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. 2024 Jul 30:101420.
doi: 10.1016/j.accpm.2024.101420. Online ahead of print.

How green is my reusable bronchoscope?

Nicolas Massart  1 , Christophe Millet  2 , Hélène Beloeil  3 , Pierre Fillatre  2 , Caroline Rouxel  4 , Magalie Daudin  5 , Nicolas Coullier  6 , Véronique Marie  7 , Elodie Peguet  8 , Pierre Bardoult  9
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How green is my reusable bronchoscope?

Nicolas Massart et al. Anaesth Crit Care Pain Med. .

Abstract

Introduction: Single-use bronchoscopes have replaced reusable ones in many institutions. This study aimed to evaluate the environmental and financial impacts of both strategies: reusable and single-use bronchoscopes.

Material and methods: We conducted a pragmatic study in a 21-bed polyvalent ICU, in Saint-Brieuc, Bretagne, France. The eco-audit consisted of estimating greenhouse gas (GHG) emissions, considering the life cycle of each strategy. Greenhouse gas (GHG) emissions related to construction, packaging, transport and waste elimination were compared between 2 devices: the reusable bronchoscope, a Pentax® FI-16RBS that was disinfected twice daily; and the single-use bronchoscope, the bronchoflex agile® from TSC.

Results: For the reusable bronchoscope, GHG emissions were marginally impacted by the number of bronchoscopies performed (from 185 kg eq.CO2 per year to 192 kg eq.CO2 for 10 or 110 bronchoscopies per year). For the reusable device, GHG emissions directly depended on the number of bronchoscopies performed with 3.82 kg eq.CO2 emitted per bronchoscopy. The breakeven point for the reusable bronchoscope was estimated at 50 bronchoscopies in terms of GHG emissions and 96 bronchoscopies for financial considerations.

Conclusion: Considering current practice in our ICU, reusable bronchoscopes have lower GHG emissions when used more than 50 times a year and a lower cost when used more than 96 times a year as compared with single-use bronchoscopes.

Keywords: Bronchoscopy; Life cycle assessment; critical care; global warming.

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