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A Cultural Shift: Implementing Reusable Anesthesia Circuits in US Pediatric Anesthesia to Address Supply Chain and
Elizabeth E Hansen1,2, Hannah C Cockrell2,3, Forbes McGain4
1Department of Anesthesiology and Pain Medicine University of Washington, Seattle, Washington, USA.
Paediatric Anaesthesia
|December 19, 2025
Summary
Reusable anesthesia breathing circuits offer a safe, sustainable alternative to single-use disposable (SUD) materials in pediatric care, significantly reducing plastic waste. Implementing protocols for monitoring and leak testing ensures patient safety with these eco-friendly anesthesia circuits.
Area of Science:
- Anesthesiology
- Environmental Science
- Healthcare Sustainability
Background:
- Healthcare generates substantial plastic waste, primarily from single-use disposable (SUD) materials.
- Reusable anesthesia machine breathing circuits are underutilized in the US due to institutional policies and litigation concerns.
Purpose of the Study:
- To evaluate the safety, sustainability, and cost-effectiveness of reusable anesthesia breathing circuits in a US pediatric ambulatory surgery setting.
- To assess the pediatric anesthesia team's attitudes towards reusable circuits and identify barriers to adoption.
Main Methods:
- A multi-site, single-institution perspective piece examining the use of both SUD and reusable anesthesia circuits.
- Data collection included surveys on team attitudes and anonymous safety concern reporting over a defined observation period.
- Comparison of weekly reusable circuit changes with individual patient filters versus daily changes or SUD circuits.
Main Results:
- Weekly changes of reusable circuits with filters were found to be a safe alternative to daily changes or SUD circuits in pediatric ambulatory surgery.
- Estimated plastic waste reduction was 84% (27.8 kg/week) compared to SUD and 53% (17.5 kg/week) compared to daily reusable changes.
- Identified challenges included supply chain issues and water vapor buildup, emphasizing the need for proper draining and leak testing.
Conclusions:
- Reusable anesthesia circuits are feasible in pediatric settings with appropriate protocols, demonstrating significant plastic waste reduction.
- Ongoing vigilance for water vapor accumulation and pre-use leak testing are critical patient safety measures.
- Further cost analysis and microbiologic studies are warranted, though prior research exists.
