Aim: To compare a new method of extubation with present standard procedure at the Central ICUafter HIPEC surgery. Method: In a randomized controlled study patients were randomized into two groups. Patients wereeither extubated according to a study algorithm based on best current knowledge, or according tostandard procedure. Results: The oxygenation remained on the same level in the study group (37,5 kPa to 36,6 kPa) butdecreased in the control group from 50,1 kPa to 40,6 kPa from 10 minutes after arrival to 15minutes after extubation. After 13 to 18 hours, just before the discharge from the ICU theoxygenation in both groups was at the same level as 15 minutes after extubation. Thus a decrease inoxygenation in the control group was found at discharge compared to 10 minutes after arrival in theICU. Conclusion: The result of the study showed that it may be benificial to extubate according to thestudy algorithm compared to present standard procedure. By directing focus from when to how theextubation is made, this study may contribute to the improvement of a clinical procedure that iscurrently lacking in scientific consencus. Further studies are needed to confirm these findings.