P0398 Point of Care Intestinal ultrasound – is it the key to reducing the carbon footprint of IBD Care?

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Abstract Background Sustainability of IBD care has been identified as a key priority for the coming years by ECCO as part of the REACH strategy. Additionally, the Irish Health Service Climate Action Strategy aims to achieve net-zero emissions by 2050 and provide healthcare that is environmentally and socially sustainable. The STRIDE II consensus discusses new treatment goals in the care of IBD such as endoscopic healing which would require more frequent monitoring. However this poses an environmental burden as one MRI generates approximately 20kg CO2e, 3 times more than a CT scan (7kg CO2e), and 20 times more than an ultrasound (1kg CO2e) and 1 colonoscopy is estimated to generate between 28-55kg CO2e. Decontamination of the endoscope generate a further 11.19 kg CO2e. Point of Care Intestinal ultrasound (POC-IUS) offers a low carbon alternative compared to CT, MRI and endoscopy for disease assessment and monitoring. Aim To calculate the potential reduction in Greenhouse Gas (GHG) emissions from the use of POC-IUS for disease monitoring. Methods A retrospective analysis of all POC-IUS performed over a 12mth period was conducted. We focused on the impact of utilising IUS in the IBD clinic instead of interval MRE or colonoscopy to assess disease activity. The immediate carbon emissions saved as a result of utilising IUS alone was calculated. The long term reduction of carbon emissions over a three year period from using IUS as an alternative tool for disease monitoring was also calculated. Data on patient travel, investigations and associated emissions were collected from the patient health record and calculated on ecotree.green. Results 259 patients were identified who underwent IUS, 92% had Crohns disease. 20% (n=52) of patients had active disease which was followed up by POC-IUS alone. Mean F.Calpro was 495. Consequently, 14 fewer colonoscopies and 43 fewer MRE were performed over the 12mth period due to the immediate assessment offered by IUS corresponding to at least 5460km reduction in travel to and from appointments with an overall reduction in GHG emission of 1,485kg CO2e. Overall, the use of POC-IUS instead of MRE and/or colonoscopy led to an estimated reduction in GHG of 3269kg CO2e. Projecting these results over an interval period where IUS is used as the only primary monitoring tool to assess disease activity showed potential carbon emission savings of 36,531kg C02e.This is equivalent to 15 Round-Trip Flights from New York to London. Conclusion The findings emphasise the role IUS delivered within the IBD clinic might play in reducing the carbon footprint of IBD care. POC-IUS is a low carbon alternative and is a tool in providing a lean care system which are two key principles of delivering a sustainable clinical practice.