Don’t use high fresh gas flows; prefer low flows and the minimum effective oxygen concentration.

Don’t use high fresh gas flows; prefer low flows and the minimum effective oxygen concentration.

Type of practice

Drugs

Age

Adult, Geriatric, Pediatric

Topic Area

Anesthesia, Analgesia, Resuscitation and Intensive Care

High fresh gas flows unnecessarily increase the consumption of halogenated anesthetic gases, thereby amplifying greenhouse gas emissions with a significant environmental impact. The administration of inhaled agents is now safer thanks to modern systems for monitoring exhaled gases and anesthetic depth. Reducing fresh gas flows to ≤ 0.5 L/min, when clinically safe and technically feasible, significantly decreases the consumption of halogenated agents and oxygen, resulting in both economic and environmental benefits. Routine oxygen use should be reserved for clinical conditions where it provides real benefit, contributing to a more responsible anesthetic practice.

 

Sources

1. Gonzalez-Pizarro P, Brazzi L, Koch S, et al. European Society of Anaesthesiology and Intensive Care consensus document on sustainability: 4 scopes to achieve a more sustainable practice. Eur J Anaesthesiol 2024; 41:260–277.
2. Kalmar, A F, Teunkens, A, Rex S.. Navigating Europe's sustainable anaesthesia pathway. Eur J Anaesthesiol 2024; 41: 465-467. doi: 10.1097/EJA.0000000000001993.
3. Bałys M, Brodawka E, Korzeniewska A et al. LCA and economic study on the local oxygen supply in Central Europe during the COVID-19 pandemic. Sci Total Environ. 2021;10;786:147401. doi: 10.1016/j.scitotenv.2021.147401.
4. Torrano V, Zadek F, Abbiati G et al. Oxygen-Sparing Anesthesia with Electrically Controlled Ventilators: A Bench Study with Implications for Clinical Practice and Resource Management. Anesthesia & Analgesia 2025;140:990-992. doi: 10.1213/ANE.0000000000007270.
5. Seglenieks R, Szental J, McAlister S et al. Environmental impact of eliminating routine supplemental oxygen for Caesarean delivery: a breath of fresh air. Br J Anaesth. 2022;128:e307-8. doi: 10.1016/j.bja.2022.01.035.

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Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.