Bio


Dr. Praveen Kalra is Board Certified in Anesthesia and in Critical Care. He specializes in trauma, orthopedic, brain and spine surgery, urology, and cancer surgery. He was appointed Fellow of the American Society of Anesthesiology (FASA) in 2023. Appointed Medical Director of Sustainability for Stanford Healthcare in Dec 2023.

His professional interests include devising protocols for patient safety, informed consent, reducing the impact of anesthetics on the environment, addressing climate change by reducing green house gas emissions in the health care setting, resident education to emphasize evidence based safe care and mentoring medical students. He has been in practice for over 18 years.

Received the Inaugural Sustainability Ambassador Award in 2022 at SHC for removing Desflurane (anesthetic gas with highest global warming potential) from the OR and undertaking multiple initiatives such as creating a Green Team at SHC, an elective Green Rotation for residents, green curriculum video series and addressing plastic & biohazardous waste in the OR. Current projects are focused on decommissioning nitrous oxide pipelines in the OR. As Medical Director of Sustainability, I work on collaborating with experts, fostering clinician engagement in change management, and spearheading transformative initiatives.

Dr. Kalra completed his residency in Anesthesia from Harvard Medical School’s Beth Israel Deaconess Hospital and a fellowship in Critical Care from Johns Hopkins Hospital, Baltimore.

Clinical Focus


  • Anesthesia
  • Greening the Health care

Academic Appointments


Administrative Appointments


  • Clinical Associate Professor, Stanford Health Care (2023 - Present)
  • Medical Director Sustainability, Stanford Health care (2023 - Present)
  • Clinical Assistant Professor, Stanford Health Care (2013 - 2023)
  • Clinical Assistant Professor, Oklahoma University Health Science Center (2005 - 2013)

Honors & Awards


  • Inaugural Sustainability Ambassador Award, Stanford Health Care (9/2022)

Professional Education


  • Fellowship: Johns Hopkins University School of Medicine (2005) MD
  • Board Certification: American Board of Anesthesiology, Critical Care Medicine (2006)
  • Board Certification: American Board of Anesthesiology, Anesthesia (2006)
  • Residency: Beth Israel Deaconess Medical Center (2004) MA
  • Internship: Advocate Illinois Masonic Medical Center (2001) IL
  • Medical Education: King Georges Medical College (1999) India

All Publications


  • Reducing Greenhouse Gas Emissions and Modifying Nitrous Oxide Delivery at Stanford: Observational, Pilot Intervention Study. JMIR perioperative medicine Kraybill, E. P., Chen, D., Khan, S., Kalra, P. 2025; 8: e64921

    Abstract

    BACKGROUND: Inhalational anesthetic agents are a major source of potent greenhouse gases in the medical sector, and reducing their emissions is a readily addressable goal. Nitrous oxide (N2O) has a long environmental half-life relative to carbon dioxide combined with a low clinical potency, leading to relatively large amounts of N2O being stored in cryogenic tanks and H cylinders for use, increasing the chance of pollution through leaks. Building on previous findings, Stanford Health Care's (SHC's) N2O emissions were analyzed at 2 campuses and targeted for waste reduction as a precursor to system-wide reductions.OBJECTIVE: We aimed to determine the extent of N2O pollution at SHC and subsequently whether using E-cylinders for N2O storage and delivery at the point of care in SHC's ambulatory surgery centers could reduce system-wide emissions.METHODS: In phase 1, total SHC (Palo Alto, California) N2O purchase data for calendar year 2022 were collected and compared (volume and cost) to total Palo Alto clinical delivery data using Epic electronic health records. In phase 2, a pilot study was conducted in the 8 operating rooms of SHC campus A (Redwood City). The central N2O pipelines were disconnected, and E-cylinders were used in each operating room. E-cylinders were weighed before and after use on a weekly basis for comparison to Epic N2O delivery data over a 5-week period. In phase 3, after successful implementation, the same methodology was applied to campus B, one of 3 facilities in Palo Alto.RESULTS: In phase 1, total N2O purchased in 2022 was 8,217,449 L (33,201.8 lbs) at a total cost of US $63,298. Of this, only 780,882.2 L (9.5%) of N2O was delivered to patients, with 7,436,566.8 L (90.5%) or US $57,285 worth lost or wasted. In phase 2, the total mass of N2O use from E-cylinders was 7.4 lbs (1 lb N2O=247.5 L) or 1831.5 L at campus A. Epic data showed that the total N2O volume delivered was 1839.3 L (7.4 lbs). In phase 3, the total mass of N2O use from E-cylinders was 10.4 lbs or 2574 L at campus B (confirming reliability within error propagation margins). Epic data showed that the total N2O volume delivered was 2840.3 L (11.5 lbs). Over phases 2 and 3, total use for campuses A and B was less than the volume of 3 E-cylinders (1 E-cylinder=1590 L).CONCLUSIONS: Converting N2O delivery from centralized storage to point-of-care E-cylinders dramatically reduced waste and expense with no detriment to patient care. Our results provide strong evidence for analyzing N2O storage in health care systems that rely on centralized storage, and consideration of E-cylinder implementation to reduce emissions. The reduction in N2O waste will help meet SHC's goal of reducing scope 1 and 2 emissions by 50% before 2030.

    View details for DOI 10.2196/64921

    View details for PubMedID 39786852