Colquhoun DA, Leis AM, Shanks AM, et al. - Whether a putative one-lung protective ventilation regimen would be independently related to reduced odds of pulmonary complications following thoracic surgery, was investigated in this multicenter retrospective observational study. Relevant data from Society of Thoracic Surgeons Database and Multicenter Perioperative Outcomes Group were combined. One-lung protective ventilation was defined as the integration of both median tidal volume 5 ml/kg or lower predicted body weight and positive end-expiratory pressure 5 cm H ₂ O or greater. A composite of 30-day major postoperative pulmonary complications was the primary outcome. Overall 3,232 cases were analyzed. Protective ventilation (mean tidal volume 6.4 vs. 4.4 ml/kg) was not related to a decrease in pulmonary complications, as revealed in a propensity score matched cohort (381 matched pairs). Experts found no independent link between a low tidal volume lung-protective ventilation regimen and a composite of postoperative pulmonary complications in this study population of patients receiving one-lung ventilation during thoracic surgery.