心肺复苏的犬猫初始及后续可电击心脏骤停节律的患病率、相关因素及其与患者预后的关联：一项RECOVER注册研究
Prevalence and factors associated with initial and subsequent shockable cardiac arrest rhythms and their association with patient outcomes in dogs and cats undergoing cardiopulmonary resuscitation: A RECOVER registry study.
作者信息
Vega Suarez Laura, Epstein Steven E, Martin Linda G, Davidow Elizabeth B, Hoehne Sabrina N
机构信息
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington, USA.
Department of Veterinary Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, California, USA.
出版信息
J Vet Emerg Crit Care (San Antonio). 2023 Sep-Oct;33(5):520-533. doi: 10.1111/vec.13320. Epub 2023 Aug 12.
OBJECTIVE
To report the prevalence of initial shockable cardiac arrest rhythms (I-SHKR), incidence of subsequent shockable cardiac arrest rhythms (S-SHKR), and factors associated with I-SHKRs and S-SHKRs and explore their association with return of spontaneous circulation (ROSC) rates in dogs and cats undergoing CPR.
DESIGN
Multi-institutional prospective case series from 2016 to 2021, retrospectively analyzed.
SETTING
Eight university and eight private practice veterinary hospitals.
ANIMALS
A total of 457 dogs and 170 cats with recorded cardiac arrest rhythm and event outcome reported in the Reassessment Campaign on Veterinary Resuscitation CPR registry.
MEASUREMENTS AND MAIN RESULTS
Logistic regression was used to evaluate association of animal, hospital, and arrest variables with I-SHKRs and S-SHKRs and with patient outcomes. Odds ratios (ORs) were generated, and significance was set at P < 0.05. Of 627 animals included, 28 (4%) had I-SHKRs. Odds for I-SHKRs were significantly higher in animals with a metabolic cause of arrest (OR 7.61) and that received lidocaine (OR 17.50) or amiodarone (OR 21.22) and significantly lower in animals experiencing arrest during daytime hours (OR 0.22), in the ICU (OR 0.27), in the emergency room (OR 0.13), and out of hospital (OR 0.18) and that received epinephrine (OR 0.19). Of 599 initial nonshockable rhythms, 74 (12%) developed S-SHKRs. Odds for S-SHKRs were significantly higher in animals with higher body weight (OR 1.03), hemorrhage (OR 2.85), or intracranial cause of arrest (OR 3.73) and that received epinephrine (OR 11.36) or lidocaine (OR 18.72) and significantly decreased in those arresting in ICU (OR 0.27), emergency room (OR 0.29), and out of hospital (OR 0.38). Overall, 171 (27%) animals achieved ROSC, 81 (13%) achieved sustained ROSC, and 15 (2%) survived. Neither I-SHKRs nor S-SHKRs were significantly associated with ROSC.
CONCLUSIONS
I-SHKRs and S-SHKRs occur infrequently in dogs and cats undergoing CPR and are not associated with increased ROSC rates.
目的
报告初始可电击心脏骤停节律（I-SHKR）的发生率、后续可电击心脏骤停节律（S-SHKR）的发生率，以及与I-SHKR和S-SHKR相关的因素，并探讨它们与接受心肺复苏（CPR）的犬猫自主循环恢复（ROSC）率的关联。
设计
2016年至2021年多机构前瞻性病例系列研究，进行回顾性分析。
地点
8所大学和8所私人执业兽医医院。
动物
在兽医复苏CPR重新评估运动登记处记录了心脏骤停节律和事件结果的457只犬和170只猫。
测量和主要结果
采用逻辑回归评估动物、医院和心脏骤停变量与I-SHKR和S-SHKR以及患者结局的关联。生成比值比（OR），显著性设定为P<0.05。在纳入的627只动物中，28只（4%）有I-SHKR。因代谢原因导致心脏骤停的动物（OR 7.61）、接受利多卡因（OR 17.50）或胺碘酮（OR 21.22）的动物发生I-SHKR的几率显著更高，而在白天发生心脏骤停的动物（OR 0.22）、在重症监护病房（ICU）（OR 0.27）、在急诊室（OR 0.13）以及院外（OR 0.18）发生心脏骤停且接受肾上腺素的动物（OR 0.19）发生I-SHKR的几率显著更低。在599例初始不可电击节律中，74例（12%）发展为S-SHKR。体重较高（OR 1.03）、有出血（OR 2.85）或因颅内原因导致心脏骤停（OR 3.73）以及接受肾上腺素（OR 11.36）或利多卡因（OR 18.72）的动物发生S-SHKR的几率显著更高，而在ICU（OR 0.27）、急诊室（OR 0.29）以及院外（OR 0.38）发生心脏骤停的动物发生S-SHKR 的几率显著降低。总体而言，171只（27%）动物实现了ROSC，81只（13%）实现了持续ROSC，15只（2%）存活。I-SHKR和S-SHKR均与ROSC无显著关联。
结论
接受CPR的犬猫中I-SHKR和S-SHKR发生率较低，且与ROSC率升高无关。
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