Abstract
Critical care is perhaps one of the most “climate-intensive” divisions of health care. As greenhouse gas emissions continue to rise, the unprecedented threat of climate change has belatedly prompted an increased awareness of critical care's environmental impact. Within our role as pediatric critical care providers, we have a dual responsibility not only to care for children at their most vulnerable, but also to advocate on their behalf. There are clear, demonstrable effects of our worsening climate on the health of children, with the resultant increased burden of pediatric critical illness and disruption to health care systems. From increasing wildfires and their effect on lung health, to the spread of vector-borne diseases such as dengue, and the increased migration of children due to a changing climate, the effects of a changing climate are here, and we are beginning to see the changing epidemiology of pediatric critical illness. Ensuring that the effects of ongoing changes are minimized, including its future effects on child health, requires a multifaceted approach. As part of this review, we will use the Lancet Countdown on Climate Change indicators to explore the impact of pediatric critical care on climate change and the inevitable influence climate change will have on the future practice of pediatric critical care globally.
Highlights
Progressive elimination of desflurane led to a 24% reduction in greenhouse gas emissions associated with anesthetic gas use [41]
We should ensure that staff, our units, hospitals, and local authorities are all aware of the likely impact climate change will have on us all over the coming years and the increased demand on critical care resources and services that will ensue
Critical care–specific climate studies would allow us as a profession to mitigate, prepare, advocate, and inform future policies
Summary
The incidence and severity of respiratory infections may alter over the coming years, with potential increases in bacterial pneumonia and influenza and a reduction in respiratory syncytial virus during the milder winters [70] Managing this population of high-risk, critically unwell individuals with little physiological reserve in settings with strained health systems due to acute weather events, migration, or conflict will be challenging and require a global coordinated response. We should ensure that staff, our units, hospitals, and local authorities are all aware of the likely impact climate change will have on us all over the coming years and the increased demand on critical care resources and services that will ensue. As a collaboration, tracking PICU-specific Lancet Countdown metrics, both at a local and national level, would inform health care providers and policy holders of progress made toward a sustainable and carbon neutral future, keeping us accountable to the critically ill children worldwide we strive to care for
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