Professor Jan De Waele, ESICM past president, reflects on the role of professional societies such as ESICM in driving change across the critical care community.

Should sustainability become a core component of education, research, and clinical practice? How can societies support hospitals, researchers, and clinicians in reducing their environmental footprint? And what collective actions are needed to ensure that intensive care contributes to a healthier future—not only for our patients, but also for our planet?

As healthcare faces increasing environmental challenges, professional societies have a unique opportunity to lead, inspire, and unite the global community around sustainable practice.

Modern intensive care relies on vast amounts of data. Every study, database, and digital platform requires energy, storage, and resources. As research grows larger and more complex, so does its environmental footprint.

But research is also one of our most powerful tools for change. How can we better understand the carbon cost of healthcare? How can data help us identify waste, improve efficiency, and design greener systems of care? And what will future research need to focus on if we want to reduce the environmental impact of intensive care?

In our conversation with Professor Sheila Myatra, we explore how low- and middle-income countries have long faced the challenge of delivering high-quality care while working within limited resources.

What can the global intensive care community learn from these experiences? How do clinicians balance sustainability, necessity, and patient outcomes? And how can international collaboration help create solutions that are both environmentally responsible and equitable?

This discussion reminds us that sustainability is not only about technology—it is also about creativity, efficiency, and shared learning.

In this segment, prof Forbes McGain explores the main sources of carbon emissions and waste in the ICU—from energy-intensive equipment and single-use consumables to pharmaceuticals, diagnostics, and supply chains. Which aspects of intensive care contribute most to the carbon footprint, and where can meaningful reductions be achieved?

We also examine real-world examples of sustainability projects that have successfully reduced waste and emissions in healthcare settings. What actions have proven effective, and what lessons can be applied across different ICUs?

Perhaps most importantly, we address a common concern: will greener practices compromise patient care? Can sustainability initiatives improve efficiency without affecting outcomes, or are there trade-offs that healthcare professionals need to acknowledge?

Finally, we confront some of the uncomfortable truths surrounding environmental change. What changes will require us to rethink long-established practices? And how can the intensive care community balance its commitment to delivering the best possible care today while protecting the health of future generations?

Professor Pedro Povoa shares his experience leading sustainability initiatives within his university hospital. Across the world, more hospitals are creating "green teams"—multidisciplinary groups dedicated to reducing waste, improving resource use, and embedding sustainability into everyday practice.

What does a successful green team look like? Who should be involved? Can environmental initiatives coexist with excellent patient care? And where should ICUs begin if they want to start their own sustainability journey?

Through practical examples and lessons learned, Prof Povoa demonstrates that meaningful change often starts with small, achievable steps.