Nestler C, Simon P, Petroff D, et al. - Whether atelectasis, reduced end-expiratory lung volume (EELV), and diminished arterial oxygenation consequent to general anaesthesia in obese patients could be prevented by a combination of a recruitment manoeuvre (RM) and individualized positive end-expiratory pressure (PEEP) was determined. Researchers randomly assigned patients with a BMI ≥ 35 kg m⁻² undergoing elective laparoscopic surgery to mechanical ventilation with a tidal volume of 8 ml kg⁻¹ predicted body weight and an RM followed by individualized PEEP titrated using electrical impedance tomography (PEEP_IND) or no RM and PEEP of 5 cm H₂O (PEEP₅). They focused on the ratio of arterial partial pressure of oxygen to inspiratory oxygen fraction (primary endpoint). Findings revealed that restoration of EELV, regional ventilation distribution, and oxygenation during anaesthesia was brought about by an RM and higher PEEP_IND in obese patients, however, these differences did not persist post-extubation. Hence, the inclusion of the postoperative period in lung protection strategies was recommended.