Post operative pulmonary complication (PPC) is one of the cause of mortality and morbidity after sternotomy. There is no accessible confirmation which shows the impact of Pre Extubation Manual Hyperinflation method with Regular Extubation procedure. After sternotomy manual hyperinflation technique is not taken during extubation. The objective of the study was to determine the effect of Pre Extubation Manual Hyperinflation technique VS regular Extubation technique on vitals and respiratory parameters in patients after Sternotomy.

Inclusion Criteria:

1. Age 40 to 60
2. Patient undergone surgery (sternotomy)
3. Elective intubated (ETT orally)
4. Ventilated more than 3 hours -

Exclusion Criteria:

1. Patient with any neurological issue (mentally disturbed) who cannot understand the command
2. Complicated extubation
3. Pulmonary pathology where lung hyperinflation was contra-indicated (e.g. acute respiratory distress syndrome, undrained pneumothorax or exacerbation of chronic obstructive pulmonary disease and acute pulmonary edema.
4. Raised intracranial pressure
5. Redo or reopen. -