Feline Cardiopulmonary Resuscitation: Getting the Most out of All Nine Lives

Overview

Journal J Feline Med Surg

Specialty Veterinary Medicine

Date 2021 Mar 15

PMID 33719693

Authors

Melody J Ward

April E Blong

Rebecca A Walton

Affiliations

Soon will be listed here.

Abstract

Practical Relevance: Cardiopulmonary arrest (CPA) can occur in any veterinary or animal care setting and is a particular risk in scenarios involving ill, injured or anesthetized patients. Education of all staff on the prevention and recognition of CPA, as well as the performance of cardiopulmonary resuscitation (CPR), is vital to influencing outcome.

Evidence Base: While there is a plethora of information regarding CPA and CPR in human medicine, there are comparably few studies in the veterinary literature. Many of the current veterinary guidelines are extrapolated from human medicine or studies based on animal models. Ongoing work is needed to tailor guidelines and recommendations to our domestic feline (and canine) patients in a clinical setting.

Aim: The aim of this article, which is intended for veterinarians in all areas of small animal practice, is to provide an evidence-based review of CPA and CPR in feline patients. The authors have drawn heavily on detailed recommendations published by the Reassessment Campaign on Veterinary Resuscitation (RECOVER) initiative - one of the few resources specific to the veterinary clinical setting - as well as reviewing the available peer-reviewed literature studies, in constructing this article. Among the topics discussed are recognizing and preventing CPA, staff training and clinic preparedness, basic life support and advanced life support interventions, and appropriate post-cardiac arrest care.

References

Neumar R, Nolan J, Adrie C, Aibiki M, Berg R, Bottiger B . Post-cardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. A consensus statement from the International Liaison Committee on Resuscitation (American Heart Association, Australian and New Zealand Council on.... Circulation. 2008; 118(23):2452-83. DOI: 10.1161/CIRCULATIONAHA.108.190652. View

Hopper K, Epstein S, Fletcher D, Boller M . RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 3: Basic life support. J Vet Emerg Crit Care (San Antonio). 2012; 22 Suppl 1:S26-43. DOI: 10.1111/j.1476-4431.2012.00753.x. View

Brainard B, Boller M, Fletcher D . RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 5: Monitoring. J Vet Emerg Crit Care (San Antonio). 2012; 22 Suppl 1:S65-84. DOI: 10.1111/j.1476-4431.2012.00751.x. View

Boller M, Boller E, Oodegard S, Otto C . Small animal cardiopulmonary resuscitation requires a continuum of care: proposal for a chain of survival for veterinary patients. J Am Vet Med Assoc. 2012; 240(5):540-54. DOI: 10.2460/javma.240.5.540. View

Neumar R, Otto C, Link M, Kronick S, Shuster M, Callaway C . Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010; 122(18 Suppl 3):S729-67. DOI: 10.1161/CIRCULATIONAHA.110.970988. View

Kern K, Sanders A, Badylak S, Janas W, Carter A, Tacker W . Long-term survival with open-chest cardiac massage after ineffective closed-chest compression in a canine preparation. Circulation. 1987; 75(2):498-503. DOI: 10.1161/01.cir.75.2.498. View

Dick W, Eberle B, Wisser G, Schneider T . The carotid pulse check revisited: what if there is no pulse?. Crit Care Med. 2000; 28(11 Suppl):N183-5. DOI: 10.1097/00003246-200011001-00002. View

Buckley G, Shih A, Garcia-Pereira F, Bandt C . The effect of using an impedance threshold device on hemodynamic parameters during cardiopulmonary resuscitation in dogs. J Vet Emerg Crit Care (San Antonio). 2012; 22(4):435-40. DOI: 10.1111/j.1476-4431.2012.00782.x. View

Hofmeister E, Brainard B, Egger C, Kang S . Prognostic indicators for dogs and cats with cardiopulmonary arrest treated by cardiopulmonary cerebral resuscitation at a university teaching hospital. J Am Vet Med Assoc. 2009; 235(1):50-7. DOI: 10.2460/javma.235.1.50. View

10.

Ashton A, McCluskey A, Gwinnutt C, Keenan A . Effect of rescuer fatigue on performance of continuous external chest compressions over 3 min. Resuscitation. 2002; 55(2):151-5. DOI: 10.1016/s0300-9572(02)00168-5. View

11.

Hogen T, Cole S, Drobatz K . Evaluation of end-tidal carbon dioxide as a predictor of return of spontaneous circulation in dogs and cats undergoing cardiopulmonary resuscitation. J Vet Emerg Crit Care (San Antonio). 2018; 28(5):398-407. DOI: 10.1111/vec.12755. View

12.

White L, Rogers J, Bloomingdale M, Fahrenbruch C, Culley L, Subido C . Dispatcher-assisted cardiopulmonary resuscitation: risks for patients not in cardiac arrest. Circulation. 2009; 121(1):91-7. DOI: 10.1161/CIRCULATIONAHA.109.872366. View

13.

Gaddis G, Dolister M, Gaddis M . Mock drug delivery to the proximal aorta during cardiopulmonary resuscitation: central vs peripheral intravenous infusion with varying flush volumes. Acad Emerg Med. 1995; 2(12):1027-33. DOI: 10.1111/j.1553-2712.1995.tb03143.x. View

14.

Weisfeldt M, Becker L . Resuscitation after cardiac arrest: a 3-phase time-sensitive model. JAMA. 2002; 288(23):3035-8. DOI: 10.1001/jama.288.23.3035. View

15.

Rozanski E, Rush J, Buckley G, Fletcher D, Boller M . RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 4: Advanced life support. J Vet Emerg Crit Care (San Antonio). 2012; 22 Suppl 1:S44-64. DOI: 10.1111/j.1476-4431.2012.00755.x. View

16.

Cunningham L, Mattu A, OConnor R, Brady W . Cardiopulmonary resuscitation for cardiac arrest: the importance of uninterrupted chest compressions in cardiac arrest resuscitation. Am J Emerg Med. 2012; 30(8):1630-8. DOI: 10.1016/j.ajem.2012.02.015. View

17.

Wingfield W, Van Pelt D . Respiratory and cardiopulmonary arrest in dogs and cats: 265 cases (1986-1991). J Am Vet Med Assoc. 1992; 200(12):1993-6. View

18.

Girotra S, Nallamothu B, Spertus J, Li Y, Krumholz H, Chan P . Trends in survival after in-hospital cardiac arrest. N Engl J Med. 2012; 367(20):1912-20. PMC: 3517894. DOI: 10.1056/NEJMoa1109148. View

19.

McMichael M, Herring J, Fletcher D, Boller M . RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 2: Preparedness and prevention. J Vet Emerg Crit Care (San Antonio). 2012; 22 Suppl 1:S13-25. DOI: 10.1111/j.1476-4431.2012.00752.x. View

20.

Blecic S, Chaskis C, Vincent J . Atropine administration in experimental electromechanical dissociation. Am J Emerg Med. 1992; 10(6):515-8. DOI: 10.1016/0735-6757(92)90174-v. View