儿童医院采用影像大包装碘对比剂减少对比剂浪费、成本与温室气体排放
该研究在单中心儿童医院统计2025年1–6月所有增强CT，量化碘对比剂浪费并估算高峰时段改用大包装（IBP）的效益。结果显示每例平均浪费37 mL，6个月共浪费66 L；高峰时段用IBP可降至17 mL（P<0.001），并减少玻璃瓶浪费、节省费用和降低温室气体排放。
要点
- 儿童医院增强CT每例平均浪费碘对比剂37 mL，6个月共66 L。
- 工作日9 AM–9 PM为高峰时段，改用IBP可将每例浪费降至17 mL。
- 高峰用IBP加无针筒注射器可减少温室气体排放72%。
局限性
- 单中心研究，结论外推需谨慎。
- 为回顾性研究，估算结果可能受实践差异影响。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
BACKGROUND: There are environmental and financial benefits to reducing iodinated contrast media (ICM) waste. While Imaging Bulk Package (IBP) bottles have been demonstrated to reduce contrast waste in adult hospitals, lower computed tomography (CT) volumes and smaller contrast doses pose challenges for utilizing IBP in children's hospitals.
OBJECTIVE: Primary outcome: quantification of CT contrast waste during a 6-month period at a single children's hospital.
SECONDARY OUTCOMES: quantification of single-use product waste and greenhouse gas emissions, identification of the 12-h periods of highest contrast use, and estimation of reductions in contrast waste, single-use product use, costs, and greenhouse gas emissions by using IBP ICM during peak hours.
MATERIALS AND METHODS: All contrast-enhanced CT performed from January through June 2025 were reviewed. Volume of contrast wasted was calculated. The 12-h time period with the highest contrast-enhanced CT volume was determined. Reductions in contrast waste, single-use products, cost, and greenhouse gas emissions by using IBP ICM during these peak hours were estimated.
RESULTS: Approximately 291 contrast-enhanced CT exams were performed per month. Mean contrast waste was 37 mL per study, totaling 66 L of wasted contrast over 6 months. Peak hours were 9 AM to 9 PM on weekdays. The mean ICM waste per exam was 37 mL using single-dose bottles versus 17 mL using IBP bottles during peak hours (P<0.001). Using IBP ICM during peak hours and single-use ICM at other times could reduce contrast waste by 56%, glass bottle waste by 33%, and save $40,740 per year. Using IBP during peak hours with a syringeless contrast injector would decrease greenhouse gas emissions by 72% due to added benefits of decreased waste of single-use plastics.
CONCLUSION: Implementing IBP ICM during peak hours would substantially reduce contrast waste, single-use product waste, and costs at our hospital. Other children's hospitals may evaluate their contrast utilization practices, including quantification of contrast waste and single-use products, to identify opportunities to reduce waste through use of IBP and syringeless contrast injectors.
引用
- Noda SM, Eckelman MJ, Porter P, et al. Reduction of iodinated contrast waste, cost, and greenhouse gas emissions using imaging bulk packaging in a pediatric hospital. Pediatr Radiol. 2026. PMID: 42149152. doi:10.1007/s00247-026-06654-7
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。