Recommendations from the Italian intersociety consensus on Perioperative Anesthesia Care in Thoracic surgery (PACTS) par
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Recommendations from the Italian intersociety consensus on Perioperative Anesthesia Care in Thoracic surgery (PACT S) part 1: preadmission and preoperative care Federico Piccioni1* , Andrea Droghetti2, Alessandro Bertani3, Cecilia Coccia4, Antonio Corcione5, Angelo Guido Corsico6, Roberto Crisci7, Carlo Curcio8, Carlo Del Naja9, Paolo Feltracco10, Diego Fontana11, Alessandro Gonfiotti12, Camillo Lopez13, Domenico Massullo14, Mario Nosotti15, Riccardo Ragazzi16, Marco Rispoli17, Stefano Romagnoli18,19, Raffaele Scala20, Luigia Scudeller21, Marco Taurchini22, Silvia Tognella23, Marzia Umari24, Franco Valenza25,26, Flavia Petrini27, 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 and SIP, Società Italiana di Pneumologia
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). (Continued on next page)
* Correspondence: [email protected] 1 Department of Critical and Supportive Care, Fondazione IRCCS Istituto Nazionale dei Tumori, via Venezian 1, 20133 Milan, Italy Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in
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