From carbon cost to climate care: Greening our intensive care units

Table 2 Illustrative international examples of emerging green intensive care unit models

Country/region	Health system/initiative	Scope of sustainability action	Key features relevant to ICU practice
United Kingdom	National Health Service	System-wide net-zero strategy	National commitment to net-zero emissions; phase-down of high-global-warming-potential inhaled anaesthetics; ICU-level initiatives focusing on waste segregation, procurement reform, and infrastructure optimisation
United States	Integrated healthcare systems (e.g., kaiser permanente)	Organisation-wide sustainability programs	Carbon-neutral operations; ICU-led “Green Teams”; device reprocessing; transition to reusable patient care items; energy-efficient building systems
Australia	Clinician-led ICU sustainability programmes	Multicentre research and practice initiatives	Life-cycle assessments in ICUs; adoption of reusable gowns and underpads; reduction in low-value blood testing; incorporation of sustainability into ICU redesign
New Zealand	Public hospital networks	Medical gas and equipment optimisation	Elimination of nitrous oxide use in selected ICUs; transition to alternative analgesia and sedation strategies; waste reduction initiatives
Netherlands	National ICU sustainability networks	Policy-supported institutional change	Circular procurement practices; waste reduction strategies; integration of sustainability within national critical care frameworks
Low- and middle-income settings	Institution-level ICU practices	Resource-constrained adaptations	Emphasis on equipment reuse and repair, extended device lifespan, and supply resilience, often driven by necessity rather than environmental intent

Examples are illustrative and reflect heterogeneous, context-specific approaches rather than uniform national practice. ICU: Intensive care unit.