The prospective cohort study by Acosta et al., focusing on the effects of capnoperitoneum on lung strain and stress in children aged 3 to 7 yr, is particularly notable.1 The significance of atelectasis in healthy children following general anesthesia and mechanical ventilation has attracted considerable interest.2 This study employs individualized lung recruitment and tailored positive end-expiratory pressure (PEEP) strategies to mitigate atelectasis, demonstrating that lung-protective ventilation can reduce lung strain, albeit with a slight increase in lung stress during laparoscopic surgery.
There is a notable gap in the literature concerning the mechanisms of ventilator-induced lung injury in healthy, anesthetized children. Addressing this, the study utilizes a comprehensive methodology, incorporating ultrasonography, the air-test, and end-expiratory transpulmonary pressure measurements. These noninvasive, reliable techniques allow for the early detection of atelectasis in pediatric surgical patients, enabling timely interventions.3 Additionally, the study’s statistical analysis, especially the use of linear mixed...