A 5-year-old returns of spontaneous circulation after drowning-related cardiac arrest. He is ventilated and oxygenated with FiO2 1.0. Which oxygen saturation target should guide weaning of inspired oxygen during post-resuscitation care?

• A 100 percent
• B Maintain PaO2 above 150 mmHg irrespective of SpO2
• C 80 to 85 percent
• D 94 to 99 percent ✓

Explanation

PALS post-cardiac arrest care recommends titrating inspired oxygen to an SpO2 of 94 to 99 percent, avoiding both hypoxia and hyperoxia, since hyperoxia after resuscitation worsens reperfusion injury and neurological outcome. Once arterial sampling is available, a PaO2 of 60 to 80 mmHg suffices, which makes option B incorrect despite its apparent safety margin.

Reference: PALS Provider Manual, American Heart Association, 2020 ed.

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