Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Practice Guideline
. 2024 Jul-Aug:34 Suppl 1:104-123.
doi: 10.1111/vec.13391.

2024 RECOVER Guidelines: Updated treatment recommendations for CPR in dogs and cats

Jamie M Burkitt-Creedon  1 , Manuel Boller  2   3 , Daniel J Fletcher  4 , Benjamin M Brainard  5 , Gareth J Buckley  6 , Steven E Epstein  1 , Erik D Fausak  7 , Kate Hopper  1 , Selena L Lane  8 , Elizabeth A Rozanski  9 , Jacob Wolf  10
Affiliations
Free article
Practice Guideline

2024 RECOVER Guidelines: Updated treatment recommendations for CPR in dogs and cats

Jamie M Burkitt-Creedon et al. J Vet Emerg Crit Care (San Antonio). 2024 Jul-Aug.
Free article

Abstract

Objective: After the 2012 Reassessment Campaign on Veterinary Resuscitation (RECOVER) CPR Guidelines, this is an update of evidence-based consensus guidelines for Basic Life Support (BLS), advanced life support (ALS), and periarrest monitoring.

Design: These RECOVER CPR Guidelines were generated using a modified version of the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system for evidence evaluation and translation of this evidence into clear and actionable clinical instructions. Prioritized clinical questions in the Population, Intervention, Comparator, and Outcome (PICO) format were used as the basis to conduct systematic literature searches by information specialists, to extract information from relevant publications, to assess this evidence for quality, and finally to translate the findings into treatment recommendations. These recommendations were reviewed by the RECOVER writing group and opened for comment by veterinary professionals for 4 weeks.

Setting: Transdisciplinary, international collaboration in university, specialty, and emergency practice.

Results: A total of 40 worksheets were prepared to evaluate questions across the 3 domains of BLS, ALS and Monitoring, resulting in 90 individual treatment recommendations. High-dose epinephrine is no longer recommended, and atropine, if used, is only administered once. Bag-mask ventilation is prioritized over mouth-to-nose ventilation in nonintubated animals. In addition, an algorithm for initial assessment, an updated CPR algorithm, a rhythm diagnosis tool, and an updated drug dosing table are provided.

Conclusions: While the majority of the BLS and ALS recommendations remain unchanged, some noteworthy changes were made due to new evidence that emerged over the past 10 years. Indirectness of evidence remains the largest impediment to the certainty of guidelines formulation and underscores an urgent need for more studies in the target species of dogs and cats.

Keywords: canine; cardiopulmonary resuscitation; clinical trials; consensus guidelines; critical care; evidence‐based medicine; feline.

PubMed Disclaimer

References

REFERENCES

    1. McIntyre RL, Hopper K, Epstein SE. Assessment of cardiopulmonary resuscitation in 121 dogs and 30 cats at a university teaching hospital (2009‐2012). J Vet Emerg Crit Care. 2014;24(6):693‐704. doi:10.1111/vec.12250
    1. Kawase K, Ujiie H, Takaki M, Yamashita K. Clinical outcome of canine cardiopulmonary resuscitation following the RECOVER clinical guidelines at a Japanese nighttime animal hospital. J Vet Med Sci. 2018;80(3):518‐525. doi:10.1292/jvms.17‐0107
    1. Hoehne SN, Hopper K, Epstein SE. Prospective evaluation of cardiopulmonary resuscitation performed in dogs and cats according to the RECOVER Guidelines. Part 2: patient outcomes and CPR practice since guideline implementation. Front Vet Sci. 2019;6:439. doi:10.3389/fvets.2019.00439
    1. Dazio VER, Gay JM, Hoehne SN. Cardiopulmonary resuscitation outcomes of dogs and cats at a veterinary teaching hospital before and after publication of the RECOVER guidelines. J Small Anim Pract. 2023;64(4):270‐279. doi:10.1111/jsap.13582
    1. Hofmeister EH, Brainard BM, Egger CM, Kang S. Prognostic indicators for dogs and cats with cardiopulmonary arrest treated by cardiopulmonary cerebral resuscitation at a university teaching hospital. J Am Vet Med Assoc. 2009;235(1):50‐57.

Publication types