DISCUSSION
inflammation, pulmonary infections, lung atrophy, volume injury, trauma
INFLAMMATION, PULMONARY INFECTIONS, INFLAMMATORY RESPONSE
This randomized controlled trial found that OLV with increasing or decreasing personalized titration of PEEP in PCV‐VG mode significantly improved pulmonary air exchange and lung mechanics, and reduced serum inflammation, which contributes to an anti‐inflammatory and pulmonary protective effect. In addition, incremental or decremental personalized titration of PEEP in the OLV was effective in suppressing the incidence of postoperative PPCs and reducing the length of stay in the SICU.VCV, a ventilation model commonly used in clinical practice, ensures stable ventilation but generates high airway pressures, which in turn generates volume injury and leads to uneven gas distribution in the lungs.Cydn is used clinically as an indicator to assess the efficacy of PEEP pulmonary resuscitation.In this study, patients were randomized into three groups based on different PEEP titrations. Hemodynamics, respiratory mechanisms, and blood gas indices during the three phases of TLV (TPrevious studies have demonstrated that OLV and surgical trauma are accompanied by the release of excess inflammatory cytokines and neutrophil elastase, leading to pulmonary infections and systemic inflammation,PPCs are among the most serious problems in the perioperative period and affect patient morbidity as well as lifetime.However, our study had several limitations. First, limited resources constrained us from recruiting sufficient sample sizes to investigate the clinical outcomes of patients with PPCs and other conditions. To ensure data rigor, this study used strict inclusion and exclusion criteria, which may have biased the results. Therefore, the focus of future research should be on conducting multicenter studies with larger sample sizes to explore and elaborate on the various perspectives in depth. In addition, the correlation between cytokine levels and the PEEP, or driving pressure used was missing from this study, which will be addressed in a subsequent study. Surgical procedures and lung atrophy are factors that can affect serum inflammation levels, warranting further investigation in subsequent studies. Additionally, more detailed hemodynamic monitoring, such as emergency fluid pushing, could not be performed during the procedure. Finally, there is a lack of measurement of intrinsic PEEP at zero PEEP.In conclusion, the combination of PCV‐VG with incremental or decremental PEEP titration ventilation strategies in the OLV showed a favorable effect on intraoperative respiratory mechanics, arterial blood gas indices, and inflammatory response, which reduced the incidence of postoperative PPCs. This study provides a new perspective on ventilation strategies for OLV.