Post-Arrest Tidal Volume Setting

• Most patients with ROSC from out-of-hospital cardiac arrest undergo endotracheal intubation and mechanical ventilation.
• Optimal management of mechanical ventilation for the post-arrest patient is currently not well defined.
• A recent retrospective cohort study sought to determine if a lower tidal volume (Vt) was associated with improved neurocognitive outcome at hospital discharge.
• Of 256 patients included in the study, investigators found:
  • 38% were ventilated with Vt > 8 ml/kg predicted body weight
  • Lower Vt was significantly associated with favorable neurocognitive outcome, decreased duration of mechanical ventilation, and decreased ICU length of stay
• Take Home Pearl: Pay attention to Vt in the post-arrest patient.

References

Beitler JR, et al. Favorable neurocognitive outcome with low tidal volume ventilation after cardiac arrest. Am J Respir Crit Care Med. 2017; 195:1196-1206.