Greening the OR - Revision history

Aesetholephews at 22:51, 12 March 2026

2026-03-12T22:51:54Z

Aesetholephews at 19:49, 14 August 2025

2025-08-14T19:49:55Z

Aesetholephews at 18:17, 11 December 2024

2024-12-11T18:17:04Z

Aesetholephews at 18:15, 11 December 2024

2024-12-11T18:15:37Z

Aesetholephews at 23:36, 9 December 2024

2024-12-09T23:36:26Z

Aesetholephews at 23:36, 9 December 2024

2024-12-09T23:36:08Z

Aesetholephews at 23:35, 9 December 2024

2024-12-09T23:35:36Z

Aesetholephews at 23:35, 9 December 2024

2024-12-09T23:35:07Z

Aesetholephews: Created page with "* Use TIVA/regional techniques when possible. In cases where no volatile anesthetic is used, FGF should be 6 LPM or match the patients MV, whichever is higher to prevent undue..."

2024-12-09T23:34:45Z

Created page with "* Use TIVA/regional techniques when possible. In cases where no volatile anesthetic is used, FGF should be 6 LPM or match the patients MV, whichever is higher to prevent undue..."

New page

* Use TIVA/regional techniques when possible. In cases where no volatile anesthetic is used, FGF should be 6 LPM or match the patients MV, whichever is higher to prevent undue consumption of CO2 absorbent. [Zhong G, Abbas A, Jones J, Kong S, McCulloch T. Environmental and economic impact of using increased fresh gas flow to reduce carbon dioxide absorbent consumption in the absence of inhalational anaesthetics. Br J Anaesth. . 2020;125(5):773-778. doi:10.1016/j.bja.2020.07.043 1]

← Older revision		Revision as of 22:51, 12 March 2026
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−	* Use TIVA/regional techniques when possible. In cases where no volatile anesthetic is used, an in vitro [https://www.sciencedirect.com/science/article/pii/S0007091220306346?via%3Dihub study published in BJA in 2020] showed that FGF should be 6 LPM or match the patients MV (whichever is higher), to prevent undue consumption of CO2 absorbent. However, a follow up [https://www.sciencedirect.com/science/article/pii/S0007091222005025 letter to the editor] in 2022 by the same authors reporting their in vivo results was more nuanced. While CO2 absorber lifespan was indeed significantly prolonged in high flow TIVA patients (160 hrs vs 16 hrs), and running costs were significantly decreased, the GWP100 was moderately higher with FiO2 of 30%, and significantly higher if FiO2 was 60%. They speculate that selective use of high flows in high CO2 output TIVA cases (e.g. laparoscopic or bariatric) may yield environmental as well as economic benefits.	+	* Use TIVA/regional techniques when possible. In cases where no volatile anesthetic is used, an ''in vitro'' [https://www.sciencedirect.com/science/article/pii/S0007091220306346?via%3Dihub study published in BJA in 2020] showed that FGF should be 6 LPM or match the patients MV (whichever is higher), to prevent undue consumption of CO2 absorbent. However, a follow up [https://www.sciencedirect.com/science/article/pii/S0007091222005025 letter to the editor] in 2022 by the same authors reporting their ''in vivo'' results was more nuanced. While CO2 absorber lifespan was indeed significantly prolonged in high flow TIVA patients (160 hrs vs 16 hrs), and running costs were significantly decreased, the GWP100 was moderately higher with FiO2 of 30%, and significantly higher if FiO2 was 60%. They speculate that selective use of high flows in high CO2 output TIVA cases (e.g. laparoscopic or bariatric) may yield environmental as well as economic benefits. A [https://www.sciencedirect.com/science/article/pii/S1521689625000102#cebib0010 2024 paper] claimed that matching FGF to MV was always the more environmentally friendly option. Some of their assumptions were based on the above papers. My own analysis with some modifications to account for OHSU's cleaner grid intensity and different waste stream for CO2 absorbers (landfill vs. incineration) showed that there are select cases where low flow anesthesia during TIVA is still better. Specifically, if MV and FIO2 are both high, then the emissions cost of generating the air/O2 outweighs the CO2 absorber savings.

← Older revision		Revision as of 19:49, 14 August 2025
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−	* Use TIVA/regional techniques when possible. In cases where no volatile anesthetic is used, an in vitro [https://www.sciencedirect.com/science/article/pii/S0007091220306346?via%3Dihub study published in BJA in 2020] showed that FGF should be 6 LPM or match the patients MV (whichever is higher), to prevent undue consumption of CO2 absorbent. However, a follow up [https://~~ovidsp-dc2-ovid-com~~.~~liboff~~.~~ohsu.edu~~/~~ovid-new-b~~/~~ovidweb.cgi?&S=GCKOFPCDEIEBGKEKJPIJJEIHPOGCAA00&Complete+Reference=S.projects.17%7c24%7c1~~ letter to the editor] in 2022 by the same authors reporting their in vivo results was more nuanced. While CO2 absorber lifespan was indeed significantly prolonged in high flow TIVA patients (160 hrs vs 16 hrs), and running costs were significantly decreased, the GWP100 was moderately higher with FiO2 of 30%, and significantly higher if FiO2 was 60%. They speculate that selective use of high flows in high CO2 output TIVA cases (e.g. laparoscopic or bariatric) may yield environmental as well as economic benefits.	+	* Use TIVA/regional techniques when possible. In cases where no volatile anesthetic is used, an in vitro [https://www.sciencedirect.com/science/article/pii/S0007091220306346?via%3Dihub study published in BJA in 2020] showed that FGF should be 6 LPM or match the patients MV (whichever is higher), to prevent undue consumption of CO2 absorbent. However, a follow up [https://www.sciencedirect.com/science/article/pii/S0007091222005025 letter to the editor] in 2022 by the same authors reporting their in vivo results was more nuanced. While CO2 absorber lifespan was indeed significantly prolonged in high flow TIVA patients (160 hrs vs 16 hrs), and running costs were significantly decreased, the GWP100 was moderately higher with FiO2 of 30%, and significantly higher if FiO2 was 60%. They speculate that selective use of high flows in high CO2 output TIVA cases (e.g. laparoscopic or bariatric) may yield environmental as well as economic benefits.

← Older revision		Revision as of 18:17, 11 December 2024
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−	* Use TIVA/regional techniques when possible. In cases where no volatile anesthetic is used, [https://www.sciencedirect.com/science/article/pii/S0007091220306346?via%3Dihub FGF should be 6 LPM] or match the patients MV (whichever is higher), to prevent undue consumption of CO2 absorbent. However, a follow up [https://ovidsp-dc2-ovid-com.liboff.ohsu.edu/ovid-new-b/ovidweb.cgi?&S=GCKOFPCDEIEBGKEKJPIJJEIHPOGCAA00&Complete+Reference=S.projects.17%7c24%7c1 letter to the editor] in 2022 reporting their in vivo results was more nuanced. While CO2 absorber lifespan was indeed significantly prolonged in high flow TIVA patients (160 hrs vs 16 hrs), and running costs were significantly decreased, the GWP100 was moderately higher with FiO2 of 30%, and significantly higher if FiO2 was 60%. They speculate that selective use of high flows in high CO2 output TIVA cases (e.g. laparoscopic or bariatric) may yield environmental as well as economic benefits.	+	* Use TIVA/regional techniques when possible. In cases where no volatile anesthetic is used, an in vitro [https://www.sciencedirect.com/science/article/pii/S0007091220306346?via%3Dihub study published in BJA in 2020] showed that FGF should be 6 LPM or match the patients MV (whichever is higher), to prevent undue consumption of CO2 absorbent. However, a follow up [https://ovidsp-dc2-ovid-com.liboff.ohsu.edu/ovid-new-b/ovidweb.cgi?&S=GCKOFPCDEIEBGKEKJPIJJEIHPOGCAA00&Complete+Reference=S.projects.17%7c24%7c1 letter to the editor] in 2022 by the same authors reporting their in vivo results was more nuanced. While CO2 absorber lifespan was indeed significantly prolonged in high flow TIVA patients (160 hrs vs 16 hrs), and running costs were significantly decreased, the GWP100 was moderately higher with FiO2 of 30%, and significantly higher if FiO2 was 60%. They speculate that selective use of high flows in high CO2 output TIVA cases (e.g. laparoscopic or bariatric) may yield environmental as well as economic benefits.

← Older revision		Revision as of 18:15, 11 December 2024
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−	* Use TIVA/regional techniques when possible. In cases where no volatile anesthetic is used, [https://www.sciencedirect.com/science/article/pii/S0007091220306346?via%3Dihub FGF should be 6 LPM] or match the patients MV (whichever is higher), to prevent undue consumption of CO2 absorbent.	+	* Use TIVA/regional techniques when possible. In cases where no volatile anesthetic is used, [https://www.sciencedirect.com/science/article/pii/S0007091220306346?via%3Dihub FGF should be 6 LPM] or match the patients MV (whichever is higher), to prevent undue consumption of CO2 absorbent. However, a follow up [https://ovidsp-dc2-ovid-com.liboff.ohsu.edu/ovid-new-b/ovidweb.cgi?&S=GCKOFPCDEIEBGKEKJPIJJEIHPOGCAA00&Complete+Reference=S.projects.17%7c24%7c1 letter to the editor] in 2022 reporting their in vivo results was more nuanced. While CO2 absorber lifespan was indeed significantly prolonged in high flow TIVA patients (160 hrs vs 16 hrs), and running costs were significantly decreased, the GWP100 was moderately higher with FiO2 of 30%, and significantly higher if FiO2 was 60%. They speculate that selective use of high flows in high CO2 output TIVA cases (e.g. laparoscopic or bariatric) may yield environmental as well as economic benefits.

← Older revision		Revision as of 23:36, 9 December 2024
Line 1:		Line 1:
−	* Use TIVA/regional techniques when possible. In cases where no volatile anesthetic is used, [https://www.sciencedirect.com/science/article/pii/S0007091220306346?via%3Dihub FGF should be 6 LPM] or match the patients MV, whichever is higher to prevent undue consumption of CO2 absorbent.	+	* Use TIVA/regional techniques when possible. In cases where no volatile anesthetic is used, [https://www.sciencedirect.com/science/article/pii/S0007091220306346?via%3Dihub FGF should be 6 LPM] or match the patients MV (whichever is higher), to prevent undue consumption of CO2 absorbent.

← Older revision		Revision as of 23:35, 9 December 2024
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−	* Use TIVA/regional techniques when possible. In cases where no volatile anesthetic is used, FGF should be 6 LPM or match the patients MV, whichever is higher to prevent undue consumption of CO2 absorbent. ~~Source~~: ~~Zhong G, Abbas A, Jones J, Kong S, McCulloch T~~. ~~Environmental and economic impact of using increased fresh gas flow to reduce carbon dioxide absorbent consumption in the absence of inhalational anaesthetics~~. ~~Br J Anaesth. . 2020;125(5):773-778. doi:10.1016~~/~~j.bja.2020.07.043~~	+	* Use TIVA/regional techniques when possible. In cases where no volatile anesthetic is used, FGF should be 6 LPM or match the patients MV, whichever is higher to prevent undue consumption of CO2 absorbent. [https://www.sciencedirect.com/science/article/pii/S0007091220306346?via%3Dihub 1]