Goel S, Kataria S, Juneja D. From carbon cost to climate care: Greening our intensive care units. World J Crit Care Med 2026; 15(3): 119925 [DOI: 10.5492/wjccm.119925]
Corresponding Author of This Article
Deven Juneja, MD, Director, Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, 1 Press Enclave Road, New Delhi 110017, India. devenjuneja@gmail.com
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Critical Care Medicine
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review-article
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Goel S, Kataria S, Juneja D. From carbon cost to climate care: Greening our intensive care units. World J Crit Care Med 2026; 15(3): 119925 [DOI: 10.5492/wjccm.119925]
World J Crit Care Med. Sep 9, 2026; 15(3): 119925 Published online Sep 9, 2026. doi: 10.5492/wjccm.119925
From carbon cost to climate care: Greening our intensive care units
Sargam Goel, Sahil Kataria, Deven Juneja
Sargam Goel, Department of Anaesthesiology, ESI Hospital, Okhla, New Delhi 110020, India
Sahil Kataria, Department of Critical Care Medicine, Holy Family Hospital, New Delhi 110025, India
Deven Juneja, Institute of Critical Care Medicine, Max Super Speciality Hospital, New Delhi 110017, India
Author contributions: Goel S contributed to conceptualisation, study design, literature synthesis, drafting of the manuscript, critical revision, and final approval; Kataria S contributed to conceptualization, literature synthesis, figure development, manuscript drafting and revision, and final approval; Juneja D contributed to conceptualisation, literature synthesis, intellectual input, critical manuscript revision, overall supervision of the work, and final approval.
AI contribution statement: ChatGPT and Grammarly were primarily used for language polishing, grammar correction, and reframing the sentences. The AI tools did not participate in the design of the study, the interpretation of the results, or the generation of any images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Deven Juneja, MD, Director, Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, 1 Press Enclave Road, New Delhi 110017, India. devenjuneja@gmail.com
Received: February 10, 2026 Revised: February 17, 2026 Accepted: May 12, 2026 Published online: September 9, 2026 Processing time: 192 Days and 11.1 Hours
Abstract
Healthcare systems are major contributors to global greenhouse gas emissions, with intensive care units (ICUs) among the most carbon-intensive environments due to continuous energy demand, extensive reliance on single-use medical devices, and high pharmaceutical consumption. This narrative review examines the environmental footprint of ICUs, synthesising contemporary life-cycle evidence and international case studies describing feasible and clinically safe sustainability interventions in critical care. We outline practical strategies for ICU decarbonisation, including energy-efficient infrastructure, sustainable procurement, waste reduction, digital optimisation, and re-evaluation of low-value clinical practices. Importantly, many of these interventions align with established quality-improvement principles and are associated with clinical co-benefits such as reduced iatrogenic harm, improved patient comfort, and enhanced staff wellbeing. Broader policy frameworks, including the Sustainable Development Goals and national net-zero healthcare commitments, are discussed as enabling levers for system-level adoption. Greening ICUs should therefore be viewed not as a competing priority, but as an opportunity to deliver safer, more resilient, and patient-centred critical care while advancing planetary health.
Core Tip: Intensive care units (ICUs) are vital to modern healthcare, but they are also disproportionately resource-intensive. This review outlines the carbon footprint of critical care and offers a blueprint for transformation that balances clinical excellence with environmental responsibility. By embedding sustainability into equipment procurement, clinical workflows, energy management, and policy alignment, the ICU can evolve into a space that heals both patients and the planet. The path forward demands coordinated action across sectors. Hospitals must commit resources, policymakers must provide incentives, and clinicians must lead cultural shifts. The tools and knowledge exist. What remains is the collective will to act decisively. Greening our ICUs is no longer a luxury; it is a necessity for ethical, effective, and future-ready healthcare.
