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Assessment of cardiopulmonary resuscitation in 121 dogs and 30 cats at a university teaching hospital (2009-2012).
Journal of Veterinary Emergency and Critical Care 2014 November
OBJECTIVE: To prospectively describe cardiopulmonary resuscitation (CPR) and evaluate factors associated with outcome in dogs and cats with cardiopulmonary arrest (CPA).
DESIGN: Prospective observational study.
SETTING: University teaching hospital.
ANIMALS: One hundred twenty-one dogs and 30 cats that underwent CPR.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Supervising clinicians completed a data form immediately following completion of CPR. Eighty-seven (58%) animals attained return of spontaneous circulation (ROSC), 49 (32%) had ROSC >20 minutes, 15 (10%) were alive at 24 hours, and 8 (5%) were discharged alive. Cardiovascular abnormalities were the most common suspected precipitating cause of CPA (51/151, 34%). Presence of an IV catheter before CPA (P = 0.01) and the presence of palpable pulses during CPR (P = 0.007) were both associated with ROSC. Increased time from CPA to CPR (P = 0.04), longer duration of CPR (P < 0.0001), and neurologic cause of arrest (P = 0.02) were associated with not achieving ROSC. There was no association between ROSC and the initial arrest rhythm identified on ECG, animal weight, number of people present, and ventilation or compression rate. In patients achieving ROSC, those with a "survived event" were more likely to be euthanized and less likely to experience a second CPA than those with ROSC ≤ 20 minutes. Thirty-four percent of patients submitted for necropsy had gross and histological lesions considered secondary to CPR.
CONCLUSIONS: Early CPR interventions were associated with a greater likelihood of ROSC, emphasizing the importance of prompt recognition, and initiation of CPR efforts. Although ROSC rates in this study were comparable or higher than previous human and veterinary studies, the rate of "survived events" was lower than that reported in human patients. This may suggest that advances in post CPR care could have benefits to the veterinary CPR patient in the future.
DESIGN: Prospective observational study.
SETTING: University teaching hospital.
ANIMALS: One hundred twenty-one dogs and 30 cats that underwent CPR.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Supervising clinicians completed a data form immediately following completion of CPR. Eighty-seven (58%) animals attained return of spontaneous circulation (ROSC), 49 (32%) had ROSC >20 minutes, 15 (10%) were alive at 24 hours, and 8 (5%) were discharged alive. Cardiovascular abnormalities were the most common suspected precipitating cause of CPA (51/151, 34%). Presence of an IV catheter before CPA (P = 0.01) and the presence of palpable pulses during CPR (P = 0.007) were both associated with ROSC. Increased time from CPA to CPR (P = 0.04), longer duration of CPR (P < 0.0001), and neurologic cause of arrest (P = 0.02) were associated with not achieving ROSC. There was no association between ROSC and the initial arrest rhythm identified on ECG, animal weight, number of people present, and ventilation or compression rate. In patients achieving ROSC, those with a "survived event" were more likely to be euthanized and less likely to experience a second CPA than those with ROSC ≤ 20 minutes. Thirty-four percent of patients submitted for necropsy had gross and histological lesions considered secondary to CPR.
CONCLUSIONS: Early CPR interventions were associated with a greater likelihood of ROSC, emphasizing the importance of prompt recognition, and initiation of CPR efforts. Although ROSC rates in this study were comparable or higher than previous human and veterinary studies, the rate of "survived events" was lower than that reported in human patients. This may suggest that advances in post CPR care could have benefits to the veterinary CPR patient in the future.
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