Awake or intubated surgery in diagnosis of interstitial lung diseases? A prospective study. Issue 3 (5th July 2021)

• Record Type: Journal Article
• Authors: Guerrera, Francesco; Costardi, Lorena; Rosboch, Giulio L.; Lyberis, Paraskevas; Ceraolo, Edoardo; Solidoro, Paolo; Filippini, Claudia; Verri, Giulia; Brazzi, Luca; Albera, Carlo; Ruffini, Enrico
• Is Part Of: ERJ open research. Volume 7:Issue 3(2021)
• Publication Date: 2021-07-05
• Subjects: Respiratory organs -- Diseases -- Periodicals; Respiration -- Periodicals; Respiration; Respiratory organs -- Diseases; Respiratory organs -- Diseases -- Treatment; Respiratory Tract Diseases; Electronic journals; Fulltext; Internet Resources; Periodicals; Periodical; 616.2005
• DOI: 10.1183/23120541.00630-2020
• Languages: English
• ISSNs: 2312-0541

Abstract

Background: Risks associated with video-assisted surgical lung biopsy (VASLB) for interstitial lung disease (ILD) with endotracheal intubation and mechanical ventilation are not nil. Awake video-assisted surgical lung biopsy (Awake-VASLB) has been proposed as a method to obtain a precise diagnosis in several different thoracic diseases. Objectives: To compare clinical outcomes of Awake-VASLB and Intubated-VASLB in patients with suspected ILDs. Methods: From June 2016 to February 2020, all patients submitted to elective VASLB for suspected ILD were included. Differences in outcomes between Awake-VASLB and Intubated-VASLB were assessed through univariable, multivariable-adjusted, and a propensity score-matched analysis. Results: Awake-VASLB was performed in 66 out of 100 patients, while 34 underwent Intubated-VASLB. The Awake-VASLB resulted in a lower post-operative morbidity (OR 0.025; 95% CI 0.001–0.35; p=0.006), less unexpected intensive care unit admission, less need for rescue therapy for pain, a reduced surgical and anaesthesiologic time, a reduced chest drain duration, and a lower post-operative length of stay. Conclusion: Awake-VASLB in patients affected by ILD is feasible and seems safer than Intubated-VASLB. Awake surgical lung biopsy in patients affected by ILD is feasible and safer than intubated surgical lung biopsy https://bit.ly/2SnMATh