Ines Veselinovic - Academia.edu (original) (raw)

Papers by Ines Veselinovic

Research paper thumbnail of Implications of anesthetic techniques on cardiocirculatory stability in laparoscopic cholecystectomy

Acta Facultatis Medicae Naissensis, 2023

Background and Aim: The aim of the present study was to compare the effect of volatile induction ... more Background and Aim: The aim of the present study was to compare the effect of volatile induction and maintenance of anesthesia (VIMA) and target controlled infusion (TCI) on cardiovascular stability in New York Heart Association (NYHA) grade II patients who underwent laparoscopic cholecystectomy. Patients and methods: In the present study, 90 patients were randomized into two groups depending on whether they received VIMA or TCI. Heart rate, systolic, diastolic and mean arterial pressure were monitored continuously and recorded in five time intervals. Results: Statistical analysis showed that VIMA with sevoflurane provides better cardiocirculatory stability (less than 10% deviation from basal values for each measured parameter) than TCI group (p < 0.01). Conclusion: Volatile induction and maintenance of anesthesia with sevoflurane provides better hemodynamic stability for NYHA II patients with concomitant cardiovascular diseases compared to TCI.

Research paper thumbnail of Comparative analysis of effects of three different doses of fentanyl and standard dose of bupivacaine on a spinal block in patients with hip endoprosthesis surgery

Srpski Arhiv Za Celokupno Lekarstvo, 2021

Introduction/Objective Spinal anesthesia is often used for hip endoprosthesis surgery. Significan... more Introduction/Objective Spinal anesthesia is often used for hip endoprosthesis surgery. Significant surgical stress response consisting of hormonal, metabolic and inflammatory changes can be initiated by the hip replacement surgery. Intrathecal opioids, as adjuvants to local anesthetics, make spinal block sufficient even with lower doses of the local anesthetics, and the incidence of the side effects reduce to minimum. Methods This study included 162 patients of either sex, American Society of Anesthesiology classification (ASA) 1-2, scheduled for total hip arthroplasty. The patients had spinal anesthesia with 10 mg of 0.5% bupivacaine with 20 µg (Group I), or 25 µg (Group II) or 30 µg fentanyl intrathecally (Group III). Results Mean time to achieve maximum motor and sensory blockade was with no significant difference among the groups. Time of motor block duration was shorter in the Group III. Four hours after the operation, patients in the Group I had significantly higher cortisol serum levels. Blood glucose levels were with no significant difference among the groups. Levels of CRP increased remarkably postoperatively in the Group I. Incidence of hypotension, bradycardia, nausea and vomiting was significantly higher in the Group III. Pruritus and shevering were not recorded among the groups. The first time an analgetic was needed postoperatively was the longest in the Group III. Conclusion The dose of 10 mg of bupivacaine combined with 25 µg fentanyl was the optimal option to achieve hemodynamic stability, sufficient sensory and motor blockade, and reduce the stress response and incidence of the opioids side effects such as vomiting, nausea, pruritus etc.

Research paper thumbnail of Volume Therapy in Acute Pancreatitis

Acta Medica Medianae, Sep 5, 2013

Research paper thumbnail of Mutations in Sodium Channel Gene SCN9A and the Pain Perception Disorders

Advances in Anesthesiology, Feb 15, 2015

Voltage-gated sodium channels (NaV) play a crucial role in development and propagation of action ... more Voltage-gated sodium channels (NaV) play a crucial role in development and propagation of action potentials in neurons and muscle cells. NaV1.7 channels take a special place in modern science since it is believed that they contribute to nerve hyperexcitability. Mutations of the gene SCN9A, which codes the subunit of NaV1.7 channels, are associated with pain perception disorders (primary erythermalgia, congenital analgesia, and paroxysmal pain disorder). It is considered that the SCN9A gene mutations may cause variations in sensitivity to pain, from complete insensitivity to extreme sensitivity. Further research of the SCN9A gene polymorphism influence on pain sensitivity is essential for the understanding of the pathophysiology of pain and the development of the appropriate targeted pain treatment.

Research paper thumbnail of Caffeic acid phenethyl ester attenuates changes in pancreatic tissue damage biomarkers induced by cisplatin

Canadian Journal of Physiology and Pharmacology, May 1, 2020

Application of cisplatin (CP) for the treatment of different cancers is known to cause pancreatit... more Application of cisplatin (CP) for the treatment of different cancers is known to cause pancreatitis, through an increase in reactive oxygen species (ROS) production, and promotion of inflammation. Caffeic acid phenethyl ester (CAPE), the main activity carrier of propolis extracts, was previously found to possess numerous beneficial properties. This study aims to determine for the first time the potential of CAPE in preventing CP-induced pancreatic tissue damage by studying the changes occurring on both biochemical and microscopic levels. The levels of serum α-amylase and a panel of pancreatic tissue biomarkers related to tissue injury (reduced glutathione, xanthine oxidase, malondialdehyde, protein carbonylated concentration) and inflammation (myeloperoxidase, nitric oxide and TNF-α) would be studied in male Wistar rats treated with either CP alone or with CP and CAPE. Additionally, microscopic analysis of pancreatic tissue would be conducted as well. Application of CAPE together with CP, statistically significantly prevented the disturbance in all here-studied pancreatic tissue damage and inflammation-related biomarkers. The changes in pancreas biochemical status was followed by the morphological disturbance. The results of the present study suggest that CAPE could act as a protective agent in pancreatic damage that arises after CP application.

Research paper thumbnail of The Advantages of Video Laryngoscopy Compared to Standard Laryngoscopy on Intubation Time and the Quality of Intubating Conditions- A Pilot Study

Research paper thumbnail of Comparative analysis of effects of three different doses of fentanyl and standard dose of bupivacaine on a spinal block in patients with hip endoprosthesis surgery

Srpski arhiv za celokupno lekarstvo, 2021

Introduction/Objective. Spinal anesthesia is often used for hip endoprosthesis surgery. Significa... more Introduction/Objective. Spinal anesthesia is often used for hip endoprosthesis surgery. Significant surgical stress response consisting of hormonal, metabolic and inflammatory changes can be initiated by the hip replacement surgery. Intrathecal opioids, as adjuvants to local anesthetics, make spinal block sufficient even with lower doses of the local anesthetics, and the incidence of the side effects reduce to minimum. Methods. This study included 162 patients of either sex, American Society of Anesthesiology classification (ASA) 1?2, scheduled for total hip arthroplasty. The patients had spinal anesthesia with 10 mg of 0.5% bupivacaine with 20 ?g (Group I), or 25 ?g (Group II) or 30 ?g fentanyl intrathecally (Group III). Results. Mean time to achieve maximum motor and sensory blockade was with no significant difference among the groups. Time of motor block duration was shorter in the Group III. Four hours after the operation, patients in the Group I had significantly higher cortiso...

Research paper thumbnail of Ultrasound-Guided Central Vein Cannulation

Acta Medica Medianae, 2021

Cannulation of large venous blood vessels is an important aspect of treating critically ill patie... more Cannulation of large venous blood vessels is an important aspect of treating critically ill patients in terms of fluid administration, medication, parenteral nutrition, and monitoring. A conventional technique that uses superficial anatomy and palpation to identify large blood vessels before cannulation is based on the presumed localization of blood vessels, identification of anatomical features on the skin, and blind needle insertion until the time of blood aspiration. This technique is associated with a higher likelihood of failure, requiring more attempts and more complications. Ultrasound-guided vascular access provides a greater percentage of overall success as well as the success of the first cannulation attempt, faster vascular access, patient satisfaction and fewer complications.

Research paper thumbnail of Caffeic acid phenethyl ester attenuates changes in pancreatic tissue damage biomarkers induced by cisplatin

Canadian Journal of Physiology and Pharmacology, 2019

Application of cisplatin (CP) for the treatment of different cancers is known to cause pancreatit... more Application of cisplatin (CP) for the treatment of different cancers is known to cause pancreatitis through an increase in reactive oxygen species production and promotion of inflammation. Caffeic acid phenethyl ester (CAPE), the main activity carrier of propolis extracts, was previously found to possess numerous beneficial properties. This study aims to determine for the first time the potential of CAPE in preventing CP-induced pancreatic tissue damage by studying the changes occurring on both biochemical and microscopic levels. The levels of serum α-amylase and a panel of pancreatic tissue biomarkers related to tissue injury (reduced glutathione, xanthine oxidase, malondialdehyde, and protein carbonylated concentration) and inflammation (myeloperoxidase, nitric oxide, and umor necrosis factor alpha) were studied in male Wistar rats treated with either CP alone or with CP and CAPE. Additionally, microscopic analysis of pancreatic tissue would be conducted as well. Application of CA...

Research paper thumbnail of Importance of Biomarkers in Preoperative Evaluation of Cardiovascular Risk

Acta Medica Medianae, 2016

Preoperative assessment of cardiovascular risk and timely diagnosis of myocardial damage are of g... more Preoperative assessment of cardiovascular risk and timely diagnosis of myocardial damage are of great importance in the prevention of postoperative morbidity and mortality. The latest guidelines by the European Society of Cardiology (ESC) / European Society of Anesthesiology (ESA) emphasize the importance of the anesthesiologist in the multidisciplinary approach as well as the central role of biomarkers in the preoperative preparation of patients. In addition to the standard battery of biomarkers, which has been used for years to assess the cardiovascular risk, there are new biomarkers which promise more accurate and more specific preoperative assessment.

Research paper thumbnail of Anesthesia for Cesarean Section and Postoperative Analgesia for the Parturient

Acta Medica Medianae, 2015

Considering the physiological changes during pregnancy and the fact that there are two lives, obs... more Considering the physiological changes during pregnancy and the fact that there are two lives, obstetric anesthesia is an extremely specific and challenging area of work. The physiological changes that occur during pregnancy are among the contributing factors for complications during general and regional anesthesia. Therefore, the preoperative consideration is very important in the prevention of complications. Neuraxial anesthesia is increasingly replacing a widely applied general anesthesia, and has become the technique of choice for the majority of caesarean sections. General anesthesia is accompanied by risks related to the airway, but is still indicated for caesarean sections of the first degree of urgency. The choice of anesthesia depends on the urgency of surgery, general condition of the mother and fetus, comorbidity of pregnant woman and her consent to the proposed anesthetic procedure. The ultimate goal of all procedures is to provide safe anesthesia for mother and fetus. Multimodal analgesia is the best form of the pain treatment after cesarean section.

Research paper thumbnail of Intenzivan blok nasuprot optimalnoj hirurškoj relaksaciji

Research paper thumbnail of Anesthesia for the patient with gastrointestinal bleeding

Research paper thumbnail of H1N1 virus infection and mechanical ventilation – experience of the Clinical Center Nis

Research paper thumbnail of Hageman factor deficiency in a patient who underwent umbilical hernia repair surgery: case report and review of the literature

Research paper thumbnail of Anaesthesia and porphyria

Research paper thumbnail of Mutations in Sodium Channel Gene SCN9A and the Pain Perception Disorders

Advances in Anesthesiology, 2015

Research paper thumbnail of Volume Therapy in Acute Pancreatitis

Acta medica medianae, 2013

Research paper thumbnail of Protective ventilation with high versus low positive end-expiratory pressure during one-lung ventilation for thoracic surgery (PROTHOR): study protocol for a randomized controlled trial

Trials, 2019

Background: Postoperative pulmonary complications (PPC) may result in longer duration of in-hospi... more Background: Postoperative pulmonary complications (PPC) may result in longer duration of in-hospital stay and even mortality. Both thoracic surgery and intraoperative mechanical ventilation settings add considerably to the risk of PPC. It is unclear if one-lung ventilation (OLV) for thoracic surgery with a strategy of intraoperative high positive end-expiratory pressure (PEEP) and recruitment maneuvers (RM) reduces PPC, compared to low PEEP without RM. Methods: PROTHOR is an international, multicenter, randomized, controlled, assessor-blinded, two-arm trial initiated by investigators of the PROtective VEntilation NETwork. In total, 2378 patients will be randomly assigned to one of two different intraoperative mechanical ventilation strategies. Investigators screen patients aged 18 years or older, scheduled for open thoracic or video-assisted thoracoscopic surgery under general anesthesia requiring OLV, with a maximal body mass index of 35 kg/m 2 , and a planned duration of surgery of more than 60 min. Further, the expected duration of OLV shall be longer than two-lung ventilation, and lung separation is planned with a double lumen tube. Patients will be randomly assigned to PEEP of 10 cmH 2 O with lung RM, or PEEP of 5 cmH 2 O without RM. During two-lung ventilation tidal volume is set at 7 mL/kg predicted body weight and, during OLV, it will be decreased to 5 mL/kg. The occurrence of PPC will be recorded as a collapsed composite of single adverse pulmonary events and represents the primary endpoint. Discussion: PROTHOR is the first randomized controlled trial in patients undergoing thoracic surgery with OLV that is adequately powered to compare the effects of intraoperative high PEEP with RM versus low PEEP without RM on PPC. The results of the PROTHOR trial will support anesthesiologists in their decision to set intraoperative PEEP during protective ventilation for OLV in thoracic surgery.

Research paper thumbnail of Implications of anesthetic techniques on cardiocirculatory stability in laparoscopic cholecystectomy

Acta Facultatis Medicae Naissensis, 2023

Background and Aim: The aim of the present study was to compare the effect of volatile induction ... more Background and Aim: The aim of the present study was to compare the effect of volatile induction and maintenance of anesthesia (VIMA) and target controlled infusion (TCI) on cardiovascular stability in New York Heart Association (NYHA) grade II patients who underwent laparoscopic cholecystectomy. Patients and methods: In the present study, 90 patients were randomized into two groups depending on whether they received VIMA or TCI. Heart rate, systolic, diastolic and mean arterial pressure were monitored continuously and recorded in five time intervals. Results: Statistical analysis showed that VIMA with sevoflurane provides better cardiocirculatory stability (less than 10% deviation from basal values for each measured parameter) than TCI group (p < 0.01). Conclusion: Volatile induction and maintenance of anesthesia with sevoflurane provides better hemodynamic stability for NYHA II patients with concomitant cardiovascular diseases compared to TCI.

Research paper thumbnail of Comparative analysis of effects of three different doses of fentanyl and standard dose of bupivacaine on a spinal block in patients with hip endoprosthesis surgery

Srpski Arhiv Za Celokupno Lekarstvo, 2021

Introduction/Objective Spinal anesthesia is often used for hip endoprosthesis surgery. Significan... more Introduction/Objective Spinal anesthesia is often used for hip endoprosthesis surgery. Significant surgical stress response consisting of hormonal, metabolic and inflammatory changes can be initiated by the hip replacement surgery. Intrathecal opioids, as adjuvants to local anesthetics, make spinal block sufficient even with lower doses of the local anesthetics, and the incidence of the side effects reduce to minimum. Methods This study included 162 patients of either sex, American Society of Anesthesiology classification (ASA) 1-2, scheduled for total hip arthroplasty. The patients had spinal anesthesia with 10 mg of 0.5% bupivacaine with 20 µg (Group I), or 25 µg (Group II) or 30 µg fentanyl intrathecally (Group III). Results Mean time to achieve maximum motor and sensory blockade was with no significant difference among the groups. Time of motor block duration was shorter in the Group III. Four hours after the operation, patients in the Group I had significantly higher cortisol serum levels. Blood glucose levels were with no significant difference among the groups. Levels of CRP increased remarkably postoperatively in the Group I. Incidence of hypotension, bradycardia, nausea and vomiting was significantly higher in the Group III. Pruritus and shevering were not recorded among the groups. The first time an analgetic was needed postoperatively was the longest in the Group III. Conclusion The dose of 10 mg of bupivacaine combined with 25 µg fentanyl was the optimal option to achieve hemodynamic stability, sufficient sensory and motor blockade, and reduce the stress response and incidence of the opioids side effects such as vomiting, nausea, pruritus etc.

Research paper thumbnail of Volume Therapy in Acute Pancreatitis

Acta Medica Medianae, Sep 5, 2013

Research paper thumbnail of Mutations in Sodium Channel Gene SCN9A and the Pain Perception Disorders

Advances in Anesthesiology, Feb 15, 2015

Voltage-gated sodium channels (NaV) play a crucial role in development and propagation of action ... more Voltage-gated sodium channels (NaV) play a crucial role in development and propagation of action potentials in neurons and muscle cells. NaV1.7 channels take a special place in modern science since it is believed that they contribute to nerve hyperexcitability. Mutations of the gene SCN9A, which codes the subunit of NaV1.7 channels, are associated with pain perception disorders (primary erythermalgia, congenital analgesia, and paroxysmal pain disorder). It is considered that the SCN9A gene mutations may cause variations in sensitivity to pain, from complete insensitivity to extreme sensitivity. Further research of the SCN9A gene polymorphism influence on pain sensitivity is essential for the understanding of the pathophysiology of pain and the development of the appropriate targeted pain treatment.

Research paper thumbnail of Caffeic acid phenethyl ester attenuates changes in pancreatic tissue damage biomarkers induced by cisplatin

Canadian Journal of Physiology and Pharmacology, May 1, 2020

Application of cisplatin (CP) for the treatment of different cancers is known to cause pancreatit... more Application of cisplatin (CP) for the treatment of different cancers is known to cause pancreatitis, through an increase in reactive oxygen species (ROS) production, and promotion of inflammation. Caffeic acid phenethyl ester (CAPE), the main activity carrier of propolis extracts, was previously found to possess numerous beneficial properties. This study aims to determine for the first time the potential of CAPE in preventing CP-induced pancreatic tissue damage by studying the changes occurring on both biochemical and microscopic levels. The levels of serum α-amylase and a panel of pancreatic tissue biomarkers related to tissue injury (reduced glutathione, xanthine oxidase, malondialdehyde, protein carbonylated concentration) and inflammation (myeloperoxidase, nitric oxide and TNF-α) would be studied in male Wistar rats treated with either CP alone or with CP and CAPE. Additionally, microscopic analysis of pancreatic tissue would be conducted as well. Application of CAPE together with CP, statistically significantly prevented the disturbance in all here-studied pancreatic tissue damage and inflammation-related biomarkers. The changes in pancreas biochemical status was followed by the morphological disturbance. The results of the present study suggest that CAPE could act as a protective agent in pancreatic damage that arises after CP application.

Research paper thumbnail of The Advantages of Video Laryngoscopy Compared to Standard Laryngoscopy on Intubation Time and the Quality of Intubating Conditions- A Pilot Study

Research paper thumbnail of Comparative analysis of effects of three different doses of fentanyl and standard dose of bupivacaine on a spinal block in patients with hip endoprosthesis surgery

Srpski arhiv za celokupno lekarstvo, 2021

Introduction/Objective. Spinal anesthesia is often used for hip endoprosthesis surgery. Significa... more Introduction/Objective. Spinal anesthesia is often used for hip endoprosthesis surgery. Significant surgical stress response consisting of hormonal, metabolic and inflammatory changes can be initiated by the hip replacement surgery. Intrathecal opioids, as adjuvants to local anesthetics, make spinal block sufficient even with lower doses of the local anesthetics, and the incidence of the side effects reduce to minimum. Methods. This study included 162 patients of either sex, American Society of Anesthesiology classification (ASA) 1?2, scheduled for total hip arthroplasty. The patients had spinal anesthesia with 10 mg of 0.5% bupivacaine with 20 ?g (Group I), or 25 ?g (Group II) or 30 ?g fentanyl intrathecally (Group III). Results. Mean time to achieve maximum motor and sensory blockade was with no significant difference among the groups. Time of motor block duration was shorter in the Group III. Four hours after the operation, patients in the Group I had significantly higher cortiso...

Research paper thumbnail of Ultrasound-Guided Central Vein Cannulation

Acta Medica Medianae, 2021

Cannulation of large venous blood vessels is an important aspect of treating critically ill patie... more Cannulation of large venous blood vessels is an important aspect of treating critically ill patients in terms of fluid administration, medication, parenteral nutrition, and monitoring. A conventional technique that uses superficial anatomy and palpation to identify large blood vessels before cannulation is based on the presumed localization of blood vessels, identification of anatomical features on the skin, and blind needle insertion until the time of blood aspiration. This technique is associated with a higher likelihood of failure, requiring more attempts and more complications. Ultrasound-guided vascular access provides a greater percentage of overall success as well as the success of the first cannulation attempt, faster vascular access, patient satisfaction and fewer complications.

Research paper thumbnail of Caffeic acid phenethyl ester attenuates changes in pancreatic tissue damage biomarkers induced by cisplatin

Canadian Journal of Physiology and Pharmacology, 2019

Application of cisplatin (CP) for the treatment of different cancers is known to cause pancreatit... more Application of cisplatin (CP) for the treatment of different cancers is known to cause pancreatitis through an increase in reactive oxygen species production and promotion of inflammation. Caffeic acid phenethyl ester (CAPE), the main activity carrier of propolis extracts, was previously found to possess numerous beneficial properties. This study aims to determine for the first time the potential of CAPE in preventing CP-induced pancreatic tissue damage by studying the changes occurring on both biochemical and microscopic levels. The levels of serum α-amylase and a panel of pancreatic tissue biomarkers related to tissue injury (reduced glutathione, xanthine oxidase, malondialdehyde, and protein carbonylated concentration) and inflammation (myeloperoxidase, nitric oxide, and umor necrosis factor alpha) were studied in male Wistar rats treated with either CP alone or with CP and CAPE. Additionally, microscopic analysis of pancreatic tissue would be conducted as well. Application of CA...

Research paper thumbnail of Importance of Biomarkers in Preoperative Evaluation of Cardiovascular Risk

Acta Medica Medianae, 2016

Preoperative assessment of cardiovascular risk and timely diagnosis of myocardial damage are of g... more Preoperative assessment of cardiovascular risk and timely diagnosis of myocardial damage are of great importance in the prevention of postoperative morbidity and mortality. The latest guidelines by the European Society of Cardiology (ESC) / European Society of Anesthesiology (ESA) emphasize the importance of the anesthesiologist in the multidisciplinary approach as well as the central role of biomarkers in the preoperative preparation of patients. In addition to the standard battery of biomarkers, which has been used for years to assess the cardiovascular risk, there are new biomarkers which promise more accurate and more specific preoperative assessment.

Research paper thumbnail of Anesthesia for Cesarean Section and Postoperative Analgesia for the Parturient

Acta Medica Medianae, 2015

Considering the physiological changes during pregnancy and the fact that there are two lives, obs... more Considering the physiological changes during pregnancy and the fact that there are two lives, obstetric anesthesia is an extremely specific and challenging area of work. The physiological changes that occur during pregnancy are among the contributing factors for complications during general and regional anesthesia. Therefore, the preoperative consideration is very important in the prevention of complications. Neuraxial anesthesia is increasingly replacing a widely applied general anesthesia, and has become the technique of choice for the majority of caesarean sections. General anesthesia is accompanied by risks related to the airway, but is still indicated for caesarean sections of the first degree of urgency. The choice of anesthesia depends on the urgency of surgery, general condition of the mother and fetus, comorbidity of pregnant woman and her consent to the proposed anesthetic procedure. The ultimate goal of all procedures is to provide safe anesthesia for mother and fetus. Multimodal analgesia is the best form of the pain treatment after cesarean section.

Research paper thumbnail of Intenzivan blok nasuprot optimalnoj hirurškoj relaksaciji

Research paper thumbnail of Anesthesia for the patient with gastrointestinal bleeding

Research paper thumbnail of H1N1 virus infection and mechanical ventilation – experience of the Clinical Center Nis

Research paper thumbnail of Hageman factor deficiency in a patient who underwent umbilical hernia repair surgery: case report and review of the literature

Research paper thumbnail of Anaesthesia and porphyria

Research paper thumbnail of Mutations in Sodium Channel Gene SCN9A and the Pain Perception Disorders

Advances in Anesthesiology, 2015

Research paper thumbnail of Volume Therapy in Acute Pancreatitis

Acta medica medianae, 2013

Research paper thumbnail of Protective ventilation with high versus low positive end-expiratory pressure during one-lung ventilation for thoracic surgery (PROTHOR): study protocol for a randomized controlled trial

Trials, 2019

Background: Postoperative pulmonary complications (PPC) may result in longer duration of in-hospi... more Background: Postoperative pulmonary complications (PPC) may result in longer duration of in-hospital stay and even mortality. Both thoracic surgery and intraoperative mechanical ventilation settings add considerably to the risk of PPC. It is unclear if one-lung ventilation (OLV) for thoracic surgery with a strategy of intraoperative high positive end-expiratory pressure (PEEP) and recruitment maneuvers (RM) reduces PPC, compared to low PEEP without RM. Methods: PROTHOR is an international, multicenter, randomized, controlled, assessor-blinded, two-arm trial initiated by investigators of the PROtective VEntilation NETwork. In total, 2378 patients will be randomly assigned to one of two different intraoperative mechanical ventilation strategies. Investigators screen patients aged 18 years or older, scheduled for open thoracic or video-assisted thoracoscopic surgery under general anesthesia requiring OLV, with a maximal body mass index of 35 kg/m 2 , and a planned duration of surgery of more than 60 min. Further, the expected duration of OLV shall be longer than two-lung ventilation, and lung separation is planned with a double lumen tube. Patients will be randomly assigned to PEEP of 10 cmH 2 O with lung RM, or PEEP of 5 cmH 2 O without RM. During two-lung ventilation tidal volume is set at 7 mL/kg predicted body weight and, during OLV, it will be decreased to 5 mL/kg. The occurrence of PPC will be recorded as a collapsed composite of single adverse pulmonary events and represents the primary endpoint. Discussion: PROTHOR is the first randomized controlled trial in patients undergoing thoracic surgery with OLV that is adequately powered to compare the effects of intraoperative high PEEP with RM versus low PEEP without RM on PPC. The results of the PROTHOR trial will support anesthesiologists in their decision to set intraoperative PEEP during protective ventilation for OLV in thoracic surgery.