Sustainability of heart surgeries: detailed insights from Radboudumc  Potential gains in sustainable energy use and disposable materials

Healthcare faces a significant challenge: sustainability. Researchers from Radboud university medical center have mapped out the environmental impact of heart surgery and the subsequent intensive care admission. Their life cycle assessment reveals opportunities to reduce the ecological footprint of healthcare, from reducing disposable materials to improving energy efficiency. The results have been published in the European Journal of Cardio-thoracic Surgery.

Each year, 7,000 to 8,000 people in the Netherlands undergo bypass surgery, including patients at Radboudumc. During this major procedure, blood vessels from other parts of the body are used to create bypasses for the heart’s arteries. After the operation, intensive care is required. This healthcare process significantly impacts the environment, particularly through the use of disposable materials and energy consumption during the surgery and recovery period. 

Environmental impact of bypass surgery 

Under the leadership of medical researcher Egid van Bree, the research team thoroughly examined the care pathway for a patient. ‘It's like a large jigsaw puzzle’, explains Van Bree. ‘We look at each individual element of the care process and investigate its environmental effects, from the materials used to the energy needed.’ The life cycle assessment reveals that the care for one patient can result in up to 414 kg of CO2 emissions, equivalent to a 3,000-kilometer car trip, from the Netherlands to Morocco. 

Sustainability gains in the healthcare process

The researchers looked for impactful areas where the environmental footprint of bypass surgeries could be reduced and identified several opportunities. Disposable materials, such as drapes, surgical gowns, cotton gauze, and gloves, contribute to waste and CO2 emissions. More sustainable alternatives, like washable drapes and other surgical gowns, can help reduce the ecological footprint. 

Additionally, savings in energy consumption can be achieved, especially through the optimization of air handling units, and benefits can be realized by using renewable energy. Moreover, the disposable set for the heart-lung machine, which contains approximately six kilos of plastic, has a significant environmental burden. Although there is currently no alternative, this remains an important area for innovation to reduce ecological impact. 

From research to practice: the next steps

This study provides insights into how heart surgeries and intensive care admissions can be made more sustainable. A direct outcome is that Radboudumc is now exploring how to optimize its air handling systems and reduce disposable materials. Tim Stobernack, sustainability researcher at Radboudumc, emphasizes the challenge of implementing these changes across the healthcare sector. 'Step by step, we are mapping out more care pathways. We hope to soon share our results for eye surgeries, emergency room care, and the admission of other patients to intensive care.’ 

About this publication

This study has been published in European Journal of Cardio-thoracic Surgery: Assessing the environmental impact of coronary artery bypass grafting to decrease its footprint – Egid M. van Bree, Tim Stobernack, Tadzjo Boom, Klaske Geene , Emma J. Kooistra, Wilson Li, Evelyn A. Brakema, Laura Golsteijn , Pleun Hemelaar, Scott McAlister, Forbes McGain, Rosalie van Zelm, Hugo R.W. Touw. DOI: 10.1093/ejcts/ezaf054. 

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