UMEM Educational Pearls

Category: Cardiology

Title: post-cardiac arrest oxygenation

Keywords: cardiac arrest, ventilation, oxygenation (PubMed Search)

Posted: 1/11/2009 by Amal Mattu, MD (Updated: 9/24/2021)
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Most clinicians maintain ventilation with 100% oxygen for cardiac arrest patients with return of spontaneous circulation (ROSC). However, there is increasing literature demonstrating that "hyperoxia in the early stages of reperfusion harms postischemic neurons by causing excessive oxidative stress," and this may result in worse neurological outcomes. It is recommended to avoid unnecessary arterial hyperoxia and simply focus on maintaining oxygen saturations in the 94-96% range during the initial post-cardiac arrest period. [Reference: Neumar RW, Nolan J. Post-cardiac arrest syndrome and management. In The Textbook of Emergency Cardiovascular Care and CPR. Lippincott Williams & Wilkins, Philadelphia 2009.]