@article {Guerrera00630-2020, author = {Francesco Guerrera and Lorena Costardi and Giulio L. Rosboch and Paraskevas Lyberis and Edoardo Ceraolo and Paolo Solidoro and Claudia Filippini and Giulia Verri and Luca Brazzi and Carlo Albera and Enrico Ruffini}, title = {Awake or intubated surgery in diagnosis of interstitial lung diseases? A prospective study}, volume = {7}, number = {3}, elocation-id = {00630-2020}, year = {2021}, doi = {10.1183/23120541.00630-2020}, publisher = {European Respiratory Society}, 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{\textendash}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}, URL = {https://openres.ersjournals.com/content/7/3/00630-2020}, eprint = {https://openres.ersjournals.com/content/7/3/00630-2020.full.pdf}, journal = {ERJ Open Research} }