Recommendations from the Italian intersociety consensus on Perioperative Anesthesia Care in Thoracic surgery (PACTS) part 1: preadmission and preoperative care

Associazione Italiana Pneumologi Ospedalieri AIPO, Federico Piccioni, Andrea Droghetti, Alessandro Bertani, Cecilia Coccia, Antonio Corcione, Angelo Guido Corsico, Roberto Crisci, Carlo Curcio, Carlo Del Naja, Paolo Feltracco, Diego Fontana, Alessandro Gonfiotti, Camillo Lopez, Domenico Massullo, Mario Nosotti, Riccardo Ragazzi, Marco Rispoli, Stefano Romagnoli, Raffaele ScalaLuigia Scudeller, Marco Taurchini, Silvia Tognella, Marzia Umari, Franco Valenza, Flavia Petrini

Research output: Contribution to journalArticlepeer-review

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.
Original languageEnglish
JournalPerioperative Medicine
Volume9
Issue number1
DOIs
Publication statusPublished - Dec 1 2020

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