Advanced Cardiovascular Life Support (ACLS) Practice Exam

What is the usual post-cardiac arrest target range for PETCO2 when ventilating a patient who achieves return of spontaneous circulation (ROSC)?

1. 30-35 mm Hg

2. 35-40 mm Hg

3. 40-45 mm Hg

4. 45-50 mm Hg

The correct answer is: 35-40 mm Hg

The usual post-cardiac arrest target range for PETCO2, or end-tidal carbon dioxide, when a patient achieves return of spontaneous circulation (ROSC) is 35-40 mm Hg. This range is considered optimal for several reasons. First, maintaining PETCO2 within this range indicates that sufficient cardiac output is being achieved, which reflects effective ventilation and perfusion. After ROSC, a higher PETCO2 (above 40 mm Hg) can suggest poor circulation and inadequate perfusion, while a lower PETCO2 (below 35 mm Hg) may indicate hyperventilation or inadequate cardiac output. Moreover, monitoring PETCO2 is essential as it provides real-time feedback on a patient’s respiratory and circulatory status during the post-cardiac arrest phase. Achieving a PETCO2 level in the 35-40 mm Hg range supports optimal metabolic function and helps in guiding further resuscitative efforts and management strategies for the patient. This target range contributes to improved outcomes by ensuring the balance between oxygen delivery and carbon dioxide removal is maintained, which is critical in the recovery phase following a cardiac arrest.