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Post-ROSC SpO2 Target — FRCA Final MCQ

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EasyIntensive Care MedicinePost-ROSC SpO2 TargetFRCA Final

A 42-year-old man (ASA I, 80 kg) has a witnessed out-of-hospital VF cardiac arrest. Bystander CPR is commenced within 2 minutes. Paramedics deliver 3 shocks, adrenaline 1 mg, and amiodarone 300 mg. ROSC is achieved after 12 minutes. He is intubated, ventilated, and transferred to ICU. According to Resuscitation Council UK 2021, what is the target SpO2 range post-ROSC?

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Correct answer: A — No target – any SpO2 is acceptable

Post-ROSC, the Resuscitation Council UK 2021 guidelines recommend targeting SpO2 94-98% (PaO2 10-13 kPa). Both hypoxia (SpO2 <94%) and hyperoxia (SpO2 100%/PaO2 >40 kPa) are harmful. Hyperoxia causes: increased free radical production, neuronal injury, and cerebral vasoconstriction – all worsening post-arrest brain injury. FiO2 should be titrated down from 1.0 (used during resuscitation) to maintain SpO2 94-98% as soon as reliable SpO2 monitoring is available. Similarly, normocarbia (PaCO2 4.5-6.0 kPa) is targeted.

Reference: Resuscitation Council UK – 2021 – Post-resuscitation care; ERC/ESICM – 2021 – Post-resuscitation guidelines