Post-Resuscitation Care Flashcards

What is the recommended target SpO2 range during post-resuscitation care after ROSC?

Answer: 92–98%

Titrate oxygen to maintain SpO2 of 92–98% to avoid hyperoxia, which can worsen neurological outcomes.

Which blood glucose range is recommended during post-cardiac arrest care?

Answer: 140–180 mg/dL

Glucose should be maintained between 140–180 mg/dL; both hypoglycemia and severe hyperglycemia worsen outcomes.

After ROSC, a patient remains unresponsive. What is the recommended next step regarding temperature management?

Answer: Prevent fever and maintain temperature ≤37.5°C

Current guidelines recommend preventing fever (≥37.5°C) in comatose post-arrest patients rather than routine deep hypothermia.

Which ECG finding after ROSC most strongly indicates the need for emergent cardiac catheterization?

Answer: ST-elevation myocardial infarction (STEMI)

STEMI after ROSC warrants immediate coronary angiography regardless of neurological status, as the cause is likely coronary occlusion.

What ventilator setting should be targeted for PaCO2 during post-resuscitation mechanical ventilation?

Answer: 35–45 mmHg

Normocarbia (PaCO2 35–45 mmHg) is targeted to avoid cerebral vasoconstriction from hypocapnia or cerebral vasodilation from hypercapnia.

Which organ system is the most common cause of death following initially successful resuscitation from cardiac arrest?

Answer: Neurological injury (anoxic brain injury)

Anoxic brain injury from the period of no-flow and reperfusion is the leading cause of death and disability after cardiac arrest.

Which intervention should be performed routinely in all post-cardiac arrest patients after ROSC?

Answer: 12-lead ECG

A 12-lead ECG should be obtained immediately after ROSC to identify STEMI and guide reperfusion therapy decisions.

A post-arrest patient develops a mean arterial pressure (MAP) of 55 mmHg. What is the recommended MAP target?

Answer: Above 65 mmHg

A MAP ≥65 mmHg is the minimum recommended target to ensure adequate organ perfusion after cardiac arrest.

When is neuroprognostication typically considered reliable after cardiac arrest?

Answer: At least 72 hours after ROSC (or after rewarming)

Neuroprognostication should not occur before 72 hours post-ROSC (or after rewarming) because sedatives and hypothermia can confound findings.

Which of the following is a POOR prognostic indicator for neurological recovery post-cardiac arrest?

Answer: Bilaterally absent N20 SSEP waves

Bilaterally absent N20 somatosensory evoked potential waves at ≥72 hours strongly predict poor neurological outcome.

Post-cardiac arrest syndrome (PCAS) includes which combination of conditions?

Answer: Brain injury, myocardial dysfunction, systemic ischemia/reperfusion response, and persistent precipitating pathology

PCAS encompasses brain injury, myocardial dysfunction, systemic ischemia/reperfusion response, and the underlying cause of arrest.

Which vasopressor is most commonly used to treat post-resuscitation hypotension?

Answer: Norepinephrine

Norepinephrine is the preferred vasopressor for maintaining MAP ≥65 mmHg in post-cardiac arrest shock.

A patient resuscitated from cardiac arrest develops seizures. What is the recommended management?

Answer: Treat seizures with antiepileptic medications

Post-arrest seizures increase cerebral metabolic demand and worsen outcomes; they should be treated promptly with antiepileptic drugs.

What does 'post-cardiac arrest myocardial dysfunction' typically involve?

Answer: Transient global ventricular dysfunction that usually recovers within 48–72 hours

Post-arrest myocardial stunning is transient and typically improves within 2–3 days with appropriate hemodynamic support.

Which temperature range defines fever that should be actively prevented in comatose post-arrest patients?

Answer: Above 37.5°C

Fever is defined as ≥37.5°C in post-arrest guidelines, and active prevention is recommended to protect neurological outcomes.

Which finding on EEG is associated with poor neurological prognosis after cardiac arrest?

Answer: Burst suppression with identical bursts

Burst suppression with identical (stereotyped) bursts is a malignant EEG pattern predictive of poor neurological outcome.

A post-arrest patient's CT scan of the head shows loss of gray-white matter differentiation. What does this indicate?

Answer: Diffuse anoxic brain injury

Loss of gray-white matter differentiation on CT indicates diffuse cerebral edema from anoxic brain injury, a poor prognostic sign.

What is the primary goal of targeted temperature management (TTM) when implemented after cardiac arrest?

Answer: Provide neuroprotection by reducing cerebral metabolic demand

TTM reduces cerebral oxygen demand and inflammatory injury, providing neuroprotection during the vulnerable post-arrest period.

Why is hyperoxia harmful in the post-resuscitation period?

Answer: It worsens reperfusion injury through free radical production

Excess oxygen after ROSC generates reactive oxygen species that exacerbate reperfusion injury in ischemic tissues, particularly the brain.

Which laboratory value, if markedly elevated 48–72 hours post-arrest, suggests severe neurological injury?

Answer: Neuron-specific enolase (NSE)

Markedly elevated NSE at 48–72 hours after cardiac arrest correlates with severe neurological injury and poor neurological prognosis.