TY - JOUR T1 - Awake or intubated surgery in diagnosis for interstitial lung diseases? A prospective study JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00630-2020 SP - 00630-2020 AU - Francesco Guerrera AU - Lorena Costardi AU - Giulio Luca Rosboch AU - Paraskevas Lyberis AU - Edoardo Ceraolo AU - Paolo Solidoro AU - Claudia Filippini AU - Giulia Verri AU - Luca Brazzi AU - Carlo Albera AU - Enrico Ruffini Y1 - 2021/01/01 UR - http://openres.ersjournals.com/content/early/2021/05/06/23120541.00630-2020.abstract N2 - 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 (PS) analysis.Measurements and main results Awake-VASLB was performed in 66 out of 100 patients, while 34 underwent Intubated-VASLB. The Awake- VASLB resulted in a lower postoperative morbidity (OR 0.025; CI95% 0.001, 0.35; p=0.006), a less unexpected Intensive Care Unit (ICU) admission, a less need for rescue therapy for pain, a reduced surgical and anaesthesiologic time, a reduced chest drain duration, a lower postoperative length of stay.Conclusion Awake-VASLB in patients affected by ILD is feasible and seems safer than Intubated-VASLB.FootnotesThis manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.Conflict of interest: Dr. Guerrera has nothing to disclose.Conflict of interest: Dr. Costardi has nothing to disclose.Conflict of interest: Dr. Rosboch has nothing to disclose.Conflict of interest: Dr. LYBERIS has nothing to disclose.Conflict of interest: Dr. Ceraolo has nothing to disclose.Conflict of interest: Dr. SOLIDORO has served as investigator in clinical trials, consultant, or speaker for alfasigma, astrazeneca, Boehringer Ingelheim, GSK, Menarini, Novartis, Chiesi, Guidotti & Malesci, ABC farmaceutici, outside this work..Conflict of interest: Dr. Filippini has nothing to disclose.Conflict of interest: Dr. Verri has nothing to disclose.Conflict of interest: Dr. Brazzi has nothing to disclose.Conflict of interest: Dr. Albera has nothing to disclose regarding this work. Dr Carlo Albera has served as investigator in clinical trials, consultant, speaker, steering committee or scientific advisory board member for Bayer, Boehringer Ingelheim, FibroGen, Gilead, Grifols, GSK, Roche, MSD, Sanofi Aventis, outside this work.Conflict of interest: Dr. RUFFINI has nothing to disclose. ER -