Advanced Cardiovascular Life Support (ACLS) Practice Exam

What is the minimum systolic blood pressure one should attempt to achieve with fluid, inotropic, or vasopressor administration in a hypotensive post-cardiac arrest patient who achieves ROSC?

1. 70 mm Hg

2. 80 mm Hg

3. 90 mm Hg

4. 100 mm Hg

The correct answer is: 90 mm Hg

In the context of managing a post-cardiac arrest patient who achieves return of spontaneous circulation (ROSC), the appropriate goal for systolic blood pressure is critical for ensuring adequate organ perfusion and minimizing the risk of further complications. A minimum systolic blood pressure of 90 mm Hg is recommended because this threshold is generally associated with improved outcomes in patients following cardiac arrest. Achieving this level of blood pressure helps to ensure adequate cerebral and coronary perfusion, which is vital given the potential for significant myocardium and organ suffering during the preceding cardiac arrest. Lower blood pressure levels may not provide sufficient perfusion pressure for vital organs, thus increasing the risk of hypoxic injury, particularly to the brain. Moreover, guidelines emphasize that while fluid resuscitation and administration of inotropes or vasopressors are essential strategies to manage hypotension in the post-cardiac arrest period, the aim should stabilize blood pressure above this threshold to optimize recovery and support overall cardiovascular function. Hence, maintaining a systolic blood pressure at or above 90 mm Hg is adequate to support vital organ function and improve the likelihood of a favorable outcome following cardiac arrest.