Peer-reviewed veterinary case report
Shockable heart rhythms during CPR in dogs and cats and outcomes
By Vega Suarez, Laura et al.·Published in Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)·2023·Department of Veterinary Clinical Sciences, United States·View original on PubMed →
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Original publication title: 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.
Plain-English summary
A study looked at 627 dogs and cats that experienced cardiac arrest and underwent CPR to see how often they had shockable heart rhythms and what factors influenced their chances of survival. Only 4% had an initial shockable rhythm, and 12% of those with non-shockable rhythms developed a shockable rhythm later. Factors like receiving certain medications (lidocaine or epinephrine) increased the chances of developing a shockable rhythm, while being in a hospital setting decreased those chances. In the end, about 27% of the animals regained circulation, but only 2% survived long-term, showing that shockable rhythms are rare and don’t necessarily lead to better outcomes.
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Abstract
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.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/37573256/