Retrospective evaluation of cardiopulmonary arrest and resuscitation in hospitalized birds: 41 cases (2006–2019)

Abstract

ObjectiveTo describe circumstances and outcomes following cardiopulmonary arrest (CPA) in hospitalized birds.DesignRetrospective case study.SettingAcademic medical center.MethodsThe hospital medical records system was searched for avian cases that underwent CPR. Medical records were reviewed; data retrieved included association of CPA with anesthesia or handling, use of external compressions and intubation, drug administration, rates of return of spontaneous circulation (ROSC), and outcome. Cases with incomplete medical records were excluded.ResultsForty‐one cases of avian CPR were identified. Anesthesia‐related arrest was reported in 26 of 41 cases. The remainder of CPA events occurred during an examination (6/41) or were observed during hospitalization for treatment of disease or injury (11/41). Compressions were performed in 14 birds and manual ventilation performed in 21 of 41 cases via intubation (19/21), tight‐fitting face mask (1/21), or air sac cannulation (1/21). Vascular access was achieved in 24 of 41 cases. Emergency drug administration was documented in 22 of 41 cases and included epinephrine (20/22), atropine (19/22), glycopyrrolate (3/22), doxapram (2/22), dextrose (3/22), mannitol (1/22), and furosemide (1/22). Fluid therapy was administered in 24 of 41 cases. There were 3 documented cases of ROSC (7%), all in patients under general anesthesia, and 1 (2%) CPA survivor.ConclusionsThere was no standardized approach to avian CPR in this study, and ROSC was rare. When ROSC was achieved, birds were under general anesthesia with direct monitoring by a clinician, were ventilated, and were administered anesthetic reversals and anticholinergic or catecholamine emergency medications. These poor outcomes suggest that further research and an updated standardized approach to avian CPR, with special consideration of the physiological differences from mammals, are needed.

A proof‐of‐concept study evaluating cardiac compression techniques for cardiopulmonary resuscitation in laying hens (Gallus gallus)

“…7 The effectiveness of CPR in birds is unknown, but small retrospective studies have shown promise, with up to 7% of birds undergoing CPR showing successful return of spontaneous circulation (ROSC). 8,9 The primary aim of the current study was to evaluate the effect of 3 different cardiac compression techniques, SC, SC with interposed caudal coelomic compressions (ICCC), and lateral compressions (LC), on directly measured arterial pressures and gross postmortem findings after compressions. [10][11][12] Because CPR research is uncommonly performed in chickens, additional information was also collected that could serve for future experimental studies.…”

“…The relatively fixed, dorsal position and rigid parenchyma of the lungs, as opposed to expansile and contractile mammalian lungs, may also somewhat limit the efficacy of the thoracic pump 7 . The effectiveness of CPR in birds is unknown, but small retrospective studies have shown promise, with up to 7% of birds undergoing CPR showing successful return of spontaneous circulation (ROSC) 8,9 …”