The understanding on the protective roles of tidal volume and PEEP settings against PPCs has rapidly expanded. During intraoperative ventilation, low tidal volumes are protective, the protective role of high levels of PEEP is uncertain. There is convincing evidence for protection against PPCs by low tidal volumes: benefit was found in several randomized controlled trials, and was recently confirmed in meta-analyses. Evidence for protection against PPCs by high levels of positive end-expiratory pressure (PEEP) is less definite.

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