Protective intraoperative ventilation during thoracic surgery: definitively yes!

In their large, high-quality randomized clinical trial (RCT), Merret et al. provided evidence that protective intraoperative ventilation with low tidal volume and PEEP improves clinically relevant outcomes in patients undergoing lung cancer surgery (1). In fact, in the protective intraoperative ventilation group, the authors found a statistically significant reduction in major postoperative complications such as pneumonia, acute lung injury, acute respiratory distress syndrome, pulmonary embolism, shock, myocardial infarction or death within 30 days after surgery.