Basic resuscitation: ventilation targets after return of circulation: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Anaesthesia · Basic resuscitation: ventilation targets after return of circulation

Sample item

A comatose patient is ventilated after return of spontaneous circulation, and the arterial PaCO2 is 24 mmHg. What is the appropriate ventilation goal?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Normocapnia, PaCO2 about 35 to 45 mmHg

Hypocapnia causes cerebral vasoconstriction and reduces cerebral blood flow in a brain that is already vulnerable to ischaemia after arrest. Ventilation after return of circulation should aim for normal PaCO2, avoiding both hyperventilation and hypercapnia.

Option by option

  • A. Permissive hypercapnia with PaCO2 near 60 mmHg

    Hypercapnia dilates cerebral vessels, can raise intracranial pressure and is not the goal.

  • B. Normocapnia, PaCO2 about 35 to 45 mmHg (correct)

    Correct. Normal carbon dioxide levels preserve cerebral blood flow after arrest.

  • C. Hypocapnia to lower intracranial pressure further

    Hypocapnia reduces cerebral blood flow and risks further ischaemic injury.

  • D. Marked hypocapnia below 20 mmHg for brain protection

    Marked hypocapnia worsens cerebral ischaemia and has no neuroprotective role.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Anaesthesia questions

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Normocapnia, PaCO2 about 35 to 45 mmHg. Hypocapnia causes cerebral vasoconstriction and reduces cerebral blood flow in a brain that is already vulnerable to ischaemia after arrest.

Why is "Permissive hypercapnia with PaCO2 near 60 mmHg" not the answer?

Hypercapnia dilates cerebral vessels, can raise intracranial pressure and is not the goal.

Why is "Hypocapnia to lower intracranial pressure further" not the answer?

Hypocapnia reduces cerebral blood flow and risks further ischaemic injury.

Why is "Marked hypocapnia below 20 mmHg for brain protection" not the answer?

Marked hypocapnia worsens cerebral ischaemia and has no neuroprotective role.

What concept does this question test?

It tests Basic resuscitation: ventilation targets after return of circulation in Anaesthesia. Ventilation after return of circulation should aim for normal PaCO2, avoiding both hyperventilation and hypercapnia.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Basic resuscitation: ventilation targets after return of circulation?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.