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2 RECOVER : Daniel J. Fletcher, PhD, DVM, DACVECC; Manuel Boller, Dr. med. vet., MTR, DACVECC; Benjamin M. Brainard, VMD, DACVA, DACVECC; Steven C. Haskins, DVM, DACVA, DACVECC; Kate Hopper, BVSc, PhD, DACVECC; Maureen A. McMichael, DVM, DACVECC; Elizabeth A. Rozanski, DVM, DACVECC, DACVIM; John E. Rush, DVM, MS, DACVIM, DACVECC and Sean D. Smarick, VMD, DACVECC From the Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY (Fletcher); Department of Emergency Medicine, School of Medicine, Center for Resuscitation Science and the Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA (Boller); Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA (Brainard); Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California at Davis, Davis, CA (Haskins, Hopper); College of Veterinary Medicine, University of Illinois,IL (McMichael); Cummings School of Veterinary Medicine, Tufts University, North Grafton, MA (Rozanski, Rush); AVETS, Monroeville, PA (Smarick). *These authors contributed equally. The authors declare no conflict of interest. Address correspondence and request for reprints to Dr. Daniel Fletcher, Cornell University College of Veterinary Medicine, DCS Box 31, Upper Tower Rd, Ithaca, NY 14853, USA. E- mail: djf42@cornell.edu Submitted March 29, 2012; Accepted March 29, RECOVER ; RECOVER 74

3 (J Vet Emerg Crit Care 2012; 22(S1): ) ABC ALS BLS CPA CPR CRT C V CVP EtCO 2 ETT FiO 2 HTS ICU ILCOR IPPV LOE MAP MM PaCO 2 PaO 2 PCA PEA PICO RECOVER ROSC SAP ScvO 2 SpO 2 VF VT (International Liaison Committee on Resuscitation) (Reassessment Campaign on Veterinary Resuscitation) Amiodarone Atipamezole Atropine Barbituates Bicarbonate Dexamethasone Epinephrine Flumazenil

4 Hydrocortisone Lidocaine Magnesium Magnesium sulfate Mannitol Naloxone Phebobarbital Sodium bicarbonate Thiopental Vasopressin 纳 (International Liaison Committee on Resuscitation, ILCOR) (CPR) CPR 1-3 CPR 4-8 CPR 9 (Reassessment Campaign on Veterinary Resuscitation, RECOVER) ILCOR RECOVER RECOVER ILCOR RECOVER 10 (1) (2) ILCOR 11 - CPR (Preparedness and Prevention) (Basic Life Support, BLS) (Advanced Life Support, ALS) (Monitoring)(Post- Cardiac Arrest Care) CPR BLS ml/ BLS CPR

5 ALS II CPR (PCA) (ROSC) (early goal- directed therapy) 12 (ScvO 2 ) ScvO 2 PCV 25% 13 II PCA PCA PCA (CPA) CPR 14 18% CPA CPR 15 (I- A) CPR CPR CPR CPA (I- B) CPR CPR CPR CPR (I- A) (I- A) 21 CPR

6 CPR 22 CPR (I- A) CPR (I- A) CPR CPR CPA CPR 26,27 CPR(IIb- B) CPR 28 CPR (I- A) CPR 29 BLS CPR BLS CPA CPA BLS BLS CPR CPR ROSC CPA BLS ALS BLS ALS ALS BLS CPA ROSC 33,34 (I- B) CPR 35

7 ( 4a) (IIa- C) () (IIa- C) ( 4b) (IIb- C) ( 4c) ( 5a) (IIb- C) ( 5b) ROSC 24 (I- A) (IIa- A) (I- A) 40,41 ROSC CPR 42,43 CPR BLS CPA 44 CPA CPR CPR (I- A) CPR 45 CPR 25-

8 30% CPR 10 10ml/ (I- A) 46 47,48 ( 6) CPR (I- B) CPR CPR BLS BLS 49,50 (I- A) (I- B) CPR CPA BLS BLS CPA 54,55 CPA 56 BLS CPA 2% CPR 57 CPR CPA CPA CPR(I- B) 5-10 ABC (A= airway, ; B=breathing, ; C=circulation, ) CPR CPA 2 CPR 58,59 CPR (IIa- B)

9 ALS ALS BLS CPR ROSC ALS ALS BLS ALS ROSC 50% 34 CPR 25-30% ALS Epinephrine() Epinephrine α1 CPR Epinephrine β 1 ( ) CPA ROSC 60 epinephrine(0.1mg/kg IV) ROSC 61 CPR 3-5 epinephrine(0.01mg/kg IV)(I- B) CPR epinephrine(0.1mg/kg IV) (IIb- B) epinephrine BLS Vasopressin() Vasopressin V1 epinephrine α1 α1 V1 Vasopressin epinephrine epinephrine vasopressin CPR vasopressin 62 Vasopressin CPA 63,64 vasopressin epinephrine 65,66 vasopressin(0.8u/kg IV) epinephrine epinephrine 3-5 (IIb- B) Atropine( ) Atropine CPR (0.04mg/kg) atropine(0.1, 0.2, 0.4mg/kg) 67 atropine epinephrine 5% epinephrine (PEA) 68 PEA atropine IIa- B CPR atropine 0.04mg/kg IV IIb- C

10 (VF) VF VT) VF VT VF 1 2 VF 69 (I- A) /kg /kg IIa- B 70,71 VF VT 50 IIa- B ( Clear ) ( 7) VF VT CPA(I- B) CPR VF(IIb- B) VF VT BLS

11 CPR VF VT BLS (ECG) CPR I- B VF 76,77 VF VF VT VF VT CPA amiodarone lidocaine magnesium 81 amiodarone VF VT (IIb- B) lidocaine VF VT lidocaine VF VF VT amiodarone VT VF lidocaine (IIb- B) magnesium CPR magnesium sulfate( ) magnesium sulfate (torsades de pointes)(iib- B) VF VT (I- B) naloxone 纳 CPA naloxone CPR (I- B) 84 CPR naloxone(iib- B) / CPR (IIb- C) CPR naloxone flumazenil) atipamezole α2 CPA CPR CPR (III- B)

12 CPR CPR (IIb- C) CPA CPR 85 CPR (I- B) 86 CPA CPR 87 CPR IIb- C CPR dexamethasone) CPR 88 89,90 91 CPR (III- C) 装装 92 CPR 装 CPA 装 ROSC 93 装 - 12cmH 2 O 啓装 (IIa- B) CPA CPA 10 bicarbonate 94,95 bicarbonate CPR 96 CPA meq/kg sodium bicarbonate()(iib- B) CPR CPA 97 epinephrine, vasopressin, atropine(iib- B)

13 98 CPR (I- B) epinephrine CPR (FiO 2 )100% 20-30% CPR [PaO 2 ] mmhg 99,100 CPR FiO 2 21% (IIb- B) FiO 2 100% FiO 2 (IIa- B) RECOVER CPR ILCOR (ALS- D- 016A) 101 CPR 102,103 CPR (III- B) CPR (IIa- C) CPR VF CPR CPR ROSC CPR PCA CPR CPR (IIb- C) RECOVER CPR CPR CPR CPR CPA CPR CPR ROSC CPA ROSC

14 CPA CPA CPR (ABC) CPA CPA 2% 54 CPA (specificity) 65% 35% CPR CPA(III- B) CPR CPA ABC CPR CPA CPA CPA CPR CPA(III- C) CPR ECG ALS PEA VT CPA BLS CPR ECG CPA(III- B) (EtCO 2 ) CPA CPA EtCO 2 EtCO 2 EtCO 2 CPA 104,105 EtCO 2 CPA(III- B) CPA CPR RECOVER ECG EtCO 2 CPA CPR (American Heart Association) CPR RECOVER CPA CPA EtCO 2 EtCO 2 CPA (IIa- B) (III- B) CPA EtCO 2 106

15 ECG CPR ECG ECG ALS (I- C)ECG CPR ECG (III- B) 107 VF ECG (IIa- B) 108 ) 72% VF 20% VF ECG 109 EtCO 2 CPR EtCO 2 ROSC (I- A) CPR (IIa- B) CPR EtCO 2 EtCO 2 ROSC EtCO 2 CPR EtCO 2 >15mmHg >20mmHg ROSC 34 CPR CPR CPA CPR (III- B) CPR ROSC (IIb- C) CPR ROSC CPR 110 CPR CPR (IIa- C) CPR CPR (IIb- B) 111 CPA (I- C) CPR CPR (IIb- B) CPR (III- A) 112

16 VF VF VF ROSC (IIb- B) CPA CPA CPA CPA CPA CPA ECG (IIa- C) (IIa- C) EtCO 2 CPA EtCO 2 (I- A) ROSC ROSC CPA ROSC CPA CPA(I- C) (I- C) CPA ECG (I- B) CPA PCA (IIb- B) PCA ROSC CPR 60-70% ROSC CPA % ROSC 35-45% 34,115 ROSC PCA CPA CPR 4,116 PCA 117 PCA ROSC CPA 117 PCA RECOVER PCA RECOVER PCA (bundle therapy) PCA PCA 118 ScvO 2 (IIb- B) PCA PCA

17 CPA (III- C) RECOVER PCA PCA (IIa- B) CPA PCA [MAP] >150mmHg 119 PCA (IIa- B) PCA PCA CPA PCA 124 PCA [PaCO 2 ] mmhg PaCO mmhg(iia- B) EtCO 2 PCA 125 PCA PCA (FiO 2 > 0.6) (IIa- C) PCA (III- B) PCA 126 PaO 2 = mmHg [SpO 2 ] = 94-98% (I- A) PCA ,128 PCA 129 PCA ROSC (I- A)

18 (III- C) CPA ROSC PCA (IIa- A) 1 (III- A) CPA PCA 89,90 91 PCA (III- C) PCA hydrocortisone ScvO PCA hydrocortisone 1mg/kg 1mg/kg 0.15mg/kg/hour. (IIb- C) PCA 138 CPR mannitol CPA PCA mannitol (IIb- C) mannitol PCA 5-15% 40% ROSC PCA PCA 117 VF PCA thiopental 145 PCA barbituates phebobarbital [] (IIb- B) poly- ADP- ribose polymerase inhibitors ADP 酶 DNA PCA

19 117 PCA PCA PCA PCA 114,118, PCA % 41% 36 30mmHg 124 PCA (IIa- B) (IIb- B) RECOVER PCA ( ) 152 PCA 24 PCA (IIa- B) 100 CPR 101 RECOVER 2011 (International Veterinary Emeregency and Critical Care Symposium [IVECCS]) 10 CPR (American Heart Association[AHA]) CPR CPR

20 CPR RECOVER CPR JVECC(Journal of Veterinary Emeregency and Critical Care) 2017 RECOVER (American College of Veterinary Emergency and Critical Care[ACVECC]) (Veterinary Emergency and Critical Care Socity) Armelle delaforcade ACVECC Kathleen Liard ACVECC RECOVER RECOVER Dennis Burkett, ACVECC ; Gary Stamp, VECCS ; Daniel Chan, JVECC ; Elisa Mazzaferro, ; Vinay Nadkarni, ILCOR ; Erika Pratt, ; Andrea Steele, AVECCT ; Janet Olson, ; Joris Robben, EVECCS ; Kenneth Drobatz, ACVECC ; William W. Muir, ACVECC and ACVA ; Erik Hofmeister, ACVA 2011 IVECCS RECOVER (references)

21 H!!ooo!!! HH#!!!oo!!!! HHG!!!!o!!!!! HHH!!!!o!!!!! 3! 8! 4!

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03-Âå¾Ç·sª¾-4-11

03-Âå¾Ç·sª¾-4-11 2010 CPR ECC - ACLS 1966 CPR 50 2005 2010 Basic Life Support, BLS A-B-C Airway, Breathing, Chest compressions C-A-B Chest compressions, Airway, Breathing 1. cardiac arrest ventricular fibrillation, VF