RESPIRATION AND THE AIRWAY Intraoperative positive end-expiratory pressure evaluation using the intratidal compliance-volume profile

Editor’s key points † The use of PEEP is beneficial in mechanically ventilated critically ill patients with acute lung injury. † PEEP may also be useful during surgery under general anaesthesia, but the optimum levels are uncertain. † In this small observational study, a PEEP setting of 5 cm H2O was insufficient to prevent derecruitment and a reduction in compliance. † Higher, individualized settings of PEEP are probably required for most patients, but prospective studies using a variety of PEEP settings are needed. Background. Lung-protective mechanical ventilation during general surgery including the application of PEEP can reduce postoperative pulmonary complications. In a prospective clinical observation study, we evaluated volume-dependent respiratory system compliance in adult patients undergoing ear–nose–throat surgery with ventilation settings chosen empirically by the attending anaesthetist.