We read the article by Turan et al.1 with great interest and would like to congratulate the authors on conducting this large, important, factorial trial. The authors found that neither a “high” (8 cm H2O) positive end-expiratory pressure (PEEP), nor a low (6 ml/kg) tidal volume strategy or a combination impacted postextubation hypoxemia or postoperative pulmonary complications. As such, the trial confirms findings of previous studies2 that nonindividualized PEEP levels do not improve patient outcomes. It corroborates findings from a large study by Karalapillai et al.3 that simply randomizing to high versus low tidal volumes does not seem to confer benefit for patients undergoing mechanical ventilation for general anesthesia.
We would like to add two important observations based on recent literature to the discussion of the study by Turan et al.1 First, Neto et al.4 and others have shown that it is not...
