Clinical Research Directory

Inclusion criteria: 1. age \> 18 years; AND 2. scheduled for minimally invasive abdominal surgery; AND 3. at increased (i.e., intermediate or high) risk of PPCs according to the 'Assess Respiratory risk in Surgical Patients in Catalonia' (ARISCAT) risk score (≥ 26 points, see Appendix I); OR at increased risk of PPCs based on the combination of age \> 40 years, scheduled surgery lasting \> 2 hours and planned to receive an intra-arterial catheter for blood pressure monitoring during the surgery; AND 4. signed written informed consent Exclusion criteria: 1. planned for open abdominal surgery; 2. planned for surgery in lateral or prone position; 3. planned for combined abdominal and intra-thoracic surgery 4. confirmed pregnancy; 5. consent for another interventional trial during anesthesia; 6. having received invasive ventilation \> 30 minutes within the last five days; 7. any previous lung surgery; 8. history of previous severe chronic obstructive pulmonary disease (COPD) with (noninvasive) ventilation or oxygen therapy at home or repeated systemic corticosteroid therapy for acute exacerbations of COPD; 9. history of acute respiratory distress syndrome (ARDS); 10. expected to require postoperative ventilation; 11. expected hemodynamic instability or intractable shock; 12. severe cardiac disease (New York Heart Association class III or IV, acute coronary syndrome or persistent ventricular tachyarrhythmia's).