Cardiac surgery is a commonly performed procedure worldwide, with an estimated 1–1.5 million cases per year and figures destined to increase in the next few years [1]. A significant portion of these cases requires intraoperative cardiopulmonary bypass (CPB), which temporarily substitutes for the function of the heart and lungs. Postoperative complications are frequent, including nosocomial infections that may affect 5–20% patients and have a significant impact on morbidity and mortality [2,3,4]. Multifactorial immunosuppression is considered a relevant driver of these infections, and the inflammatory response associated with pulmonary atelectasis induced by discontinuation of mechanical ventilation (MV) during CPB may exacerbate lung injury and immune dysfunction, contributing to such complications [5]. Given the important implications for patient outcomes and healthcare resource utilization, considerable attention has been devoted to this topic. Several strategies have been described in an attempt to reduce risks, including continuation of MV during CPB [6, 7]. However, the optimal ventilation strategy during CPB remains controversial [8,9,10].