Related Experiment Video
Updated: Oct 15, 2026

Non-Intubated Video-Assisted Thoracoscopic Surgery
Published on: May 26, 2023
Intraoperative ventilatory settings during abdominal surgery among 1,091 anesthesia providers
Audrey De Jong1, Karubandika Kavugho1, Alina Kozoriz2
1PhyMedExp, University of Montpellier, INSERM, CNRS, CHU Montpellier, Département d'Anesthésie-Réanimation, Hôpital Saint-Eloi, 80 avenue Augustin Fliche, 34295 Montpellier cedex, France.
Background:
Data are lacking regarding current ventilatory settings during abdominal surgery. Expert recommendations emphasize the need for protective ventilation, and several tools are now available to individualize positive end-expiratory pressure (PEEP).
Methods:
We conducted a nationwide cross-sectional survey among French anesthesiologists and nurse anesthetists in November 2025 to assess ventilatory settings during abdominal surgery, both for laparotomy and laparoscopy. Protective ventilation was defined as the combination of low tidal volume (6-8 mL/kg predicted body weight), low-to-moderate PEEP (5-8 cm H2O), and recruitment maneuvers. Individualization of PEEP was defined as the use of driving pressure, mechanical power, or compliance to titrate PEEP.
Results:
Among 1091 anesthesiologists and nurse anesthetists, female responders accounted for 46% (497/1084), the median age of anesthesia providers was 39 (33-47) years, and most responders (77%, 839/1090) had an adult-based main field of activity. Main ventilatory settings used during laparotomy were 6 to 8 ml/kg of predicted body weight (93%, 1013/1084), a respiratory rate set according to EtCO2 in 53% of responders (579/1084), and a PEEP set between 5 and 8 cmH20 for 87% of responders (950/1091). Most participants performed recruitment maneuvers (98%, 1065/1091). Overall, protective ventilation was used in 70% (763/1090), and individualization of PEEP in 45% (479/1054). Similar ventilatory settings were reported for laparoscopy.
Conclusions:
In this nationwide survey, expert consensus-based recommendations for protective ventilation during abdominal surgery appeared widely implemented in France. In contrast, individualized PEEP strategies were reported in fewer than half of cases, reflecting ongoing uncertainty and variability regarding PEEP titration in routine perioperative practice.
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