New RECOVER CPR Guidelines, what’s coming?

RECOVER CPR Guidelines 2.0

RECOVER have been in the process of revising the current small animal cardiopulmonary resuscitation guidelines for some time. Speculated to be released in 2019 it’s only now that we have a date for the new guidelines. As the only evidence based CPR guidelines it is key that we keep up to date and current.

ETA January 2024

Despite the CPR guidelines draft being introduced and discussed at various congresses across Europe and America the RECOVER guidelines aren’t yet published. Going straight to the source provides us with a date, and that date is January 2024. Until then the guidelines and discussion are very much based on a draft. A draft that was open to the VetMed community to feedback on and make suggestions.

No more high dose adrenaline?

From looking at this draft we can have fairly educated guess about what’s to come. Starting with the least surprising, adrenaline. I’ve spoken about this on my socials before but in the human field there’s a lot of evidence around high dose adrenaline and neurological outcomes. It’s really interesting reading and you can have a look here. In summary whilst higher adrenaline doses do appear to have higher return of spontaneous circulation (ROSC) it also appears to leave the patients that received the higher dose with long term neurological deficits. The mechanism of which is complex but in summary it’s suspected to be due to the blood distribution.

Atropine….. ASAP and once?

Now the last point I wanted to mention is Atropine. A drug that is commonly used in practice and is indeed part of the current algorithm. Typically, people tend to alternate between adrenaline and atropine but if we look at the draft guidelines, we can see that this wouldn’t be the case. In the draft atropine is recommended to be given at 0.04mg/kg and only once. It’s also suggested that it be given as soon as possible if indicated. So quite a change from a drug perspective.

Have a read for yourself

Whilst we wait for the guidelines to be released it’s worth having a read of the draft and having these changes on our radar. They are going to be quite an adjustment for a lot of us and being armed with the knowledge and evidence is vital to introduce change. There is much more to discuss as the new guidelines are published and I will be offering a webinar to chat through these and how they will impact you in practice in the new year.

Links for more information:

https://ccforum.biomedcentral.com/articles/10.1186/s13054-018-2058-1

https://onlinelibrary.wiley.com/doi/full/10.1111/j.1476-4431.2012.00755.x