Current developments in c ar diopulmonary resuscitation

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.