Rozanski Elizabeth A, Rush John E, Buckley Gareth J, Fletcher Daniel J, Boller Manuel
Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA, USA.
J Vet Emerg Crit Care (San Antonio). 2012 Jun;22 Suppl 1:S44-64. doi: 10.1111/j.1476-4431.2012.00755.x.
To systematically evaluate the evidence of the effect of advanced life support techniques on outcome in veterinary cardiopulmonary resuscitation (CPR) and to outline knowledge gaps.
Standardized, systematic evaluation of the literature, categorization of relevant articles according to level of evidence and quality, and development of consensus on conclusions for application of the concepts to clinical practice.
Academia, referral practice, and general practice
Sixteen population, intervention, control group, outcome questions were evaluated to determine if recommendations could be made concerning drug therapy, including vasopressors, vagolytics, corticosteroids, reversal agents, buffer therapy, and correction of electrolyte disturbances. Electrical defibrillation strategies as well as other advanced interventions such as open-chest CPR, impedance threshold devices, and special considerations regarding anesthesia-related cardiopulmonary arrest (CPA) were also investigated.
There is strong evidence supporting the use of standard-dose (0.01 mg/kg) epinephrine in CPR, as well as early electrical defibrillation for animals experiencing CPA due to ventricular fibrillation or pulseless ventricular tachycardia, preferentially using a biphasic defibrillator. For CPA due to certain causes and with the availability of advanced postcardiac arrest support, open chest CPR is preferred. Many knowledge gaps regarding other pharmacologic and advanced therapies were identified, and further studies are recommended to better systematically address these questions.
系统评估高级生命支持技术对兽医心肺复苏（CPR）结局的影响证据，并概述知识空白。
对文献进行标准化、系统评估，根据证据水平和质量对相关文章进行分类，并就将这些概念应用于临床实践的结论达成共识。
学术界、转诊实践和一般实践
评估了16个关于人群、干预措施、对照组、结局的问题，以确定是否可以就药物治疗提出建议，包括血管加压药、抗迷走神经药、皮质类固醇、逆转剂、缓冲治疗以及电解质紊乱的纠正。还研究了电除颤策略以及其他高级干预措施，如开胸CPR、阻抗阈值装置，以及与麻醉相关的心搏骤停（CPA）的特殊注意事项。
有强有力的证据支持在CPR中使用标准剂量（0.01 mg/kg）肾上腺素，以及对因心室颤动或无脉性室性心动过速而发生CPA的动物尽早进行电除颤，优先使用双相除颤器。对于因某些原因导致的CPA且有高级心脏骤停后支持措施时，首选开胸CPR。发现了许多关于其他药物和高级治疗的知识空白，建议进一步开展研究以便更好地系统解决这些问题。
