Oxygen and carbon dioxide targets during and after resuscitation of cardiac arrest patients

Excerpt

The goal of cardiopulmonary resuscitation (CPR) may be summarized as an effort to rapidly restore spontaneous circulation and to prevent hypoxic ischaemic brain injury (HIBI) [1]. The key determinant of tissue oxygenation during CPR is high quality chest compressions [2]. With ventilation the aim is to increase oxygen content of arterial blood whilst decreasing arterial carbon dioxide (paCO₂), alleviating respiratory acidosis. On the other hand, reactive oxygen species play an important part in the development of HIBI, thus avoiding extreme hyperoxia seems intuitive [3]. The relationship between arterial and tissue oxygenation and ventilation during CPR is complex. Conclusive evidence of optimal oxygen or carbon dioxide targets are scarce, but taking into account the pathophysiological changes may guide clinical practice (Fig. 1). In the current commentary we discuss what is known about the optimal oxygen and carbon dioxide targets during and immediately after cardiac arrest (CA) and how we may achieve them.

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