It is not uncommon for ICU patients receiving controlled ventilation to require surgical procedures. Journeys receiving controlled ventilation to theatre are often associated with an increase in ventilation and oxygen requirements. Surgery is itself associated with an increase in oxygen requirement of up to 44% in elderly patients [1]. This is a multifactorial process of which one potentially preventable component is lung derecruitment. Lung derecruitment is an inevitable result of repeated disconnections of the tracheal tube from ventilators during a transfer. Disconnection was associated with a dramatic drop in functional residual capacity of up to 58% in lung-injured pigs [2] and is known to accentuate lung injury [3].
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