{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T08:18:19Z","timestamp":1787818699409,"version":"build-2784847793"},"reference-count":10,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Healthcare accounts for 4%\u20135% of global CO\n                      <jats:sub>2<\/jats:sub>\n                      equivalent (CO\n                      <jats:sub>2<\/jats:sub>\n                      e) emissions, of which hospitals form a considerable component. Identifying evidence\u2010based targets for carbon reduction in pediatric anesthesia can help guide meaningful reductions in healthcare\u2010related environmental harm.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A narrative review was conducted integrating published data on carbon emissions associated with anesthetic agents, perioperative workflows, waste generation, and hospital energy systems. Quantitative CO\n                      <jats:sub>2<\/jats:sub>\n                      e estimates were incorporated when available.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Preoperative strategies with measurable carbon savings include early anesthesia assessment, telehealth consultations, and standardization of diagnostic testing. Intraoperatively, avoidance of nitrous oxide and desflurane yield the largest individual reductions. Propofol waste can be reduced through dose calculators and optimized vial selection. Switching to reusable equipment further limits environmental harm. Institutional actions, including decommissioning nitrous oxide pipeline systems, enhancing sustainability training, and optimizing heating, ventilation, and air conditioning systems, offer the largest measurable carbon reductions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pediatric anesthetists can reduce environmental harm while optimizing patient care. While individual clinician choices \u2010in particular avoiding desflurane and nitrous oxide use\u2014are impactful, the largest and most sustainable emissions reductions derive from coordinated institutional and systems level changes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pan.70148","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T04:25:46Z","timestamp":1771475146000},"page":"475-478","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Sustainable Healthcare Practices in Pediatric Anesthesia"],"prefix":"10.1002","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5694-8587","authenticated-orcid":false,"given":"Andrea P. A.","family":"Yap","sequence":"first","affiliation":[{"name":"Department of Pediatric Anesthesia Al Jalila Children's Hospital  Dubai UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"McIntyre","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain Management Royal Children's Hospital  Melbourne Australia"},{"name":"Department of Critical Care University of Melbourne  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Forbes","family":"McGain","sequence":"additional","affiliation":[{"name":"Department of Critical Care University of Melbourne  Melbourne Australia"},{"name":"Department of Anaesthesia and Intensive Care Western Health  Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2542\u20105196(20)30121\u20102.2"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.7861\/fhj.2020\u20100080"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.50583"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e31824f6940"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2024.08.028"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/app12094098"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aex098"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2022.04.022"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0b013e31824ea491"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199507203330303"}],"container-title":["Pediatric Anesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pan.70148","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pan.70148","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pan.70148","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T05:38:06Z","timestamp":1775540286000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pan.70148"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,18]]},"references-count":10,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/pan.70148"],"URL":"https:\/\/doi.org\/10.1002\/pan.70148","archive":["Portico"],"relation":{},"ISSN":["1155-5645","1460-9592"],"issn-type":[{"value":"1155-5645","type":"print"},{"value":"1460-9592","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,18]]},"assertion":[{"value":"2025-09-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}