70 - year - old man 2 weeks fol lowing resection of a large mediastinal sarcoma that included oesophagectomy. His postoperative course was complicated by a bronchial injury and chyle leak. The patient was slow to wean from the ventilator - issues included potential sources of sepsis (inc luding VAP and mediastinal), ongoing chyle leak, acute brain syndrome and neuromuscular weakness. Candidates were directed to identify causes for the slow wean from ventilatory support