Journal of veterinary emergency and critical care
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J Vet Emerg Crit Care (San Antonio) · Jun 2012
Practice GuidelineRECOVER evidence and knowledge gap analysis on veterinary CPR. Part 7: Clinical guidelines.
To present a series of evidence-based, consensus guidelines for veterinary CPR in dogs and cats. ⋯ Although many knowledge gaps were identified, specific clinical guidelines for small animal veterinary CPR were generated from this evidence-based process. Future work is needed to objectively evaluate the effects of these new clinical guidelines on CPR outcome, and to address the knowledge gaps identified through this process.
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J Vet Emerg Crit Care (San Antonio) · Jun 2012
RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 3: Basic life support.
To systematically examine the evidence on basic life support (BLS) in veterinary CPR and to determine knowledge gaps. ⋯ Although veterinary clinical trials are lacking, much of the experimental literature on BLS utilized canine models. The major conclusions from this analysis of the literature are the importance of early identification of CPA, and immediate initiation of BLS in these patients. Many knowledge gaps exist, most importantly in our understanding of the optimal hand placement and technique for chest compressions, warranting coordinated future studies targeted at questions of relevance to differences between veterinary species and humans.
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J Vet Emerg Crit Care (San Antonio) · Jun 2012
RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 6: Post-cardiac arrest care.
To systematically examine the evidence for interventions after the return of spontaneous circulation (ROSC) on outcomes from veterinary cardiopulmonary resuscitation and to determine important knowledge gaps. ⋯ Despite the near complete absence of clinical veterinary studies, the process allowed the formulation of statements for several postcardiac arrest treatments that were either supportive, such as mild therapeutic hypothermia or controlled reoxygenation, or neutral, such as for mannitol administration or seizure prophylaxis. Evidence grading allowed transparency in regards to the strength of these recommendations. Moreover, numerous knowledge gaps emerged that will allow generation of a road map for progress in veterinary post-cardiac arrest care.
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J Vet Emerg Crit Care (San Antonio) · Jun 2012
RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 1: Evidence analysis and consensus process: collaborative path toward small animal CPR guidelines.
To describe the methodology used by the Reassessment Campaign on Veterinary Resuscitation (RECOVER) to evaluate the scientific evidence relevant to small animal CPR and to compose consensus-based clinical CPR guidelines for dogs and cats. ⋯ Collaborative systematic evidence review is organizationally challenging but feasible and effective in veterinary medicine. More experience is needed to refine the process.
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J Vet Emerg Crit Care (San Antonio) · Jun 2012
RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 5: Monitoring.
To systematically examine the evidence on patient monitoring before, during, and following veterinary CPR and to identify scientific knowledge gaps. ⋯ Although veterinary clinical trials are lacking, experimental literature using canine models and human clinical trials provided relevant data. The major conclusions from this analysis of the literature highlight the utility of end-tidal carbon dioxide (EtCO(2)) monitoring to identify ROSC and possibly to evaluate quality of CPR. In addition, recommendations for ECG analysis during CPR were addressed. Unless the patient is instrumented at the time of CPA, other monitoring devices (eg, Doppler flow probe) are likely not useful for diagnosis of CPA, and the possibility of pulseless electrical activity makes ECG inappropriate as a sole diagnostic tool. Optimal monitoring of the intra- and postcardiac arrest patient remains to be determined in clinical veterinary medicine, and further evaluation of the prognostic and prescriptive utility of EtCO(2) monitoring will provide material for future studies in veterinary CPR.