共查询到20条相似文献，搜索用时 15 毫秒
1.
2.
Erik H. Hofmeister DVM Brian F. Thompson MS Benjamin M. Brainard VMD DACVECC DACVA Samantha Kegge DVM Stephanie Kube DVM DACVIM Christine M. Egger DVM MVSc DACVA CVA Carl Jehn DVM Brad Green DVM 《Journal of Veterinary Emergency and Critical Care》2008,18(2):142-152
Objective: To document the clinical practice of cardiopulmonary–cerebral resuscitation (CPCR) among academic veterinarians. Design: Survey. Setting: Eight colleges of veterinary medicine in the United States. Subjects: Two hundred and one academic veterinarians. Interventions: The survey was distributed by hand by the authors into the mailboxes of small animal faculty, residents, and interns. Demographic variables, questions regarding number of cardiopulmonary arrests (CPA) supervised and number successful, do not attempt resuscitation discussions, and Likert‐style questions about client presence during CPCR, appropriateness of CPCR, and CPCR decision‐making were included. Multiple linear regression models were constructed to determine the effect of multiple questions on different target variables of interest. Measurements and main results: Numerous differences were noted based on institution, gender, specialty, and position. Most institutions did not have a standard resuscitation consent form. Most respondents believed the client, house officer, and senior clinician should determine whether to perform resuscitation or not. Quality of life was the most significant determinant of whether to resuscitate or not, followed by long‐term prognosis, then short‐term prognosis. Conclusions: Veterinarians differ in many aspects of their approach to CPA and resuscitation. Creating consensus within the veterinary profession would benefit client service and patient care. 相似文献
3.
Manuel Boller Dr med vet MTR DACVECC Lindsay Kellett‐Gregory BSc BVetMed Frances S. Shofer PhD Mark Rishniw BVSc MS PhD DACVIM 《Journal of Veterinary Emergency and Critical Care》2010,20(6):558-570
Objective – To characterize the provision of CPCR by small animal veterinarians in clinical practice and to assess how this practice varies among different levels of expertise. Design – Internet‐based survey. Setting – Academia, referral practice, and general practice. Subjects – Six hundred and two small animal veterinarians in clinical practice. Respondents were grouped a priori according to level of expertise: board‐certified (ACVECC, ACVA, ECVAA) specialists; general practitioners in emergency clinics; general practitioners in general practice (GPG). Interventions – Email invitations to the online questionnaire were disseminated via a veterinary internet platform and mailing list server discussion groups. Questions explored respondent characteristics, CPCR preparedness, infrastructural and personnel resources, and techniques of basic and advanced life support. Main Results – In this group of practitioners, the majority (65%) were in general practice. GPG were more likely to perform CPCR <5 times per year and to have 3 or fewer members on their resuscitation team. Most practitioners have a crash cart and drug‐dosing chart available. GPG were less likely to obtain resuscitation codes on their patients, and less likely to use end‐tidal carbon dioxide monitoring or defibrillation. Intubation, oxygen supplementation, vascular access, and external thoracic compressions were widely used, however, GPG were more likely to use lower chest compression rates. Drugs used for CPCR differed among the groups with GPG more likely to use doxapram and glucocorticoids. Conclusions – CPCR is heterogeneously performed in small animal veterinary medicine; differences exist, both among and within different types of veterinarians with varying levels of expertise, in respect to available infrastructure, personnel and CPCR techniques used. 相似文献
4.
Plunkett SJ McMichael M 《Journal of veterinary internal medicine / American College of Veterinary Internal Medicine》2008,22(1):9-25
In December 2005, the American Heart Association published new guidelines for cardiopulmonary cerebral resuscitation (CPCR) in humans for the 1st time in 5 years. Many of the recommendations are based on research conducted in animal species and may be applicable to small animal veterinary patients. One important change that may impact how CPCR is performed in veterinary medicine is the recommendation to avoid administration of excessive ventilatory rates because this maneuver severely decreases myocardial and cerebral perfusion, decreasing the chance of survival. The new guidelines also emphasize the importance of providing well-executed, continuous, uninterrupted chest compressions. Interruption of chest compressions should be avoided and, if necessary, should be minimized to <10 seconds. During defibrillation, immediate resumption of chest compressions for 2 minutes after a single shock, before reassessment of the rhythm by ECG, is recommended. This recommendation replaces previous recommendations for the delivery of 3 defibrillatory shocks in rapid succession. Allowing permissive hypothermia postresuscitation has been found to be beneficial and may increase success rate. Medications utilized in cardiopulmonary resuscitation, including amiodarone, atropine, epinephrine, lidocaine, and vasopressin, along with the indications, effects, routes of administration, and dosages, are discussed. The application of the new guidelines to veterinary medicine as well as a review of cardiopulmonary resuscitation in small animals is provided. 相似文献
5.
Megan B. Seekins DVM Adam J. Reiss DVM DACVECC 《Journal of Veterinary Emergency and Critical Care》2011,21(3):187-192
Objective – To review the use of impedance threshold devices (ITD) during CPCR, their proposed mechanism of action, and their application in veterinary medicine. Data Sources – Data sources include scientific reviews and original research publications using the PubMed search engine with the following keywords: ‘impedance threshold device’ and ‘resuscitation’ and the Veterinary Information Network search function using the keywords ‘impedance threshold device.’ Human Data Synthesis – Studies in human medicine have demonstrated that the use of an ITD during CPCR in patients during out‐of‐hospital cardiac arrest improves coronary perfusion pressure and cerebral perfusion pressure. This improvement in vital organ blood flow results in increased cardiac output and faster return of spontaneous circulation. The use of an ITD has been studied in people and currently holds a class IIb level of recommendation according to the 2010 American Heart Association Guidelines for CPR and Emergency Cardiovascular Care. This device is recommended as a way to improve hemodynamics during CPCR by enhancing venous return and avoiding hyperventilation, thereby increasing the likelihood of a successful resuscitation. Veterinary Data Synthesis – Multiple controlled studies using pigs with ventricular fibrillation induced cardiopulmonary arrest have demonstrated increased myocardial and cerebral perfusion with the use of an ITD. These studies have emphasized the importance of decreasing intrathoracic pressures during the decompression phase of CPCR and avoiding hyperventilation in order to maximize vital organ blood flow. Conclusions – Use of an ITD during CPCR in human and animal studies has demonstrated improved vital organ perfusion and faster return of spontaneous circulation. However, the majority of these studies have been carried out in people during out‐of‐hospital cardiac arrest and ventricular fibrillation cardiopulmonary arrest pig models. Further studies evaluating the use of an ITD during CPCR in the veterinary hospital setting are warranted. 相似文献
6.
7.
《Clinical Techniques in Equine Practice》2003,2(1):9-19
Cardiovascular or pulmonary system failure in neonatal foals requires rapid recognition and initiation of cardiopulmonary cerebral resuscitation (CPCR). Foals may require resuscitation immediately after birth or after arrest from progression of a disease process such as severe sepsis or septic shock. Initial treatment is aimed at establishing an airway and providing ventilation. Circulation is provided by closed-chest compressions. Circulatory access is important to provide intravenous fluid and pharmacologic therapy for cardiovascular support. Ventricular fibrillation and pulseless ventricular tachycardia are arrhythmias not commonly recognized with arrest in foals, whereas asystole and cardiovascular collapse are frequently encountered. Training of personnel, preparation of supplies, and organization during CPCR is essential to a successful outcome.Most of the information used for CPCR in neonatal foals is derived from human medical research and clinical medicine. As new advances are made in human neonatal and pediatric CPCR, many of these treatments and techniques can be applied to foals. This article reviews currently available CPCR guidelines in foals and highlights new perspectives in human medicine that may be applicable to foals. 相似文献
8.
Rieser TM 《Clinical Techniques in Small Animal Practice》2000,15(2):76-81
Cardiopulmonary resuscitation (CPR) is a technique used in both human and veterinary medicine. Although a number of innovative adaptations to CPR have been researched, the mainstay of CPR remains intubation, adequate ventilation, chest compressions, and basic drug therapy. The purpose of this article is to review the techniques and drugs commonly used in both closed chest and open chest CPR. 相似文献
9.
L. E. Young 《The Journal of small animal practice》1992,33(3):138-145
As veterinary surgeons, we must all deal, on occasion, with an animal who has suffered a cardiac arrest. This article reviews the recent literature concerning cardiopulmonary resuscitation (CPR) and examines the suggestions recently put forward by the American Heart Association in their improved resuscitation protocol. These protocol modifications have been shown experimentally and clinically to improve cerebral and myocardial haemodynamics during closed chest cardiac massage. The ultimate goal of CPR must be not merely to resuscitate the patient in the short term, but to promote complete neurological recovery in the longer term. Prompt recognition of cardiac arrest and the immediate initiation of resuscitative measures play a major contributing role in a favourable neurological outcome. In addition to the familiar ABC system of basic cardiac life support, the use of a high dose adrenaline (0–2 mg/kg) is proposed as the best first line drug treatment in the arrested patient. This can be accompanied by abdominal wrapping and synchronous ventilation and chest compressions to optimise cerebral and myocardial blood flow. Calcium chloride and sodium bicarbonate should no longer be included in the early resuscitative efforts. 相似文献
10.
Alberto L. Fernandez DVM Justine A. Lee DVM DACVECC Louisa Rahilly DVM DACVECC Lynn Hovda DVM RPH MS DACVIM Ahna G. Brutlag DVM MS Kristin Engebretsen PharmD DABAT 《Journal of Veterinary Emergency and Critical Care》2011,21(4):309-320
Objective – To review the use of IV lipid emulsion (ILE) for the treatment of toxicities related to fat‐soluble agents; evaluate current human and veterinary literature; and to provide proposed guidelines for the use of this emerging therapy in veterinary medicine and toxicology. Data Sources – Human and veterinary medical literature. Human Data Synthesis – Human data are composed mostly of case reports describing the response to treatment with ILE as variant from mild improvement to complete resolution of clinical signs, which is suspected to be due to the variability of lipid solubility of the drugs. The use of ILE therapy has been advocated as an antidote in cases of local anesthetic and other lipophilic drug toxicoses, particularly in the face of cardiopulmonary arrest and unsuccessful cardiopulmonary cerebral resuscitation. Veterinary Data Synthesis – The use of ILE therapy in veterinary medicine has recently been advocated by animal poison control centers for toxicoses associated with fat‐soluble agents, but there are only few clinical reports documenting successful use of this therapy. Evidence for the use of ILE in both human and veterinary medicine is composed primarily from experimental animal data. Conclusions – The use of ILE appears to be a safe therapy for the poisoned animal patient, but is warranted only with certain toxicoses. Adverse events associated with ILE in veterinary medicine are rare and anecdotal. Standard resuscitation protocols should be exhausted before considering this therapy and the potential side effects should be evaluated before administration of ILE as a potential antidote in cases of lipophilic drug toxicoses. Further research is waranted. 相似文献
11.
Richard D. Scroggin Jr. DVM DACVIM Jane Quandt MS DVM DACVA DACVECC 《Journal of Veterinary Emergency and Critical Care》2009,19(2):145-157
Objective – To discuss 3 potential mechanisms for loss of peripheral vasomotor tone during vasodilatory shock; review vasopressin physiology; review the available animal experimental and human clinical studies of vasopressin in vasodilatory shock and cardiopulmonary arrest; and make recommendations based on review of the data for the use of vasopressin in vasodilatory shock and cardiopulmonary arrest. Data Sources – Human clinical studies, veterinary experimental studies, forum proceedings, book chapters, and American Heart Association guidelines. Human and Veterinary Data Synthesis – Septic shock is the most common form of vasodilatory shock. The exogenous administration of vasopressin in animal models of fluid‐resuscitated septic and hemorrhagic shock significantly increases mean arterial pressure and improves survival. The effect of vasopressin on return to spontaneous circulation, initial cardiac rhythm, and survival compared with epinephrine is mixed. Improved survival in human patients with ventricular fibrillation, pulseless ventricular tachycardia, and nonspecific cardiopulmonary arrest has been observed in 4 small studies of vasopressin versus epinephrine. Three large studies, though, did not find a significant difference between vasopressin and epinephrine in patients with cardiopulmonary arrest regardless of initial cardiac rhythm. No veterinary clinical trials have been performed using vasopressin in cardiopulmonary arrest. Conclusion – Vasopressin (0.01–0.04 U/min, IV) should be considered in small animal veterinary patients with vasodilatory shock that is unresponsive to fluid resuscitation and catecholamine (dobutamine, dopamine, and norepinephrine) administration. Vasopressin (0.2–0.8 U/kg, IV once) administration during cardiopulmonary resuscitation in small animal veterinary patients with pulseless electrical activity or ventricular asystole may be beneficial for myocardial and cerebral blood flow. 相似文献
12.
Objectives – To introduce the basic equipment necessary to perform interventional radiology (IR) techniques in the veterinary setting, particularly those procedures of interest to the criticalist. Data Sources – Veterinary and human literature as well as author's experience. Human Data Synthesis – Since the 1950s, diagnostic angiography has played an important role in human medicine. However, over the last 2–3 decades, this once purely diagnostic modality has become a subspecialty in human medicine with vast applications throughout the body. These techniques have replaced more invasive surgeries as the standard‐of‐care in many circumstances. Veterinary Data Synthesis – Although comparable data are not available in the veterinary literature, many IR and interventional endoscopy techniques are poised to replace more invasive procedures in veterinary medicine. In addition, these techniques have already been shown to offer treatment options for patients in whom more traditional therapies have failed, have been declined, or are not indicated due to comorbidities or substantial risk to patient health. Conclusions – Like our human medical counterparts, the use of IR techniques will likely play and increasingly important role in the care of veterinary patients. With this in mind, it is important to become familiar with both the equipment used in these techniques as well as their applications both currently in clinical cases and in the near future. 相似文献
13.
Causes of cardiopulmonary arrest, resuscitation management, and functional outcome in dogs and cats surviving cardiopulmonary arrest 总被引：1，自引：0，他引：1
Jennifer E. Waldrop DVM DACVECC Elizabeth A. Rozanski DVM DACVECC DACVIM Erica D. Swanke DVM Therese E. O'Toole DVM John E. Rush DVM MS DACVECC DACVIM 《Journal of Veterinary Emergency and Critical Care》2004,14(1):22-29
Objective: To describe the functional outcome of canine and feline survivors of cardiopulmonary arrest (CPA) and the clinical characteristics surrounding their resuscitation. Design: Retrospective study. Setting: Veterinary teaching hospital. Animals: Client‐owned dogs (15) and cats (3) with CPA. Interventions: None. Measurements and main results: Eighteen animals were identified to have survived to discharge following CPA. Cardiopulmonary arrest was associated with anesthesia with or without pre‐existing disease in 10 animals, cardiovascular collapse in 5 animals, and chronic disease with an imposed stress in 3 animals. All CPAs were witnessed in the hospital. The most common initial rhythm at CPA was asystole (72%). Return of spontaneous circulation (ROSC) was achieved in less than 15 minutes from the onset of cardiopulmonary cerebral resuscitation (CPCR) in all animals. No animals had a recurrence of CPA after the initial CPA. Animals were of a wide range of ages (0.5–16 years) and breeds. Two animals were neurologically abnormal at discharge, one of which was normal at 2 months following CPA. Conclusions: A good functional recovery after CPCR was documented in the small number of CPA survivors presented in this study. This may be due to the reversible nature of their inciting cause of CPA, early detections of CPA (‘witnessed’), and/or the animal's underlying normal health status. 相似文献
14.
W E Wingfield D R Van Pelt 《Journal of the American Veterinary Medical Association》1992,200(12):1993-1996
Outcomes of cardiopulmonary arrest and resuscitation in clinically affected dogs and cats have not been adequately studied. We examined the records from 200 dogs and 65 cats that had received cardiopulmonary resuscitation for respiratory or cardiopulmonary arrest; none of the animals had been anesthetized or intubated at the time of arrest, and all had been hospitalized in a veterinary critical care facility. Cardiopulmonary arrest was found to be more common than respiratory arrest in dogs and cats. Hospital discharge rates for animals with cardiopulmonary arrest ranged from 4.1% for dogs to 9.6% for cats, and were consistent with those reported from studies of human beings with cardiopulmonary arrest. Hospital discharge rates for dogs and cats with respiratory arrest were 28% and 58.3%, respectively. 相似文献
15.
Yonaira E. Cortés DVM Jennifer L. Holm DVM DACVECC 《Journal of Veterinary Emergency and Critical Care》2008,18(2):165-169
Objective: To describe the clinical manifestations and successful outcome following an inadvertent overdose of ketamine to a cat. Case summary: A 4‐year‐old neutered male domestic shorthair cat was evaluated for a urethral obstruction. Because of an inadvertent miscalculation of ketamine, 20 times the intended dose was administered intravenously, which resulted in cardiopulmonary arrest. Cardiopulmonary‐cerebral resuscitation was successful, and short‐term mechanical ventilation, fluids and intensive monitoring were utilized to achieve full recovery and subsequent discharge of the animal. New or unique information provided: Ketamine is a common anesthetic agent used in cats that is considered to have a wide therapeutic index and minimal cardiopulmonary depressant effects at recommended doses. Successful management of inadvertent ketamine overdose has been reported in children, but not in cats. Prompt CPCR and short‐term mechanical ventilation may be necessary to treat a significant ketamine overdose. In cats, yohimbine may act as a partial antagonist of ketamine. 相似文献
16.
Computerised decision support is of emerging and increasing importance in human medicine, but as yet has not been thoroughly applied or evaluated in veterinary medicine. In this essay, the authors report on the first example of a veterinary care pathway, a specific form of computerised decision support, which guides clinicians through a clinical workflow and incorporates individual patient data to inform patient-specific decision recommendations. The veterinary care pathway was designed using consensus statements and specialist neurologist opinion to create a decision support tool concerning canine idiopathic epilepsy. The authors evaluated the care pathway by comparing 35 clinical decisions made by referral clinicians in historical cases of idiopathic epilepsy to decisions recommended by the care pathway when presented with the same clinical case. Their results show that in 77.1% (95% confidence interval [59.9, 89.6]) of cases the care pathway recommended a decision that was the same or similar to a specialist neurologist's decision. Whilst further studies are needed to explore the potential use of such technology in clinical practice, the authors believe this first application provides great promise of a new and alternative method of clinical decision support. 相似文献
17.
Sarah A. Wiechert-Brown Stefano Di Concetto Kate L. Hepworth-Warren Stacie M. Madson David M. Wong 《Equine Veterinary Education》2023,35(2):e77-e85
A 10-h-old 56-kg Thoroughbred filly was presented for treatment of partial failure of passive transfer of immunity and presumed neonatal maladjustment syndrome (NMS). The filly was hospitalised, and supportive care initiated. On Day 5 of hospitalisation, seizures were observed and were controlled with IV administration of diazepam. Due to progression of clinical signs of NMS, magnetic resonance imaging of the filly's brain was performed. During the early anaesthetic recovery period, the filly exhibited cardiopulmonary arrest (CPA) at which point cardiopulmonary cerebral resuscitation (CPCR) was performed for a total of 48 min. During this time, ventricular fibrillation (VF) was observed on ECG and the filly was defibrillated three times at 1–2-min intervals using 2–4 J/kg of monophasic electrical defibrillation. The filly successfully recovered from CPCR, was discharged 5 days later and was reported healthy 12 months post-discharge. 相似文献
18.
Lucas Pantaleon 《Journal of veterinary internal medicine / American College of Veterinary Internal Medicine》2019,33(2):356-362
A new strategy has been introduced in human health care, namely, achieving the best outcomes for the lowest cost and thus maximizing value for patients. In value‐based care, the only true measures of quality are the outcomes that matter to patients. When outcomes are measured and reported, it fosters improvement and adoption of best practices, thus further improving outcomes. Understanding outcomes is central in providing value and represents an opportunity for redefining veterinary patient care. Value is created by improving the outcomes of patients with a particular clinical condition over the full cycle of care, which normally involves multiple specialties and care sites. To be successful, a key aspect of value based care is working as teams (integrated practice units) centered around the patient's clinical condition. As veterinary medicine has become more specialized and more complex, multidisciplinary communication and trust among the care team are paramount in providing value to patients (and clients). Use of patient‐reported outcomes is an essential aspect for improving clinical care, because it enhances the connections among doctors and with patients. Designing and implementing owner‐reported outcomes in veterinary clinical practice will lead to an understanding of the effects of treatments on outcomes and quality of life (QOL) of our patients from the owner's perspective, a key way to assess a veterinary patient's QOL. 相似文献
19.
Cardiopulmonary cerebral resuscitation. 总被引：1，自引：0，他引：1
T B Hackett 《Veterinary Clinics of North America: Small Animal Practice》2001,31(6):1253-64, vii
Cardiopulmonary arrest (CPA) is defined as the abrupt and unexpected cessation of spontaneous and effective ventilation and circulation. CPA can be the natural ending of a normal and long life; however, when CPA is the result of a reversible problem in an animal that has a treatable medical condition, rapid recognition and treatment may make the difference between a happy ending and premature death. Cardiopulmonary resuscitation provides artificial ventilation and circulation until advanced cardiac life support can be provided and spontaneous cardiopulmonary function is restored. The term cardiopulmonary cerebral resuscitation originated in the early 1960s in recognition of the severe central nervous system complications of prolonged cardiac arrest in human beings. Although neurologic complications of CPA may not be as noticeable in companion animals, newer brain-sparing strategies that recognize the consequences of reperfusion injury and the inflammatory cascade may some day offer improved survival. 相似文献
20.
Vandeweerd JM Kirschvink N Clegg P Vandenput S Gustin P Saegerman C 《Veterinary journal (London, England : 1997)》2012,191(1):28-34
Evidence-based medicine (EBM) refers to the conscientious, explicit and judicious use of current best evidence from research for the care of an individual patient. The concept of EBM was first described in human medicine in the early 1990s and was introduced to veterinary medicine 10 years later. However, it is not clear that the EBM approach promulgated in human medicine can be applied to the same extent to veterinary medicine. EBM has the potential to help veterinarians to make more informed decisions, but obstacles to the implementation of EBM include a lack of high quality patient-centred research, the need for basic understanding of clinical epidemiology by veterinarians, the absence of adequate searching techniques and accessibility to scientific data bases and the inadequacy of EBM tools that can be applied to the busy daily practise of veterinarians. This review describes the development of EBM in the veterinary profession, identifies its advantages and disadvantages and discusses whether and how veterinary surgeons should further adopt the EBM approach of human medicine. 相似文献