Sohm D.Schultz M.J.Yurttas T.Mahidol University2026-01-212026-01-212025-12-01A A Practice Vol.19 No.12 (2025) , e02111https://repository.li.mahidol.ac.th/handle/123456789/114043Intraoperative ventilation in obese patients is challenging, eg, during robot-assisted surgery, where altered respiratory mechanics often require high levels of positive end-expiratory pressure (PEEP) and oxygen. With high intrathoracic pressures, hemodynamic instability may occur, while oxygenation can remain impaired. However, a gap of knowledge exists regarding the efficacy of flow-controlled ventilation (FCV) in patients with extreme obesity undergoing bariatric surgery. We describe an obese patient (body mass index [BMI] 68.6kg/m²) in whom conventional ventilation resulted in impaired oxygenation and respiratory compliance. FCV markedly improved gas exchange. Implementing FCV in high-risk obese patients may enhance gas exchange, limit ventilator-induced lung injury, and minimize hemodynamic compromise.MedicineArticleSCOPUS10.1213/XAA.00000000000021112-s2.0-1050271887172575312641525174