%0 Journal Article %A Francesco Guerrera %A Lorena Costardi %A Giulio L. Rosboch %A Paraskevas Lyberis %A Edoardo Ceraolo %A Paolo Solidoro %A Claudia Filippini %A Giulia Verri %A Luca Brazzi %A Carlo Albera %A Enrico Ruffini %T Awake or intubated surgery in diagnosis of interstitial lung diseases? A prospective study %D 2021 %R 10.1183/23120541.00630-2020 %J ERJ Open Research %P 00630-2020 %V 7 %N 3 %X 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 %U https://openres.ersjournals.com/content/erjor/7/3/00630-2020.full.pdf