRA
5. Take home messages
3. Global Warming Potential
• GWP : effect of the anesthetic greenhouse gases to the greenhouse effect?
•
Atmospheric window
Comparison of the different anesthetic
greenhouse gases
• Atmosferic/tropospheric
lifetimes of halogenated
anesthetics
• GWP
• DES, Sevo, Iso, N2O
• Atmospheric lifetime
Anes (g/h) x Anes GWP20 = Anes CDE20 (g/h)
•
CDE
•
GWP
• N2O: 114-120 yr
• Example:
o Average climate impact per anaesthetic procedure = the emission of 22 kg CO2
o Global emissions of inhalation anaesthetics
~ CO2 emissions of one coal-fired power plant
~ 1 million passenger cars (data 2010)
• Note: fossil fuels and daily waste
• UZ Leuven (data incl.2014)
Outline
1.
2.
3.
4.
Introduction – The Greenhouse effect
Ozone depletion potential
Global warming potential
Strategies
a.
b.
c.
d.
Low flow anesthesia
New technologies
Xenon and future anesthetic gases
TIVA and LRA
5. Take home messages
4. Strategies for prevention
a. Low flow anesthesia:
• Goal = reducing waste
• The optimal FGF rate has not been established
o Lowest FGF rates = best for environment
o But more CO2-absorbent used at very low flow rates
avoid unnecessarily high FGF rates, particularly when using desflurane
b. New technologies
- Dynamic Gas Scavenging System + Anesthetic Recapture System ®
b. New technologies
- Deltasorb® (Blue Zone technology)
- Future: Photochemical air purification
c. Xenon
- Does NOT add to atmospheric pollution
- Reason?
- Xenon = part of atmosphere, manufactured from liquefied air
- It simply goes back to the atmosphere
d. TIVA and LRA
Outline
1.
2.
3.
4.
Introduction – The Greenhouse effect
Ozone depletion potential
Global warming potential
Strategies
a.
b.
c.
d.
Low flow anesthesia
New technologies
Xenon and future anesthetic gases
TIVA and LRA
5. Take home messages
5. Take home messages
1. The health care industry contributes to climate change
2. Anesthetics:
• Desflurane has a greater potential impact then iso –or sevoflurane
• Avoid N2O as carrier gas
• N2O is destructive to the ozone layer as well as possessing GWP.
• Xenon: interesting characteristics on the field of climate
• LRA, TIVA vs. Anesthetic gases
3. Management of anesthesia:
• Managing fresh gas flow
avoiding unnecessarily high fresh gas flow rates
the optimal FGF has not been established
• The overall contribution of inhaled anesthetics to greenhouse gas
emission is miniscule
Walk – Run – Cycle to work
Thank you for your attention