[Comment] Ventilation during surgery: moving away from one-size-fits-all

For anaesthetists, optimising ventilation settings during surgery is a fundamental aspect of patient care. Adjusting positive end-expiratory pressure (PEEP) is central to maintaining alveolar recruitment, improving oxygenation, and reducing driving pressure. At the same time, PEEP can cause intraoperative hypotension, necessitating vasopressor use. Finding a balance between lung protection and haemodynamic stability is therefore crucial for intraoperative ventilatory management. During procedures involving one-lung ventilation, the ventilated lung is exposed to relatively high tidal volumes and increased oxygen fractions, while the non-ventilated lung collapses to facilitate surgical exposure.