Title: Post-Arrest PaCO2<br/>Author: Mike Winters<br/><a href='http://umem.org/profiles/faculty/141/'>[Click to email author]</a><hr/><p> <strong><u>PaCO2 and the Post-Arrest Patient</u></strong></p> <ul> <li> Alterations in PaCO2 are common during the post-arrest period and have been associated with worse patient centered outcomes.</li> <li> Hypercarbia can <em>dilate</em> cerebral vessels, increase cerebral blood flow, and may increase intracranial pressure.</li> <li> Conversely, hypocarbia can <em>constrict</em> cerebral vessels and may reduce cerebral blood flow.</li> <li> Though the current evidence is primarily limited to observational trials, a recent meta-analysis found that "normocarbia" was associated with improved hospital survival and neurologic outcome. </li> <li> <strong>Take Home: Adjust mechanical ventilation to target normocarbia (PaCO2 or ETCO2) in the post-arrest patient.</strong></li> </ul> <fieldset><legend>References</legend>
<p> McKenzie N, et al. A systematic review and meta-analysis of the association between arterial carbon dioxide tension and outcomes after cardiac arrest. <em>Resuscitation</em> 2017; 111:116-126.</p> </fieldset>