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RECOVER 指南发布前后小动物心肺复苏术临床实践的差异:美国和加拿大两项电子调查(2008 年和 2017 年)的结果。

Differences in the clinical practice of small animal CPR before and after the release of the RECOVER guidelines: Results from two electronic surveys (2008 and 2017) in the United States and Canada.

机构信息

Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Melbourne, Australia.

College of Veterinary Medicine, Department of Clinical Sciences, Cornell University, Ithaca, New York.

出版信息

J Vet Emerg Crit Care (San Antonio). 2020 Nov;30(6):615-631. doi: 10.1111/vec.13010. Epub 2020 Sep 25.

Abstract

OBJECTIVE

To assess whether the clinical approach to CPR has changed following the publication of the Reassessment Campaign on Veterinary Resuscitation (RECOVER) guidelines in 2012.

DESIGN

Internet-based survey.

SETTING

Academia and referral practice.

SUBJECTS

Four hundred and ninety-one small animal veterinarians in clinical practice in the United States and Canada.

INTERVENTIONS

An internet-based survey assessing the clinical approach to small animal CPR was circulated with the assistance of veterinary professional organizations on 2 separate occasions: prior to (2008) and following (2017) publication of the 2012 (RECOVER) guidelines. Survey questions identical to both surveys solicited details of clinician approaches to CPR preparedness, basic life support (BLS), and advanced life support (ALS). Respondents were grouped into level of expertise (board-certified specialists [BCS, n = 202] and general practitioners in emergency clinics [GPE, n = 289]), and year of response to the survey (2008, n = 171; 2017, n = 320).

MEASUREMENTS AND MAIN RESULTS

Compliance with the RECOVER guidelines pertaining to CPR preparedness (P < 0.01), BLS (P < 0.01), and ALS P < 0.01) was consistently higher in respondents to the 2017 survey compared to those of the 2008 survey. Being a BCS was associated with significantly higher compliance with the RECOVER recommendations than GPE in the domains of preparedness (P = 0.02), BLS (P < 0.01), and ALS (P < 0.01). Increases in age of the respondent had a negative effect on compliance with the BLS guidelines (P < 0.01), while gender had no effect.

CONCLUSIONS

Compared to 2008, current practices in small animal CPR in the North American emergency and critical care community shifted toward those recommended in the RECOVER guidelines across all CPR domains. This supports the notion that uptake of the RECOVER guidelines among veterinary emergency or critical care clinicians was sufficient to lead to a change in the practice of CPR.

摘要

目的

评估 2012 年发布的兽医复苏再评估运动(RECOVER)指南后,心肺复苏术(CPR)的临床方法是否发生了变化。

设计

基于互联网的调查。

设置

学术机构和转诊实践。

对象

美国和加拿大临床实践中的 491 名小动物兽医。

干预措施

在兽医专业组织的协助下,分 2 次在互联网上进行了一项评估小动物 CPR 临床方法的调查:在 2012 年(RECOVER)指南发布之前(2008 年)和之后(2017 年)。两次调查均提出了相同的临床医师 CPR 准备、基础生命支持(BLS)和高级生命支持(ALS)方法的问题。根据专业知识水平(委员会认证专家[BCS,n=202]和急诊诊所的普通从业者[GPE,n=289])和对调查的回应年份(2008 年,n=171;2017 年,n=320)对受访者进行分组。

测量和主要结果

与 CPR 准备(P<0.01)、BLS(P<0.01)和 ALS(P<0.01)相关的对 RECOVER 指南的依从性在 2017 年调查的受访者中始终明显高于 2008 年调查的受访者。BCS 比 GPE 更符合 RECOVER 建议,在准备(P=0.02)、BLS(P<0.01)和 ALS(P<0.01)领域更符合 RECOVER 建议。受访者年龄的增加对 BLS 指南的依从性有负面影响(P<0.01),而性别则没有影响。

结论

与 2008 年相比,北美急救和重症监护社区中小动物 CPR 的当前实践在所有 CPR 领域都朝着 RECOVER 指南推荐的方向发展。这表明兽医急救或重症监护临床医生对 RECOVER 指南的采用足以导致 CPR 实践的改变。

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