Post–Cardiac Arrest Care

Successful prolonged cardiopulmonary resuscitation in a Siamese cat: A case of post‐cardiac arrest concerns

“…Hofmeister et al reported hypoxaemia (36%), shock (18%), anaemia (13%), arrhythmia (8%), MODS (6%), traumatic brain injury (5%), anaphylaxis (1%) or other (21%) are causes of CPA 2 . Precipitating pathologies will most liking persist during ROSC and could influence the PCA care and prognosis 9 . The inciting cause in both CPA events in this case was never determined.…”

“…CPR, being one of the most commonly encountered emergencies in a veterinary field (in and out of hospital setting), has numerous aspects that need to be considered and addressed. Veterinary CPR has evolved quite substantially in the last couple of years, and evidence‐based guidelines have been developed to assist in increasing the rate of survived event and rate to discharge 1,9,10 . The major considerations, concerns and pitfalls are highlighted, looking especially at prolonged CPR, causes of CPA, equipment utilised, why rearrests occur, and the PCA care period is discussed.…”

“…More astute monitoring during the PCA period could have revealed possible indications for recurrence of CPA. Immediately after ROSC, attention should be directed at prevention of recurrence of CPA and limitation of organ injury that is reperfusion injury and ischaemia, PCA brain injury and myocardial dysfunction and persistent precipitating pathological processes 9 …”

“…Treatment of the underlying disease processes, prognostication and rehabilitation are emphasised in later care. Boller and Fletcher described two paradigms of care for the PCA period: 9 the pathophysiological process that occur post‐resuscitation and 10 a shift in treatment prioritisation as time after ROSC progresses. Vigilant PCA monitoring started to deteriorate under the assumption the animal became more stable, which could also have been the downfall.…”

Hydrocortisone therapy in a cat with vasopressor‐refractory septic shock and suspected critical illness‐related corticosteroid insufficiency

“…Although different hydrocortisone treatment regimens have been reported in both veterinary and human medicine , the ultimate goal of therapy is to provide doses of hydrocortisone adequate for the needs of the patient. The cat in the present report was treated with a dose suggested in both human and veterinary literature , as evidence‐based therapeutic guidelines for cats are lacking.…”