Ventilator mode for post operative CABG patient

Pulmonary compliance is likely to change as the lungs continue to re-expand post thoracotomy, therefore a volume-guaranteed mode would be wise. Initially the patient will be full of muscle-relaxant, and thus a mandatory mode needs to be selected. Therefore volume control (or pressure control/volume guaranteed or pressure-regulated volume control) would be appropriate. A hybrid mode such as SIMV (with a volume control mode and pressure support) could be used as the patient wakes up and starts to breathe for themselves. The key with post-operative cardiac recovery is to extubate these patients as soon as possible, so switching from positive pressure ventilation to negative pressure (restoring normal lung dynamics and intrathoracic pressures) ASAP via extubation is the aim. Once breathing spontaneously/triggering, transition from VCV to PSV with a view to extubation 4-6 hours post-op.