In Reply

We appreciate the important comment by Moreault et al. on our article, “Protective Ventilation during Anesthesia: Is It Meaningful?”¹  We agree fully with the opinion that a low tidal volume should be based on ideal body weight to avoid harmful stress and strain to the lungs during anesthesia. This is even more important during one-lung ventilation. Ideally, the tidal volume should be adjusted to the size of the ventilated lung, but without a simple recording of lung volume, ideal body weight is a reasonable alternative. However, we also believe that an appropriate positive end-expiratory pressure is a prerequisite when using a low tidal volume, whatever the calculation method of ideal body weight. We find the method proposed by the authors commendable and indeed easy to remember as most anesthesiologists already are familiar with the method for calculating body mass index.