Research Update: Functional outcome in dogs and cats surviving cardiopulmonary arrest

In this retrospective study from a veterinary teaching hospital, the records of 15 dogs and three cats surviving cardiopulmonary arrest were reviewed to describe the animals' resuscitations and outcomes. All cardiopulmonary arrests were witnessed in the hospital and were associated with anesthesia with (six animals) or without (four animals) preexisting disease, cardiovascular collapse (five animals), and chronic disease with acute stress (three animals).

Of the six patients with preexisting disease, two had neurologic abnormalities and two had pyothorax. Of the five animals with cardiovascular collapse, two had gastric dilatation-volvulus. All three of the animals with chronic diseases arrested during restraint for diagnostic procedures or treatments. The most frequent cardiopulmonary arrest rhythm was asystole (72%).

Treatments during resuscitation for cardiopulmonary arrest included intravenous crystalloids (18 animals), intravenous epinephrine (16 animals), and intravenous atropine (15 animals). Other medications the animals received included antibiotics, naloxone, lidocaine, mannitol, and dexamethasone. Thirteen animals received positive pressure ventilation for a median time of 30 minutes. Two dogs received open chest cardiopulmonary resuscitation.

A return of spontaneous circulation was noted in all the animals within 15 minutes of the onset of resuscitation. After resuscitation and extubation, six previously normal dogs had neurologic derangements, and in one of these dogs these derangements persisted for four months until the dog was euthanized. After cardiopulmonary arrest, the mean length of hospitalization was 5.1± 3.7 days with a median cost of $2,200. The authors concluded that a good functional recovery exists for witnessed cardiopulmonary arrest secondary to potentially reversible causes.

Waldrop JE, Rozanski EA, Swanke ED, et al. Causes of cardiopulmonary arrest, resuscitation management, and functional outcome in dogs and cats surviving cardiopulmonary arrest. J Vet Emerg Crit Care 2004;14:22-29.

COMMENTARY

This report documents successful resuscitation, using basic protocols, for animals with cardiopulmonary arrest during hospitalization. The normal neurologic outcome in most of the patients reported here contradicts previous publications cited by the authors and warrants further multi-institutional and specialty practice studies. Furthermore, a controlled prospective approach would validate the efficacy of resuscitation efforts and modalities used, including dosing regimens. The information on hospitalization duration and cost is also useful for clinicians, especially for those in private practice.

The information in "Research Updates" was provided by Veterinary Medicine Editorial Advisory Board member Joseph Harari, MS, DVM, DACVS, Veterinary Surgical Specalists, 21 E. Mission Ave., Spokane, WA 99202.

Joseph Harari, MS, DVM, DACVS