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Abstract Obesity is a worldwide epidemic with significant economic, social, and psychological consequences. Body mass index (BMI) more than 30 Kg/m2 can produce a life expectancy reduction equivalent to that caused by smoking (1). Weight loss surgery, often known as bariatric surgery, is an effective treatment for obesity. Most people undergoing such surgery may show an improvement or resolution of some conditions such as diabetes, dyslipidemia, hypertension, and obstructive sleep apnea (OSA) (2). The increasing number of bariatric surgeries highlights the importance of invasive ventilator support. In obese patients, anesthetic induction can cause a considerable decrease in respiratory compliance as well as an increase in airway pressure and resistance(3). A correlation was also found between high BMI and increased respiratory effort, and decreased oxygenation levels, which can lead to atelectasis and slower weaning from mechanical ventilation (4). Currently, there is no standard ventilation strategy that has been established for obese patients. However, there is some evidence that recruitment maneuvers (RM) combined with a protective lung ventilation strategy improve oxygenation and compliance compared to other strategies (5). Lung- protective ventilation consists of applying Positive End-Expiratory Pressure (PEEP), low tidal volume, and recruitment maneuvers (6). |