Peer-reviewed veterinary case report
CPR and fluid treatment effects after severe bleeding in dogs
By Jeffcoach, David R et al.·Published in The journal of trauma and acute care surgery·2016·From the University of Tennessee Medical Center (D.R.J.·View original on PubMed →
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Original publication title: Use of CPR in hemorrhagic shock, a dog model.
- Species:
- dog
Plain-English summary
A group of dogs was tested to see how well chest compressions (CPR) work in cases of severe blood loss (hemorrhagic shock). The dogs were divided into three groups: one received only CPR, another received CPR along with fluids, and the last group received fluids alone. The results showed that dogs who only received CPR had lower blood pressure and more organ damage, with two out of six dogs in that group dying. In contrast, the groups that received fluids—either alone or with CPR—did not have any deaths, suggesting that CPR may not be effective in these situations.
People also search for: dog hemorrhagic shock treatment · CPR for dogs · dog blood loss symptoms · dog fluid resuscitation · dog trauma care
Abstract
INTRODUCTION: Cardiopulmonary resuscitation was designed for sudden cardiac events usually triggered by thrombotic phenomena. Despite this, it is routinely used in trauma resuscitations as per the American Heart guidelines. There is no data supporting the use of chest compressions in hemorrhagic shock. An evidence-based cardiopulmonary resuscitation (CPR) protocol has been developed for dogs. We sought to determine the effects and outcomes of chest compressions in hemorrhagic shock in a canine model. METHODS: Eighteen dogs were randomized to three treatment groups-chest compressions only after hemorrhagic shock (CPR), CPR with fluid resuscitation after hemorrhagic shock (CPR + FLU), and fluid resuscitation alone after hemorrhagic shock (FLU). Under anesthesia, dogs were hemorrhaged until pulse was lost; they were maintained pulseless for 30 minutes and then resuscitated over 20 minutes. Vital signs and laboratory values were recorded at determined intervals. Echocardiography was performed throughout the study. Upon termination of the study, kidney, liver, heart, and brain tissue histology was evaluated for end organ damage. Statistical significance was p < 0.05 with a Bonferroni correction for multiple comparisons. RESULTS: Blood loss and mean time to loss of pulse were similar between the groups. Dogs in the CPR group had significantly lower mean arterial pressure and higher pulse at all points compared to CPR + FLU and FLU (p < 0.05). Ejection fraction was lower in the CPR group at 5 and 10 minutes compared to the other groups (p < 0.05). Vital signs and laboratory results between CPR + FLU and FLU were equivalent. Two of six dogs in the CPR group died, while no dogs died in the CPR + FLU or FLU groups. Dogs in the CPR group were found to have more episodes of end organ damage. CONCLUSION: There was no benefit to chest compressions in the hypovolemic animals. Chest compressions in addition to fluid did not reverse signs of shock better than fluid alone. Further research is needed to define if there is a role of CPR in the trauma patient with hemorrhagic shock.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/26895089/