Evidence map›Paper›PMID 39986316›Full record

Observational studyThe Lancet. Planetary health2025

Environmental and patient safety outcomes of a health-system Green Anesthesia Initiative (GAIA): a retrospective observational cohort study.

Douglas A Colquhoun, David Hovord, Robyn Rachel, Yuan Yuan, Graciela B Mentz, Prabhat Koppera, Timur Z Dubovoy, Paul Picton, George A Mashour

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The Lancet. Planetary health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Douglas A ColquhounDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA. Electronic address: dougcolq@med.umich.edu.
David HovordDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
Robyn RachelDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
Yuan YuanDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
Graciela B MentzDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
Prabhat KopperaDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
Timur Z DubovoyDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
Paul PictonDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.
George A MashourDepartment of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA.

Funding

Data Driven Approaches to Improving Risk Prediction of Pulmonary Complications After Major Inpatient SurgeryK08HL159327 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI COLQUHOUN, DOUGLAS ALASTAIR · 2021 to 2025
$811k
NHLBI NIH HHS K08 HL159327
6 · The paper itself

Abstract

backgroundInhaled anaesthetics are greenhouse gases. However, changes in the delivery of inhaled anaesthetics can mitigate environmental impact. We hypothesised that system-wide changes to the delivery of anaesthesia care would reduce environmental harm without compromising patient outcomes.

methodsWe launched the Green Anesthesia Initiative (GAIA) in March, 2022, with the aims of reducing the use of nitrous oxide, using less environmentally harmful inhaled fluorinated ethers, and increasing intravenous anaesthetic use. In this retrospective cohort study, we used electronic health record data from general anaesthetics performed on all patients older than 1 year between March 1, 2021, and Feb 28, 2023, at a single US academic medical centre across multiple sites, collecting data from before and after the introduction of GAIA. Patients with missing or invalid data recorded by the anaesthesia machine, patients given general anaesthetics for electroconvulsive therapy, and patients who met American Society of Anesthesiologists Physical Status Classification 6 were excluded. Using multivariable modelling, we compared estimated CO

findingsWe recorded 45 692 patients pre-intervention (23 193 [50·8%] female, 22 494 [49·2%] male, five [<0·1%] unknown) and 47 199 post-intervention (23 981 [50·8%] female, 23 209 [49·2%] male, nine [<0·1%] unknown). After the implementation of GAIA, CO

interpretationA health-system wide intervention reduces greenhouse gas emissions attributable to anaesthesia care without detriment to patient outcomes.

fundingUniversity of Michigan Medical School and National Institutes of Health.

Indexed as

AnesthesiaAnesthesia, GeneralAnesthetics, InhalationPatient SafetyAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesAnesthetics, Inhalation

Identifiers

PMID39986316
PMCPMC11881991

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.