1. What data in particular will be shared?
   Response - All of the individual participant data collected during the trial, after de-identification.
   


2. What additional supporting information will be shared?
   Response -  Study Protocol
   
   
3. Who will be able to view these files?
   Response - Anyone
   


4. For what types of analyses will this data be available?
   Response - Any purpose.
   


5. By what mechanism will data be made available?
   Response - Proposals should be directed to [pratishthayadav88@gmail.com].
   


6. For how long will this data be available start date provided 28-12-2022 and end date provided 28-12-2027?
   Response - Beginning 3 months and ending 5 years following article publication.
   


7. Any URL or additional information regarding plan/policy for sharing IPD? 
   Additional Information - nil

One lung ventilation (OLV) is used to ventilate one lung and leaving the other lung deflated and collapsed. OLV is required in thoracic surgery, cardiac surgery, and oesophagus surgery. OLV in lateral decubitus position has a significant impact on lung mechanics and oxygenation. Incidence of acute lung injury (ALI) after OLV is 2 %, with a mortality of 54% in patients who developed ALI post-OLV.¹ Incidence of post-operative pulmonary complications is higher with OLV as compared to other surgeries ². Lung protective ventilation recommends using low tidal volume with higher positive end-expiratory pressure (PEEP). Very low PEEP can lead to cyclical collapse and reaeration, whereas high PEEP can lead to over distention. A single value of PEEP may not be appropriate for every patient.³ Inter-individual variability in BMI, lung characteristics, chest wall dimensions,  emphasises the need to individualise PEEP for every patient. 

There is no general consensus on how to set PEEP intraoperatively. Too low a PEEP can lead to atelectasis. Lung heterogeneity due to atelectasis eventually raises driving pressure (DP)^4,5 . Unsafe ventilatory settings is one of the most important modifiable risk factor to prevent ALI due to OLV. There are several methods to identify ideal PEEP like oxygenation, best compliance, pressure - volume (P-V) curve, stress index, lung ultrasound, etc. Several retrospective studies have suggested a close association of PEEP with lung compliance and driving pressure. DP is defined as tidal volume divided by compliance or plateau pressure minus PEEP. The concept of DP was first studied in ARDS patients and was found to be strongly associated with patient outcome. If application of PEEP leads to lung recruitment, DP will decrease and SpO2 will increase. On the other hand excess PEEP can lead to lung overdistention, fall in DP and Spo2. Thus PEEP with maximum DP can be considered ideal for the given patient. Several studies have demonstrated improved oxygenation with use of individualised PEEP. But the data was restricted till the end of the surgery only. Inadequate lung recruitment while shifting the patient from OLV to TLV and loss of PEEP during the weaning phase at the end of the surgery can have a negative impact on the outcome as well.