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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.
Introduction:
Healthcare contributes significantly to global plastic waste, with single-use disposable (SUD) materials being a major culprit. Reusable anesthesia machine breathing circuits are used in many parts of the world. Their adoption in the United States (US) remains limited, driven by institutional policies and fear of litigation.
Methods:
This perspective piece reflects on our single institution multi-site experience using a variety of anesthesia machine breathing circuits, including SUD and reusable, with both daily and weekly circuit changes for pediatric anesthesia care in the US.
Results:
We report survey results on the attitudes and opinions of a pediatric anesthesia team regarding the sustainability and costs of these products, as well as the results of anonymous safety concern reporting during the October 2022 and January 2025 observation period. In our pediatric ambulatory surgery setting, weekly changes of reusable circuits with individual patient filters proved to be a safe alternative to daily changes or SUD circuits. Challenges to reusable circuit use were identified through reporting and survey data and included supply chain constraints and buildup of water vapor if circuits were not properly drained. We estimated plastic waste reduction to be 27.8 kg per week (84% reduction) compared to SUD and 17.5 kg (53% reduction) compared to daily reusable circuit changes.
Discussion:
We did not complete a full cost analysis or perform microbiologic studies as this has been previously reported. Monitoring for water vapor buildup within the reusable anesthesia breathing circuit and vigilance in performing a leak test prior to patient use remain key patient safety components. Our experience demonstrates the feasibility of reusable anesthesia circuit use with appropriate protocols.
