The environmental impact of single-use and reusable flexible bronchoscopes for tracheal intubation in France

Research highlights

• "Our results show that using reusable bronchoscopes generates a lower potential environmental impact in all the analysed categories (from a 26% reduction in global warming impact to a 99.5% reduction for abiotic depletion), except for water use (50% increase)."
• "Life-cycle assessment at the study site are in line with previous comparisons of single-use vs reusable medical devices, but contradict the only existing LCA of flexible bronchoscopes. Several reasons could explain the diverging outcomes, from different cleaning procedures to use of different databases."
• "Life-cycle costing results showed that the use of single-use bronchoscopes is associated with higher costs, confirming previous similar assessments.[9] different results could be obtained in different contexts."
• "In the hospital setting investigated, use of reusable flexible bronchoscopes for tracheal intubation might be preferable than use of single-use devices because of their lower environmental impact, lower cost, and technical reliability." 

Abstract

Reusable flexible bronchoscopes have historically been used for difficult tracheal intubation in the operating theatre, but the use of single-use bronchoscopes is on the rise. Single-use bronchoscopes are assumed to reduce the risks of cross-contamination1 and reduce hospital costs. However, their technical reliability for difficult tracheal intubation compared with reusable devices is unclear. Moreover, an economic advantage largely depends on the type and number of procedures performed per year as well as study-site specificities. Finally, the potential environmental consequences of this transition have not been sufficiently assessed. This study marks the first attempt to compare the use of single-use and reusable flexible bronchoscopes for difficult tracheal intubation with a holistic approach, encompassing environmental, economic, and clinician satisfaction assessments.  

Methods & Results

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Citation

Bringier R, Arrigoni A, Muret J, Dro A, Gayat E, Vallée F, Arrigoni Marocco S. An integrated environmental, economic, and clinician satisfaction comparison between single-use and reusable flexible bronchoscopes for tracheal intubation. British journal of anaesthesia : BJA. 2023