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Wprowadzenie i cel:
Światowa Organizacja Zdrowia (WHO) podkreśla, że zmiany klimatyczne stanowią poważne i narastające zagrożenie dla zdrowia ludzi. Szacuje się, że w latach 2030–2050 mogą one spowodować dodatkowo 250 tys. zgonów rocznie – e efekcie powodzi, susz, zanieczyszczenia powietrza czy chorób zakaźnych. Sam system opieki zdrowotnej przyczynia się do tego kryzysu, a praktyki anestezjologiczne odgrywają istotną rolę w emisji gazów cieplarnianych (GHG). Celem tego przeglądu jest podsumowanie obecnej wiedzy na temat wpływu gazów anestetycznych na środowisko, z jednoczesnym wskazaniem praktycznych rozwiązań, które mogą zostać wdrożone w szpitalach.

Opis stanu wiedzy:
Choć system opieki zdrowotnej poprawia jakość życia, ma również koszt środowiskowy, odpowiadając za 1–5% globalnego wpływu na środowisko. Emisje bezpośrednie z placówek zdrowotnych stanowią 17% emisji GHG tego sektora. Gazy anestetyczne odpowiadają za 0,6% emisji sektora zdrowia i 0,1% globalnych emisji GHG. Ich udział co prawda wydaje się niewielki, jednak długotrwała akumulacja tych gazów w atmosferze i ich wpływ na środowisko są słabo zbadane.

Podsumowanie:
Aby ograniczyć wpływ lotnych środków anestetycznych na środowisko, zaproponowano kilka działań: zmniejszenie przepływu świeżego gazu (FGF) podczas podtrzymywania znieczulenia, minimalizację lub eliminację bardziej szkodliwych gazów lotnych oraz wdrożenie technologii wychwytywania tych substancji. W sytuacjach uzasadnionych klinicznie zaleca się również całkowite znieczulenie dożylne jako alternatywę. Kluczową rolę odgrywają edukacja i zwiększanie świadomości wśród anestezjologów. Niezbędne są także odpowiednie regulacje wspierające długoterminowe zmiany w praktykach medycznych oraz promujące zrównoważone rozwiązania w ochronie zdrowia.

Introduction and objective:
It is emphasized by the World Health Organization (WHO) that climate change poses a significant and increasing threat to human health. It is estimated that between 2030–2050, climate change could result in an additional 250,000 deaths annually due to factors such as flooding, droughts, air pollution, and infectious diseases. The healthcare system itself contributes to this crisis. Anaesthetic practices play a significant role in greenhouse gas (GHG) emissions. The aim of the review is to summarize current knowledge on the environmental impact of anaesthetic gases, while highlighting practical solutions that can be adopted in hospitals.

Brief description of the state of knowledge:
Although the healthcare system improves lives, it also has an environmental cost, contributing to 1–5% of the total global environmental impact. Direct emissions from healthcare facilities constitute 17% of the sector’s GHG emissions. Anaesthetic gases alone contribute 0.6% of healthcare emissions and 0.1% of the total global GHG emissions. Although the global share might seem small, the long-term accumulation of these gases in the atmosphere and their effects remain under-explored.

Summary:
To mitigate the environmental impact of volatile anaesthetic agents, several strategies have been proposed. These include reducing the Fresh Gas Flow (FGF) during the maintenance phase of anaesthesia, minimizing or avoiding the use of more harmful volatile agents, and adopting Volatile Capture Technologies (VCT). Total intravenous anaesthesia, when clinically appropriate, is also highlighted as a viable alternative. Education and awareness among anaesthesiologists play a pivotal role in these efforts. Additionally, policy implementation by healthcare authorities is crucial to support long-term behavioural changes and promote sustainable practices in the medical field.
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