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Post-cardiac arrest oxygen management — SCE Acute Medicine MCQ

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HardCritical Care MedicinePost-cardiac arrest oxygen managementSCE Acute Medicine

A 72-year-old woman is intubated after out-of-hospital cardiac arrest and return of spontaneous circulation. She is comatose, BP is supported with noradrenaline, SpO2 is 99% on FiO2 0.8 and PaO2 is 28 kPa. Temperature is 35.8 C. What is the most appropriate immediate ventilatory target?

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Correct answer: C — Titrate oxygen to avoid both hypoxaemia and marked hyperoxaemia

After cardiac arrest, oxygen should be titrated to avoid hypoxaemia while also avoiding unnecessary hyperoxaemia. Maintaining very high PaO2 is not beneficial and may increase oxidative injury. Routine hyperventilation can reduce cerebral blood flow. Normal saturation does not mean a comatose post-arrest patient is ready for extubation.

Reference: Resuscitation Council UK post-resuscitation care guidelines