Mechanical ventilation after cardiac arrest: protecting the brain by protecting the lungs.

PURPOSE OF REVIEW: To review the current knowledge on mechanical ventilation after cardiac arrest, carefully balancing the protection of both the brain and the lungs.

RECENT FINDINGS: Although lung-protective ventilation (LPV) strategies are often considered in the general population and widely studied in acute respiratory distress syndrome (ARDS) patients, current knowledge focused on patients after cardiac arrest is unclear. Mechanical ventilation in this unique population should prevent potential brain injury while also avoiding ventilation-induced lung injury. This includes optimizing ventilation parameters, such as tidal volume ( VT ), positive end-expiratory pressure (PEEP), and gas exchange targets, while also considering the impact on cerebral perfusion and intracranial pressure. The role of LPV in patients without ARDS and after cardiac arrest is still uncertain.

SUMMARY: In this review, we updated the strategy to optimize mechanical ventilation after cardiac arrest with the primary aim of protecting the lungs and brain, improving the patients' outcomes.