We read with great interest the article by Jeong et al. titled “Pressure Support versus Spontaneous Ventilation during Anesthetic Emergence—Effect on Postoperative Atelectasis: A Randomized Controlled Trial.” Although many studies have looked at the potential effects of various intraoperative open lung ventilation strategies on postoperative pulmonary outcomes, recent evidence suggests that their potential benefits may be limited if no action is taken to minimize lung derecruitment during the emergence period. Considering that postoperative atelectasis plays a central role in the development of postoperative pulmonary complications, and that maintaining positive pressure during emergence may help preserve lung aeration, the research question of Jeong et al. is of paramount importance. However, we have some concerns regarding key aspects of the study’s methodology.

First, we were especially worried about elements used to define and measure the incidence of atelectasis, the study’s primary outcome. The authors’ definition (more than three lung...

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