An audit of the carbon footprint of travel for the Canadian Anesthesiologists' Society International Education Foundation partnerships.

PURPOSE: International partnerships have an important role in capacity building in global health, but frequently involve travel and its associated carbon footprint. The environmental impact of global health partnerships has not previously been quantified. METHODS: We conducted a retrospective internal audit of the environmental impact of air travel for the international education programs of the Canadian Anesthesiology Society's International Education Fund (CASIEF). We compiled a comprehensive list of volunteer travel routes and used the International Civil Aviation Organization Carbon Emissions Calculator, which considers travel distance, passenger numbers, and average operational data for optimized estimates. Comparisons were made with average Canadian household emissions and disability adjusted life years (DALYs) lost from climate change consequences. RESULTS: The total carbon dioxide emitted (CO2-e) for the Rwanda, Ethiopia, and Guyana CASIEF partnerships were 268.2, 60.7, and 52.0 tons, respectively. The DALYs cost of these programs combined is estimated to be as high as 1.1 years of life lost due to the effects of CO2-e. The mean daily carbon cost of the average Rwanda partnership was equivalent to daily emissions of 2.2 Canadians (or 383 Rwandans), for the Guyana partnership was equivalent to 1.6 Canadians (or 7.6 Guyanese people), and for the Ethiopia partnership was equivalent to 2.4 Canadians (or 252 Ethiopian people). CONCLUSIONS: Air travel from these CASIEF partnerships resulted in 380.9 tons CO2-e but also enabled 5,601 volunteer days-in-country since 2014. The estimated environmental cost needs to be balanced against the impact of the programs. Regardless, carbon-reduction remains a priority, whether by discouraging premium class travel, organizing longer trips to reduce daily emissions, prioritizing remote support and virtual education, or developing partnerships closer to home.

RéSUMé: OBJECTIF: Les partenariats internationaux jouent un rôle important dans le renforcement des capacités en santé mondiale, mais impliquent souvent des voyages et une empreinte carbone qui y est associée. L'impact environnemental des partenariats pour la santé mondiale n'a pas encore été quantifié. MéTHODE: Nous avons réalisé un audit interne rétrospectif de l'impact environnemental du transport aérien pour les programmes de formation internationale du Fonds d'éducation internationale de la Société canadienne des anesthésiologistes (FÉI SCA). Nous avons compilé une liste complète des itinéraires de voyage des bénévoles et utilisé le Calculateur d'émissions de carbone de l'Organisation de l'aviation civile internationale, qui prend en compte la distance parcourue, le nombre de passagers et les données opérationnelles moyennes pour des estimations optimisées. Des comparaisons ont été faites avec les émissions moyennes des ménages canadiens et les années de vie corrigées de l'incapacité (AVCI) perdues en raison des conséquences des changements climatiques. RéSULTATS: Le dioxyde de carbone total émis (CO2-e) dans le cadre des partenariats de la FÉI SCA avec le Rwanda, l'Éthiopie et le Guyana, étaient de 268,2, 60,7 et 52,0 tonnes, respectivement. Le coût combiné des AVCI de ces programmes est estimé à 1,1 année de vie perdue en raison des effets du CO2-e. Le coût quotidien moyen du carbone du partenariat moyen avec le Rwanda équivalait aux émissions quotidiennes de 2,2 Canadiens (ou 383 Rwandais); pour le partenariat avec le Guyana, cela équivalait à 1,6 Canadien (ou 7,6 Guyanais) et pour le partenariat avec l'Éthiopie, à 2,4 Canadiens (ou 252 Éthiopiens). CONCLUSION: Les voyages aériens des partenariats de la FÉI SCA ont entraîné la production de 380,9 tonnes de CO2-e mais ils ont également permis 5601 journées de bénévolat dans les pays partenaires depuis 2014. Le coût environnemental estimé doit être mis en perspective avec l'impact des programmes. Quoi qu'il en soit, la réduction des émissions de carbone reste une priorité, que ce soit en décourageant les voyages en première classe, en organisant des voyages plus longs pour réduire les émissions quotidiennes, en donnant la priorité à l'assistance à distance et à l'éducation virtuelle, ou en développant des partenariats plus près de chez soi.

Administration of intrapulmonary sodium polyacrylate to induce lung injury for the development of a porcine model of early acute respiratory distress syndrome.

BACKGROUND: The loss of alveolar epithelial and endothelial integrity is a central component in acute respiratory distress syndrome (ARDS); however, experimental models investigating the mechanisms of epithelial injury are lacking. The purpose of the present study was to design and develop an experimental porcine model of ARDS by inducing lung injury with intrapulmonary administration of sodium polyacrylate (SPA). METHODS: The present study was performed at the Centre for Comparative Medicine, University of British Columbia, Vancouver, British Columbia. Human alveolar epithelial cells were cultured with several different concentrations of SPA; a bioluminescence technique was used to assess cell death associated with each concentration. In the anesthetized pig model (female Yorkshire X pigs (n = 14)), lung injury was caused in 11 animals (SPA group) by injecting sequential aliquots (5 mL) of 1% SPA gel in aqueous solution into the distal airway via a rubber catheter through an endotracheal tube. The SPA was dispersed throughout the lungs by manual bag ventilation. Three control animals (CON group) underwent all experimental procedures and measurements with the exception of SPA administration. RESULTS: The mean (± SD) ATP concentration after incubation of human alveolar epithelial cells with 0.1% SPA (0.92 ± 0.27 µM/well) was approximately 15% of the value found for the background control (6.30 ± 0.37 µM/well; p < 0.001). Elastance of the respiratory system (E RS) and the lung (E L) increased in SPA-treated animals after injury (p = 0.003 and p < 0.001, respectively). Chest wall elastance (E CW) did not change in SPA-treated animals. There were no differences in E RS, E L, or E CW in the CON group when pre- and post-injury values were compared. Analysis of bronchoalveolar lavage fluid showed a significant shift toward neutrophil predominance from before to after injury in SPA-treated animals (p < 0.001) but not in the CON group (p = 0.38). Necropsy revealed marked consolidation and congestion of the dorsal lung lobes in SPA-treated animals, with light-microscopy evidence of bronchiolar and alveolar spaces filled with neutrophilic infiltrate, proteinaceous debris, and fibrin deposition. These findings were absent in animals in the CON group. Electron microscopy of lung tissue from SPA-treated animals revealed injury to the alveolar epithelium and basement membranes, including intra-alveolar neutrophils and fibrin on the alveolar surface and intravascular fibrin (microthrombosis). CONCLUSIONS: In this particular porcine model, the nonimmunogenic polymer SPA caused a rapid exudative lung injury. This model may be useful to study ARDS caused by epithelial injury and inflammation.