2024 RECOVER Guidelines: Basic Life Support. Evidence and knowledge gap analysis with treatment recommendations for...

Area of Science:

• Veterinary Emergency and Critical Care
• Cardiopulmonary Resuscitation
• Animal Health

Background:

• Basic life support (BLS) protocols in veterinary medicine require systematic review to ensure evidence-based recommendations.
• Previous guidelines may not fully address the nuances of BLS in diverse canine and feline patient populations.
• Identifying knowledge gaps is crucial for advancing veterinary resuscitation science.

Purpose of the Study:

• To systematically review existing evidence for basic life support (BLS) in dogs and cats.
• To develop updated, evidence-based treatment recommendations for veterinary BLS.
• To identify critical knowledge gaps in canine and feline CPR research.

Main Methods:

• Systematic literature evaluation using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology.
• International, transdisciplinary collaboration involving university, specialty, and emergency veterinary professionals.
• Development of treatment recommendations based on evidence quality, risk-benefit analysis, and clinical feasibility.

Main Results:

• Thirty-two treatment recommendations formulated, focusing on chest compressions (25) and ventilation (7) during CPR.
• Emphasis on high-quality, uninterrupted chest compressions with technique modifications for wide-chested dogs.
• Bag-mask ventilation with oxygen recommended over mouth-to-nose when intubation is not feasible.

Conclusions:

• Updated RECOVER BLS recommendations prioritize continuous chest compressions and conformation-specific techniques for all animals.
• The certainty of recommendations is limited by the very low quality of available clinical data in dogs and cats.
• Significant need for further veterinary research to strengthen evidence for BLS protocols.