Kawase Koudai, Ujiie Hazuki, Takaki Motonori, Yamashita Kazuto
Sapporo Nighttime Animal Hospital, Sapporo, Hokkaido 060-0062, Japan.
Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan.
J Vet Med Sci. 2018 Mar 30;80(3):518-525. doi: 10.1292/jvms.17-0107. Epub 2018 Jan 29.
A set of evidence-based consensus guidelines for cardiopulmonary resuscitation (CPR) in dogs and cats (RECOVER guidelines) was published in 2012. The purpose of this study was to investigate the clinical outcomes of CPR performed according to those guidelines in dogs. A total of 141 dogs with cardiopulmonary arrest (CPA) were identified and underwent CPR between January 2012 and December 2015 at the Sapporo Nighttime Animal Hospital. CPR was performed according to no-consensus traditional veterinary CPR procedures in 68 dogs (TRADITIONAL group), and according to the RECOVER guidelines in 73 dogs (RECOVER group). There was no significant difference in the age, body weight, or time from CPA identification to initiation of CPR between the TRADITIONAL and RECOVER groups (median [range]: 10 [0-16] vs. 11 [0-16] years; 6.6 [1.0-58.6] vs. 5.5 [1.1-30.4] kg; and 0 [0-30] vs. 0 [0-30] min, respectively). In the TRADITIONAL group, 12 dogs (17%) achieved a return of spontaneous circulation (ROSC), but none survived to hospital discharge. However, 32 dogs (43%) in the RECOVER group achieved ROSC, and 4 dogs (5%) were discharged from the hospital. Incorporating the RECOVER guidelines into clinical practice significantly improved the ROSC rate (P<0.001). However, the rate of survival to hospital discharge was still low. This may suggest that a superior intensive care unit that provides advanced post-CPA care could benefit veterinary CPR patients.
一套针对犬猫心肺复苏(CPR)的循证共识指南(RECOVER指南)于2012年发布。本研究的目的是调查按照这些指南对犬进行心肺复苏的临床结果。2012年1月至2015年12月期间,在札幌夜间动物医院共识别出141只发生心肺骤停(CPA)的犬,并对其进行了心肺复苏。68只犬按照无共识的传统兽医心肺复苏程序进行心肺复苏(传统组),73只犬按照RECOVER指南进行心肺复苏(RECOVER组)。传统组和RECOVER组在年龄、体重或从识别CPA到开始心肺复苏的时间方面无显著差异(中位数[范围]:分别为10[0 - 16]岁对11[0 - 16]岁;6.6[1.0 - 58.6]千克对5.5[1.1 - 30.4]千克;0[0 - 30]分钟对0[0 - 30]分钟)。在传统组中,12只犬(17%)实现了自主循环恢复(ROSC),但无一存活至出院。然而,RECOVER组中有32只犬(43%)实现了ROSC,4只犬(5%)出院。将RECOVER指南纳入临床实践显著提高了ROSC率(P<0.001)。然而,出院存活率仍然很低。这可能表明,一个提供先进的CPA后护理的优质重症监护病房可能会使接受兽医心肺复苏的患者受益。