Cardiopulmonary cerebral resuscitation in small animals—A clinical practice review. Part II

Objective: To review the principles and practice of cardiopulmonary cerebral resuscitation (CPCR) in veterinary medicine, and to incorporate recommendations from the human International Guidelines 2000 Conference on cardiopulmonary resuscitation and emergency cardiovascular care. Data sources: Both clinical and experimental studies from the human and veterinary literature were reviewed for this manuscript. Summary: Cardiopulmonary cerebral resuscitation consists of basic life support measures, advanced life support measures, and post‐resuscitation care. Part I of this article introduced the evidence‐based recommendations from human medicine and reviewed basic life support. Part II of this article reviews advanced life support, including drug therapy and electrical defibrillation based upon the electrocardiographic rhythm present at the time of cardiopulmonary arrest (CPA). Post‐resuscitation care is discussed, with a particular focus on optimizing perfusion to the brain, kidneys, and gastrointestinal tract. Several currently investigational methods that may improve future patient outcomes are also addressed. Conclusions: Advanced life support techniques provide methods to augment CPCR efforts. As with basic life support, recent recommendations to improve advanced life support in humans may be also be applied to veterinary patients. However, clinical research evaluating these interventions in veterinary CPCR is necessary. Post‐resuscitation care requires vigilant monitoring and aggressive support to ensure vital organ perfusion and maximize patient outcomes.