Abstract：
OBJECTIVE: To systematically review evidence on and devise treatment recommendations for patient monitoring before, during, and following CPR in dogs and cats, and to identify critical knowledge gaps.
METHODS: Standardized, systematic evaluation of literature pertinent to peri-CPR monitoring following Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Prioritized questions were each reviewed by Evidence Evaluators, and findings were reconciled by Monitoring Domain Chairs and Reassessment Campaign on Veterinary Resuscitation (RECOVER) Co-Chairs to arrive at treatment recommendations commensurate to quality of evidence, risk:benefit relationship, and clinical feasibility. This process was implemented using an Evidence Profile Worksheet for each question that included an introduction, consensus on science, treatment recommendations, justification for these recommendations, and important knowledge gaps. A draft of these worksheets was distributed to veterinary professionals for comment for 4 weeks prior to finalization.
METHODS: Transdisciplinary, international collaboration in university, specialty, and emergency practice.
RESULTS: Thirteen questions pertaining to hemodynamic, respiratory, and metabolic monitoring practices for identification of cardiopulmonary arrest, quality of CPR, and postcardiac arrest care were examined, and 24 treatment recommendations were formulated. Of these, 5 recommendations pertained to aspects of end-tidal CO2 (ETco2) measurement. The recommendations were founded predominantly on very low quality of evidence, with some based on expert opinion.
CONCLUSIONS: The Monitoring Domain authors continue to support initiation of chest compressions without pulse palpation. We recommend multimodal monitoring of patients at risk of cardiopulmonary arrest, at risk of re-arrest, or under general anesthesia. This report highlights the utility of ETco2 monitoring to verify correct intubation, identify return of spontaneous circulation, evaluate quality of CPR, and guide basic life support measures. Treatment recommendations further suggest intra-arrest evaluation of electrolytes (ie, potassium and calcium), as these may inform outcome-relevant interventions.
METHODS: Standardized, systematic evaluation of literature pertinent to peri-CPR monitoring following Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Prioritized questions were each reviewed by Evidence Evaluators, and findings were reconciled by Monitoring Domain Chairs and Reassessment Campaign on Veterinary Resuscitation (RECOVER) Co-Chairs to arrive at treatment recommendations commensurate to quality of evidence, risk:benefit relationship, and clinical feasibility. This process was implemented using an Evidence Profile Worksheet for each question that included an introduction, consensus on science, treatment recommendations, justification for these recommendations, and important knowledge gaps. A draft of these worksheets was distributed to veterinary professionals for comment for 4 weeks prior to finalization.
METHODS: Transdisciplinary, international collaboration in university, specialty, and emergency practice.
RESULTS: Thirteen questions pertaining to hemodynamic, respiratory, and metabolic monitoring practices for identification of cardiopulmonary arrest, quality of CPR, and postcardiac arrest care were examined, and 24 treatment recommendations were formulated. Of these, 5 recommendations pertained to aspects of end-tidal CO2 (ETco2) measurement. The recommendations were founded predominantly on very low quality of evidence, with some based on expert opinion.
CONCLUSIONS: The Monitoring Domain authors continue to support initiation of chest compressions without pulse palpation. We recommend multimodal monitoring of patients at risk of cardiopulmonary arrest, at risk of re-arrest, or under general anesthesia. This report highlights the utility of ETco2 monitoring to verify correct intubation, identify return of spontaneous circulation, evaluate quality of CPR, and guide basic life support measures. Treatment recommendations further suggest intra-arrest evaluation of electrolytes (ie, potassium and calcium), as these may inform outcome-relevant interventions.
摘要：
目的：系统审查证据，并制定治疗建议，用于患者监测之前，during,在狗和猫身上进行心肺复苏后，并确定关键的知识差距。
方法：标准化，在建议分级后，对与心肺复苏前后监测相关的文献进行系统评估，评估,发展,和评估(等级)方法。优先考虑的问题均由证据评估人员进行审查，监测领域主席和兽医复苏再评估运动（RECOVER）联合主席对调查结果进行了协调，以得出与证据质量相称的治疗建议，风险：利益关系，和临床可行性。此过程是使用证据概况工作表对每个问题实施的，其中包括介绍，关于科学的共识，治疗建议,这些建议的理由，和重要的知识差距。在定稿之前，这些工作表的草稿已分发给兽医专业人员以征求意见4周。
方法：跨学科，大学国际合作，专业,应急实践。
结果：关于血液动力学的十三个问题，呼吸,以及用于识别心肺骤停的代谢监测实践，CPR质量,并检查了心脏骤停后的护理，并制定了24项治疗建议。其中,5个建议涉及潮气末CO2（ETco2）测量的方面。这些建议主要基于非常低的证据质量，有些是基于专家的意见。
结论：监测领域的作者继续支持在没有脉搏触诊的情况下开始胸部按压。我们建议对有心肺骤停风险的患者进行多模式监测，有再次被捕的危险,或全身麻醉。本报告重点介绍了ETco2监测在验证正确插管方面的实用性，确定自发循环的返回，评估心肺复苏的质量，指导基本生命支持措施。治疗建议进一步建议对电解质进行阻滞内评估（即，钾和钙)，因为这些可能为结果相关的干预提供信息。
方法：标准化，在建议分级后，对与心肺复苏前后监测相关的文献进行系统评估，评估,发展,和评估(等级)方法。优先考虑的问题均由证据评估人员进行审查，监测领域主席和兽医复苏再评估运动（RECOVER）联合主席对调查结果进行了协调，以得出与证据质量相称的治疗建议，风险：利益关系，和临床可行性。此过程是使用证据概况工作表对每个问题实施的，其中包括介绍，关于科学的共识，治疗建议,这些建议的理由，和重要的知识差距。在定稿之前，这些工作表的草稿已分发给兽医专业人员以征求意见4周。
方法：跨学科，大学国际合作，专业,应急实践。
结果：关于血液动力学的十三个问题，呼吸,以及用于识别心肺骤停的代谢监测实践，CPR质量,并检查了心脏骤停后的护理，并制定了24项治疗建议。其中,5个建议涉及潮气末CO2（ETco2）测量的方面。这些建议主要基于非常低的证据质量，有些是基于专家的意见。
结论：监测领域的作者继续支持在没有脉搏触诊的情况下开始胸部按压。我们建议对有心肺骤停风险的患者进行多模式监测，有再次被捕的危险,或全身麻醉。本报告重点介绍了ETco2监测在验证正确插管方面的实用性，确定自发循环的返回，评估心肺复苏的质量，指导基本生命支持措施。治疗建议进一步建议对电解质进行阻滞内评估（即，钾和钙)，因为这些可能为结果相关的干预提供信息。
