Basic resuscitation: oxygen 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.

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Anaesthesia · Basic resuscitation: oxygen after return of circulation

Sample item

A ventilated patient who has just had return of spontaneous circulation after cardiac arrest has SpO2 of 100 percent on FiO2 of 1.0. What should be done with the inspired oxygen?

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

The answer and the reasoning

B. Titrate FiO2 down to avoid hyperoxia

After return of circulation, hyperoxia may add to reperfusion injury, so the inspired oxygen is reduced as soon as reliable saturations are available while hypoxia is still avoided. Abrupt withdrawal of oxygen is also unsafe. Hyperventilation reduces cerebral blood flow.

Option by option

  • A. Keep FiO2 at 1.0 and hyperventilate

    Hyperventilation cuts cerebral perfusion.

  • B. Titrate FiO2 down to avoid hyperoxia (correct)

    Correct. Titrate oxygen to a safe saturation and avoid hyperoxia.

  • C. Switch to room air immediately

    An abrupt drop to room air risks hypoxia in a recovering patient.

  • D. Continue FiO2 of 1.0 for 24 hours

    Prolonged maximal oxygen causes hyperoxic injury.

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.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Titrate FiO2 down to avoid hyperoxia. After return of circulation, hyperoxia may add to reperfusion injury, so the inspired oxygen is reduced as soon as reliable saturations are available while hypoxia is still avoided.

Why is "Keep FiO2 at 1.0 and hyperventilate" not the answer?

Hyperventilation cuts cerebral perfusion.

Why is "Switch to room air immediately" not the answer?

An abrupt drop to room air risks hypoxia in a recovering patient.

Why is "Continue FiO2 of 1.0 for 24 hours" not the answer?

Prolonged maximal oxygen causes hyperoxic injury.

What concept does this question test?

It tests Basic resuscitation: oxygen after return of circulation in Anaesthesia. Abrupt withdrawal of oxygen is also unsafe. Hyperventilation reduces cerebral blood flow.

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: oxygen 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.