Title: Post-Arrest Mechanical Ventilation<br/>Author: Mike Winters<br/><a href='http://umem.org/profiles/faculty/141/'>[Click to email author]</a><hr/><p> <strong><u>Post-Arrest Tidal Volume Setting</u></strong></p> <ul> <li> Most patients with ROSC from out-of-hospital cardiac arrest undergo endotracheal intubation and mechanical ventilation.</li> <li> Optimal management of mechanical ventilation for the post-arrest patient is currently not well defined.</li> <li> A recent retrospective cohort study sought to determine if a lower tidal volume (Vt) was associated with improved neurocognitive outcome at hospital discharge.</li> <li> Of 256 patients included in the study, investigators found: <ul> <li> 38% were ventilated with Vt > 8 ml/kg predicted body weight</li> <li> Lower Vt was significantly associated with <u>favorable neurocognitive outcome</u>, <u>decreased duration of mechanical ventilation</u>, and <u>decreased ICU length of stay</u></li> </ul> </li> <li> <strong>Take Home Pearl: Pay attention to Vt in the post-arrest patient.</strong></li> </ul> <fieldset><legend>References</legend>
<p> Beitler JR, et al. Favorable neurocognitive outcome with low tidal volume ventilation after cardiac arrest. <em>Am J Respir Crit Care Med. </em>2017; 195:1196-1206.</p> </fieldset>