The authors do not answer the question of what the ideal tidal volume is–they just find that short-term increases in volume are not beneficial. But are they hazardous? What is the best tidal volume at which to ventilate such morbidly obese patients?
The authors themselves pointed out the limitations of their study. For example, hypocapnia, which may have had a major effect, could have been circumvented by decreasing ventilatory rate. Did the small sample size preclude finding out how many patients would benefit by the increase in tidal volume? Clearly, some benefit accrued in some of the patients.
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