ArticleJournal of anesthesia, analgesia and critical care2026
Attitudes, knowledge, practices, and perceived barriers on sustainability actions among Italian anesthesiologists-intensivists: a nationwide survey.
Article in Journal of anesthesia, analgesia and critical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHealthcare systems contribute approximately 4.6% of global carbon emissions, with anesthesia and intensive care representing major sources of environmental impact. Although awareness of sustainable practices is increasing, real-world implementation in these fields remains limited. This study aimed to describe knowledge, attitudes, practices, and perceived barriers toward sustainability among Italian anesthesiologists-intensivists.
methodsA cross-sectional, web-based survey was conducted among members of the Italian Society of Anesthesia, Analgesia, Resuscitation, and Intensive Care (SIAARTI) between June and July 2025. The questionnaire assessed demographics, clinical practices, environmental behaviors, and perceived barriers to sustainability. Descriptive statistics and an unsupervised clustering approach (Factor Analysis of Mixed Data followed by hierarchical clustering) were applied to identify distinct respondent profiles.
resultsA total of 459 responses were analyzed. Overall, 83.4% rated environmental sustainability as "very important," and 95.6% supported the adoption of renewable energy in hospitals. Despite this, 93.1% reported routine use of single-use devices, and only 7.4% worked in departments with a designated sustainability officer. Cluster analysis identified two main groups: the Experienced Generation (older, senior specialists) and the Green Generation (younger, early-career clinicians). While both valued sustainability, the Green Generation more frequently implemented eco-friendly practices, including the use of total intravenous anesthesia (71.2% vs. 57.5%), regional anesthesia (74.1% vs. 64.0%), and reusable/recyclable devices (> 80% vs. < 20%). The most frequently reported barriers to sustainability application were lack of training (76.3%), resistance to change (66.4%), and absence of guidelines (54.7%).
conclusionsItalian anesthesiologists-intensivists demonstrate strong environmental awareness but variable implementation of sustainable practices. Strengthening formal education, institutional leadership, and guideline dissemination is essential to promote widespread adoption of sustainable anesthesia and intensive care practices.
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