Abstract

Introduction

Anesthetic care in patients undergoing thoracic surgery presents specific challenges that necessitate standardized, multidisciplionary, and continuously updated guidelines for perioperative care.

Methods

A multidisciplinary expert group, the Perioperative Anesthesia in Thoracic Surgery (PACTS) group, comprising 24 members from 19 Italian centers, was established to develop recommendations for anesthesia practice in patients undergoing thoracic surgery (specifically lung resection for cancer). The project focused on preoperative patient assessment and preparation, intraoperative management (surgical and anesthesiologic care), and postoperative care and discharge. A series of clinical questions was developed, and PubMed and Embase literature searches were performed to inform discussions around these areas, leading to the development of 69 recommendations. The quality of evidence and strength of recommendations were graded using the United States Preventative Services Task Force criteria.

Results

Recommendations for preoperative care focus on risk assessment, patient preparation (prehabilitation), and the choice of procedure (open thoracotomy vs. video-assisted thoracic surgery).

Conclusions

These recommendations should help pulmonologists to improve preoperative management in thoracic surgery patients. Further refinement of the recommendations can be anticipated as the literature continues to evolve.

Details

Title
Recommendations from the Italian intersociety consensus on Perioperative Anesthesia Care in Thoracic surgery (PACTS) part 1: preadmission and preoperative care
Author
Piccioni, Federico  VIAFID ORCID Logo  ; Droghetti, Andrea; Bertani, Alessandro; Coccia, Cecilia; Corcione, Antonio; Angelo Guido Corsico; Crisci, Roberto; Curcio, Carlo; Carlo Del Naja; Feltracco, Paolo; Fontana, Diego; Gonfiotti, Alessandro; Lopez, Camillo; Massullo, Domenico; Nosotti, Mario; Ragazzi, Riccardo; Rispoli, Marco; Romagnoli, Stefano; Scala, Raffaele; Scudeller, Luigia; Taurchini, Marco; Tognella, Silvia; Umari, Marzia; Valenza, Franco; Petrini, Flavia; on behalf of AIPO; Associazione Italiana Pneumologi Ospedalieri; SIAARTI; Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva; SIC; Società Italiana di Chirurgia; SICT; Società Italiana di Chirurgia Toracica; SIET; Società Italiana di Endoscopia Toracica; SIP; Società Italiana di Pneumologia
Pages
1-17
Section
Consensus
Publication year
2020
Publication date
2020
Publisher
BioMed Central
e-ISSN
20470525
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1186/s13741-020-00168-y
ProQuest document ID
2471211302
Copyright
© 2020. This work is licensed under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.