CPR, PCA Flashcards
What is the equation for coronary perfusion pressure?
CPP = Aortic diastolic pressure - Right atrial diastolic pressure
How much time can be taken for inter-cycle rhythm checks?
2-5 seconds
What is the recommended tidal volume during CPR?
10 mL/kg
What are the two reasons to avoid hyperventilation during CPR
- increased intrathoracic pressure impeding venous return
- hypocapnia causing cerebral vasoconstriction»_space; decreased perfusion
What are the 3 phases of ischemia during ventricular fibrillation?
0-4 min: electrical phase - minimal ischemia, enough cellular energy stores available to maintain metabolic processes
4-10 min: circulatory phase - reversible ischemic injury - depletion of cellular ATP stores
>10 min: metabolic phase - potentially irreversible ischemic damage
After an unsuccessful attemp to defibrillate, how much should the joules dose be increased?
by 50% - do not increase subsequent doses
Describe how to perform open-chest CPR
- left-sided thoracotomy between 4th and 5th rub
- Finochietto retractors to open the chest
- consider removing the pericardium in any patient - but definitely indicated if pericardial disease present
- if one hand technique: right hand around left ventricule
- compress heart from apex to base to promote forward flow
How does CPR prognosis between dogs and cats compare?
Recent prospective observational study showed cats are almost 5 times as likely to survive to discharge compared to dogs
What is the recommended PaO2 and SpO2 target for PCA care?
PaO2 80-100 mm Hg
SpO2 94-98%
What are the MAP, ScvO2, lactate goals for PCA care?
80-120 mm Hg or higher
70% or more
less than 2.5 mmol/L
List 3 neuroprotective PCA care strategies
slow rewarming (0.25-0.5 C/hr)
seizure prophylaxis
osmotic therapy
What percentage of dogs and cats achieving ROSC die or are euthanzied before hospital discharge?
79%
What are the recommended PaCO2 targets for dogs and cats during PCA care?
dogs 32-43 mm Hg
cats 26-36 mm Hg
Why is the target MAP relatively high in PCA care?
because cerebral autoregulation may be absent
What is the recommendation for corticosteroid administration during PCA care?
- routine use not recommended
- consider low-dose hydrocortisone in patients with vasopressor-dependent shock after CPA