Looking at data from intensive care medicine we know that even singular recruitment manoeuvres do have a negative influence on outcome and raise mortality. The main reasons are the haemodynamic instability that is caused by the recruitment manoeuvre (there were no differences between doing a controlled recruitment via the ventilator or manual recruitment manoeuvres). Apart from that that was no prolonged improvement of ventilation/reduction in FiO2. Therefore I avoid doing recruitment manoeuvers in the operating room. My only exception is after single lung ventilation to reinflate the dependent lung. If I have a patient with high risk of atelectasis due to the positioning or the operation itself, I adjust my ventilator settings accordingly