Date of Award

Spring 4-21-2025

Document Type

Project

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Advisor

Ruth Chavez

First Committee Member

Amy Bishop

Second Committee Member

Danielle Winch

Keywords

video-assisted, thoracoscopic surgery, VATS, NI-VATS, non-intubated

Subject Categories

Medicine and Health Sciences

Abstract

Since the 1990s, video-assisted thoracoscopic surgery (VATS) has become the standard for many thoracic operations, providing a minimally invasive approach. Traditional VATS management with general anesthesia (GA), muscle relaxation, and one-lung ventilation (OLV) poses risks of postoperative pulmonary complications (PPCs) that can lead to a prolonged length of hospital stay (LOS). Recently, non-intubated VATS (NI-VATS) has become popular due to fewer anesthesia-related complications and faster recovery, especially for patients with compromised respiratory function who may not tolerate GA or intubation. NI-VATS combines regional anesthesia with spontaneous non-invasive ventilation mechanisms, avoiding GA, intubation, and OLV complications. Studies show NI-VATS leads to reduced LOS and PPC development while providing a safety profile comparable to traditional VATS. The growing popularity of NI-VATS warrants the development of evidence-based guidelines for optimal patient selection, perioperative interventions, and complication management. This theoretical scholarly project aims to provide evidence-based guidelines for anesthetic management for NI-VATS procedures to address the above mentioned concerns. Preparation for guideline implementation will include project approval and staff education for the anticipated changes. Trial guideline implementation will take approximately 10 months, or until 50 NI-VATS cases are completed. Project members will compare pre- and post-implementation data of target outcomes to determine guideline effectiveness.

Keywords: video-assisted thoracoscopic surgery, one-lung ventilation, length of stay, postoperative pulmonary complications, non-intubated video-assisted thoracoscopic surgery

Acknowledgement 1

1

Acknowledgement 2

1

Licensing Permission

Copyright, all rights reserved. Fair Use

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