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Fluid Therapy During Cardiopulmonary Resuscitation
Daniel J Fletcher1, Manuel Boller2
1Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States.
Frontiers in Veterinary Science
|February 15, 2021
Summary
Advanced life support (ALS) fluid therapies for cardiopulmonary arrest (CPA) require careful patient assessment. Tailoring interventions like fluid boluses and buffer therapy to individual patient characteristics is crucial for improving outcomes and avoiding harm.
Area of Science:
- Emergency Medicine
- Critical Care Medicine
- Cardiology
Background:
- Cardiopulmonary arrest (CPA) is a critical condition requiring immediate intervention.
- Cardiopulmonary resuscitation (CPR) aims to restore circulation and oxygen delivery.
- Advanced life support (ALS) includes fluid therapy to enhance CPR effectiveness.
Purpose of the Study:
- To evaluate the role and impact of various intravenous fluid therapies during advanced life support for CPA.
- To determine the specific indications and potential benefits or harms of different fluid interventions in CPA patients.
Main Methods:
- Review of current literature on intravenous fluid administration in cardiopulmonary arrest.
- Analysis of the effects of different fluid types (crystalloids, colloids, hypertonic saline) and specific therapies (buffers, lipid emulsions) in CPA.
- Consideration of patient-specific factors like volume status and electrolyte balance.
Main Results:
- Fluid boluses may benefit hypovolemic CPA patients, with hypertonic saline offering potential neuroprotection.
- Isotonic or hypertonic crystalloids might be detrimental in euvolemic CPA patients by impairing perfusion.
- Synthetic colloids are not recommended due to lack of benefit and potential harm.
- Targeted therapies for electrolyte abnormalities, toxin exposure, and acidemia are indicated.
- Buffer therapy may harm acute CPA patients but benefit those with prolonged CPA and acidemia.
Conclusions:
- ALS fluid therapies in CPA should be guided by specific patient indications.
- Individualized assessment of volume status, electrolytes, and acid-base balance is essential for effective fluid management.
- Judicious use of specific interventions like hypertonic saline or buffer therapy can improve outcomes in select CPA patients.
Keywords:
bicarbonatecalcium gluconatecardiopulmonary resuscitationcatsdogsfluid resusciationlipid emulsion infusionMore Related Videos
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