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Post-ROSC oxygenation — DIPIMC MCQ

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HardResuscitationPost-ROSC oxygenationDIPIMCDipIMC

A 58-year-old has return of spontaneous circulation after an out-of-hospital cardiac arrest. He remains unconscious and is being ventilated. Saturations are 100% on 15 litres per minute, and the monitor shows a sinus tachycardia. Which approach to oxygenation and ventilation is most appropriate during transfer?

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Correct answer: E — Titrate oxygen to a saturation of 94-98% and ventilate to normocapnia

After return of spontaneous circulation, both hypoxia and hyperoxia are harmful, so oxygen is titrated to a saturation of 94-98% with ventilation targeting normocapnia. Sustained 100% oxygen risks hyperoxic injury, and routine hyperventilation causes cerebral vasoconstriction that worsens brain injury. A target of 88-92% applies to those at risk of hypercapnic respiratory failure, not to standard post-arrest care. Pearl: controlled oxygenation and normocapnia are central pillars of post-resuscitation care in current guidance.

Reference: Resuscitation Council UK Guidelines 2025 (Post-Resuscitation Care)