What is the role of oxygenation targets in pediatric resuscitation?

• A. Maximize oxygen delivery by keeping FiO2 at 100% indefinitely.
• B. Optimize oxygen delivery while avoiding hyperoxia; adjust FiO2 to maintain target saturations.
• C. Use fixed FiO2 regardless of saturations.
• D. Oxygenation targets are not considered.

Answer: (B)

In pediatric resuscitation, the goal of oxygenation targets is to provide enough oxygen to meet the body's needs while avoiding oxygen toxicity. We monitor oxygen delivery with pulse oximetry and set age-appropriate SpO2 targets. FiO2 is then adjusted to keep saturations within that target range. If SpO2 is too low, we increase FiO2; if it’s safely high, we reduce FiO2 to prevent hyperoxia. This balances preventing hypoxemia (which can worsen tissue and organ injury during and after arrest) with avoiding excessive oxygen that can generate harmful free radicals and cause lung or other tissue injury. Therefore, oxygenation targets guide titration of FiO2 to maintain desired saturations rather than using a fixed 100% oxygen or ignoring saturations altogether.