Restrictive oxygen targets show no mortality benefit after cardiac arrest

A systematic review and meta-analysis of 11 RCTs (4136 patients) compared restrictive versus higher oxygenation targets in adult cardiac arrest patients on invasive mechanical ventilation after ROSC. The authors report no significant difference in all-cause mortality or unfavorable neurological outcomes between strategies, though restrictive oxygenation increased hypoxemia risk while improving ventilator-free days. The authors state that under normothermia protocols, current evidence trends toward futility for a restrictive approach, though they note the definitive information size has not yet been fully accrued.

Most relevant for: Adult patients undergoing invasive mechanical ventilation after return of spontaneous circulation from cardiac arrest.

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