The reply to Kanterian offers a rebuttal of his central criticisms. It reaffirms the difference between Kant's arguments in the Aesthetic and at B 148-9; it rejects the alleged error of logic in Fischer's (and my) arguments; and it rejects Kanterian's reading of passages in the Preface (A xx-xxii) and of the Amphiboly. Beyond these specific points Kanterian assumes that Kant's project in the first Critique cannot be understood as a ‘descriptive metaphysics’ and so begs the question at issue.

We prospectively evaluated the effects of pneumoperitoneum and reverse Trendelenburg position on cardiopulmonary function in 20 ASA physical status II–III morbidly obese patients (body mass index > 35 kg m−2) undergoing laparoscopic gastric banding. After general anaesthesia was induced, patients' lungs were ventilated using intermittent positive pressure ventilation (at measurement times, the following parameters were used: tidal volume 12 mL kg−1 ideal body weight, respiratory rate of 12 bpm, an inspiratory to expiratory time ratio of 1 : 2). Haemodynamic variables, blood gas parameters, and lung/chest compliance were recorded: in the supine position, after induction of general anaesthesia (T0, baseline) and induction of pneumoperitoneum (T1); after placing the patient in a 25° reverse Trendelenburg position (T2); during the surgical time (T3); before deflating the abdomen (T4); after pneumoperitoneum resolution (T5), and before the end of anaesthesia, with the patient supine (T6). The PaO2, PaO2/FiO2 ratio, and lung/chest compliance decreased during the study. After the pneumoperitoneum had been resolved, lung/chest compliance but not oxygenation parameters returned to baseline values. The arterial to end-tidal CO2 tension difference progressively increased from 0.38 ± 0.3 kPa (2.85 ± 2.25 mmHg) (T0) to 0.63 ± 0.3 kPa (4.73 ± 2.25 mmHg) (T6). In morbidly obese patients, undergoing laparoscopic gastric banding, a CO2 pneumoperitoneum markedly affected gas exchange and lung/chest compliance, while positioning the patient in a 25° reverse Trendelenburg position had no beneficial effects.