To investigate the association of point-of-care biochemical variables obtained during CPR or within 24 hours of return of spontaneous circulation (ROSC) with patient outcomes.
University teaching hospital.
Ninety-four dogs and 27 cats undergoing CPR according to the Reassessment Campaign on Veterinary Resuscitation guidelines.
Measurements and Main Results
Blood gas, acid–base, electrolyte, glucose, and plasma lactate values obtained during CPR or within 24 hours of ROSC were retrospectively evaluated and are described. The blood sample type and collection time with respect to CPR initiation and ROSC were recorded. Measured variables, collection times, and species were included in a multivariable logistic regression model to estimate the odds ratio (OR) and 95% confidence interval of ROSC, sustained ROSC (≥20 min), and survival to hospital discharge. Significance was set at P < 0.05. Seventy-two venous blood samples obtained during CPR and 45 first venous and arterial blood samples obtained after ROSC were included in logistic regression analysis. During CPR, PvO2 (1.09 [1.036–1.148], P = 0.001) and venous standard base excess (SBE) (1.207 [1.094–1.331], P < 0.001) were associated with ROSC. PvO2 (1.075 [1.028–1.124], P = 0.002), SBE (1.171 [1.013–1.353], P = 0.032), and potassium concentration (0.635 [0.426–0.946], P = 0.026) were associated with sustained ROSC. Potassium concentration (0.235 [0.083–0.667], P = 0.007) was associated with survival to hospital discharge. Following ROSC, pH (69.110 [4.393–1087], P = 0.003), potassium concentration (0.222 [0.071–0.700], P = 0.010), and chloride concentration (0.805 [0.694–0.933], P = 0.004) were associated with survival to hospital discharge.
Biochemical variables such as PvO2, SBE, and potassium concentration during CPR and pH, potassium, and chloride concentration in the postarrest period may help identify dogs and cats with lower odds for ROSC or survival to hospital discharge following CPR.
Journal of Veterinary Emergency and Critical Care, EarlyView.Wiley: Journal of Veterinary Emergency and Critical Care: Table of Contents