Survey of thoracic anesthetic practice in Italy.

OBJECTIVE The object of this study was to conduct and analyze the output of a survey involving a cohort of all Italian hospitals performing thoracic surgery to gather data on anesthetic management, one-lung ventilation (OLV) management, and post-thoracotomy pain relief in thoracic anesthesia. DESIGN Survey. SETTING Italy. PARTICIPANTS An invitation to participate in the survey was e-mailed to all the members of the Italian Society of Anesthesia and Intensive Care Medicine. INTERVENTION None. MEASUREMENTS AND MAIN RESULTS A total of 62 responses were received from 47 centers. The key findings were: Double-lumen tube is still the first choice lung separation technique in current use; pressure-controlled ventilation and volume-controlled ventilation modes are homogenously distributed across the sample and, a tidal volumes (VT) of 4-6 mL/kg during OLV was preferred to all others; moderate or restrictive fluid management were the most used strategies of fluid administration in thoracic anesthesia; thoracic epidural analgesia represented the "gold standard" for post-thoracotomy pain relief in combination with intravenous analgesia. CONCLUSION The results of this survey showed that Italian anesthesiologist follow the recommended standard of care for anesthetic management during OLV.

[1]  E. Cohen.  Back to blockers?: the continued search for the ideal endobronchial blocker. , 2013, Anesthesiology.

[2]  B. Naidu,et al.  Does a conservative fluid management strategy in the perioperative management of lung resection patients reduce the risk of acute lung injury? , 2012, Interactive cardiovascular and thoracic surgery.

[3]  J. Kinsella,et al.  Anesthesia for thoracic surgery: a survey of UK practice. , 2011, Journal of cardiothoracic and vascular anesthesia.

[4]  G. Hedenstierna,et al.  Ventilatory Protective Strategies During Thoracic Surgery: Effects of Alveolar Recruitment Maneuver and Low-Tidal Volume Ventilation on Lung Density Distribution , 2011 .

[5]  G. Hedenstierna,et al.  Effects of Volatile and Intravenous Anesthesia on the Alveolar and Systemic Inflammatory Response in Thoracic Surgical Patients , 2011, Anesthesiology.

[6]  T. Brennan,et al.  Thoracic epidural analgesia and acute pain management. , 2011, Anesthesiology.

[7]  G. Grubhofer,et al.  Randomized clinical trial comparing double-lumen tube and EZ-Blocker for single-lung ventilation. , 2011, British journal of anaesthesia.

[8]  G. Della Rocca,et al.  Ventilatory management of one-lung ventilation. , 2011, Minerva anestesiologica.

[9]  C. Yi,et al.  Does a protective ventilation strategy reduce the risk of pulmonary complications after lung cancer surgery?: a randomized controlled trial. , 2011, Chest.

[10]  J. Freixinet.  [Comments on "Anesthesia in thoracic surgery in Catalonia: results of a survey carried out in 2003"]. , 2009, Archivos de bronconeumologia.

[11]  W. Karzai,et al.  Hypoxemia during One-lung Ventilation: Prediction, Prevention, and Treatment , 2009, Anesthesiology.

[12]  P. Slinger,et al.  Choosing a Lung Isolation Device for Thoracic Surgery: A Randomized Trial of Three Bronchial Blockers Versus Double-Lumen Tubes , 2009, Anesthesia and analgesia.

[13]  G. Hedenstierna,et al.  Lung computed tomography density distribution in a porcine model of one-lung ventilation. , 2009, British journal of anaesthesia.

[14]  D. Ferrante,et al.  Thoracic epidural analgesia in post-thoracotomy patients: comparison of three different concentrations of levobupivacaine and sufentanil. , 2009, British journal of anaesthesia.

[15]  Javier H. Campos.  Update on tracheobronchial anatomy and flexible fiberoptic bronchoscopy in thoracic anesthesia. , 2009, Current opinion in anaesthesiology.

[16]  Chang Ye-tia.  Pressure-controlled versus volume-controlled ventilation during one-lung ventilation for thoracic surgery , 2009 .

[17]  J. Canet,et al.  [Anesthesia in thoracic surgery in Catalonia: results of a survey carried out in 2003]. , 2009, Archivos de bronconeumologia.

[18]  G. Hedenstierna,et al.  One-lung ventilation induces hyperperfusion and alveolar damage in the ventilated lung: an experimental study. , 2008, British journal of anaesthesia.

[19]  G. Scheffer,et al.  Chronic post-thoracotomy pain: A retrospective study , 2006 .

[20]  M. Şentürk.  New concepts of the management of one-lung ventilation , 2006, Current opinion in anaesthesiology.

[21]  Javier H. Campos.  Progress in lung separation. , 2005, Thoracic surgery clinics.

[22]  A. Casati,et al.  A multicenter survey on anaesthesia practice in Italy. , 2004, Minerva anestesiologica.

[23]  H. Lemmens,et al.  Left double-lumen tubes: clinical experience with 1,170 patients. , 2003, Journal of cardiothoracic and vascular anesthesia.

[24]  G. Jacobsen,et al.  The utility of a double-lumen tube for one-lung ventilation in a variety of noncardiac thoracic surgical procedures. , 1992, Journal of cardiothoracic and vascular anesthesia.