How does Reusable Ventilator Breathing Circuits save costs for Hospitals and the Environment ? 

INTRODUCTION

The breathing circuit ( also regarded as a Ventilator circuit or Patient circuit) is one of the most essential components of the Ventilator system. The breathing circuits in anaesthesia machines/ventilators serve as a tube channelling the gases between a patient’s airway and ventilator. 

 The 2 classification types of anaesthesia breathing circuits are 

• Disposable / Single-use Breathing Circuits 

• Reusable Anaesthesia / Ventilator breathing circuits 

There is a common misconception revolving around the effect of disposable breathing circuits and reusable Ventilator breathing circuits on hospital budgets. The intervention on weighing the cost factors of both circuits is an absolute necessity for hospitals that are constantly working on minimising their financial and environmental cost budgets while still maintaining the medical standards. 

Financial Costs

Reusable breathing circuits play a vital role in reducing hospital costs, however still eliminating the risk of cross infections. Many hospitals tap onto disposable breathing circuits, that are coupled with tied capital, and involvement of high inventory costs. On the flip side, the reuse of breathing circuits is economical in many ways as there is no need to dispose of the patient circuits after each patient use.

Nevertheless, in such cases, the circuits need to be autoclaved or cold sterilised. Therefore, hospitals that are aiming at substantial savings, can benefit from using  reusable Ventilator circuits.However, there is a second thought being focused on the costs involved in sterilizing/disinfecting the Ventilator circuits. The majority of the hospitals employ autoclave machines that possess the sterilizing capacity of 15-20 trays of medical equipment per cycle.

Based on various studies and research papers, considering numerous factors such as energy source, and water consumption, the costs involved in disinfectant varies in the given range in table 1. Thus, the cost of disinfectant is negligible in comparison to the cost factors of disposable breathing circuits in alignment with purchasing costs, inventory costs, and waste disposal costs.The circuits can be changed when there is a mechanical malfunction or visibly soiled.

Cost-Effective analysis

The estimated cost-effective analysis depicts the total cost difference between reusable and disposable breathing circuits for 2 years.  

Table 1 

Table 2 

In the long run, disposable ventilator circuits being expensive, are borne by the patient, thereby raising the patient care bill.

Needless to mention, the estimated substantial savings can alter depending on the type, quality and manufacturer of the circuits. The price varies according to various countries.

Environmental costs

Breathing Circuits is one of the arenas that causes an impact on the environmental footprint.One of the benefits of using Reusable Ventilator breathing circuits is the fact that less medical waste is produced. By utilising the circuits for multiple patients, there is a reduction in medical wastage. This in turn leads to a reduction of disposal costs. 

Estimated Disposal costs 

WHO report states that high-income countries generally produce 0.5kg of medical waste per hospital bed per day whereas low-income countries produce 0.2kg of medical waste per hospital bed per day.

According to the article by Deccan Herald, the disposal cost of biomedical waste has been increased from 50 Rs to almost 120 Rs per kg (during pandemic situation). As in the case, a single hospital produces an average of 100kg biomedical waste, the total disposal costs range around 12000 Rs.

By tapping on the advantage of reusable Ventilator breathing circuits, the disposal costs can be reduced. Since the autoclave sterilization machines possess the capacity of disinfecting 15-20 trays of breathing circuits, it can considerably save the utility costs such as reduction in power energy and water consumption. Thus, the environmental costs can be decreased. 

Life Cycle Assessment (LCA) is a type of process that analyses the emissions and energy utilisation in resource extraction, manufacturing process, packaging, transportation, processing and disposal. The resource extraction process for manufacturing breathing circuits is an energy-intensive process, which contributes to a high carbon footprint.

Given the same number of plastics and metal components used in the manufacturing process of breathing circuits that are to be utilised for 2-year purposes, the CO₂ emissions of 104 disposable circuits are relatively larger as compared to 1 reusable circuit cycle. 

Eventually, the CO₂ emissions in packaging the 104 disposable circuits fall on a larger spectrum than the single reusable circuit. Compared to Reusable circuits, Disposable breathing circuits contribute to a high volume of operating theatre/ICU waste. The incineration disposal method itself produces enormous quantities of Greenhouse Gas Emissions. On the contrary, the CO₂ emissions from disposing of a reusable circuit are comparatively on a lesser scale.

The carbon footprint (ie) carbon dioxide emissions are lesser in the manufacturing process of Reusable Anaesthesia / Ventilator breathing circuits than the disposable circuits. Therefore, hospitals focusing on the environmental cost scrutiny can incline towards Reusable Ventilator breathing circuits.

Conclusion

Many hospitals who are facing stiff pressure in cutting down their budgets can leverage on the Reusable ventilator circuits over disposable breathing circuits. Through our estimated cost-effective analysis, it is evident that using quality Reusable Ventilator circuits from a reliable breathing circuit manufacturer can help healthcare facilities work towards substantial savings and reduction in environmental footprint.