Arterial lactate concentration, hospital survival, sepsis and SIRS in critically ill neonatal foals.
Abstract: Blood lactate concentration has been shown to be a useful clinical indicator in human patients, but has not been formally investigated in critically ill foals. Objective: To investigate the association of blood lactate with hospital survival, markers of cardiovascular status, metabolic acid base status, sepsis and systemic inflammatory response syndrome (SIRS). Methods: A database containing clinical, haematological, plasma biochemical and hospital outcome data on neonatal foals referred to an intensive care unit in 2000-2001 was analysed. Seventy-two foals for which arterial lactate was measured at admission were included in the study. Results: Sixty-one foals had an admission lactate concentration > 2.5 mmol/l. Admission lactate was statistically associated with hospital survival, mean arterial pressure, blood creatinine concentration, bacteraemia, anion gap, lactate concentration at 18-36 h after admission and evidence of SIRS, but not with packed cell volume or heart rate. Lactate at 18-36 h was also associated with survival and evidence of SIRS. Anion gap, base excess, base excess due to unidentified anions (BEua), simplified strong ion gap or bicarbonate correctly classified foals for presence of hyperlactaemia (> 5 mmol/l) in < or = 80% of animals. Conclusions: Admission blood lactate gives important prognostic information. Lactate should be measured rather than assumed from the anion gap, base excess, BEua, simplified strong ion gap or bicarbonate. Conclusions: Blood lactate concentrations at admission are clinically relevant in neonatal foals and warrant further investigation. This should include the clinical value of measuring changes in lactate in response to treatment.
Publication Date: 2005-01-18 PubMed ID: 15651735DOI: 10.2746/0425164054406856Google Scholar: Lookup
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- Journal Article
Summary
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This research investigates the relevance of blood lactate in the survival of critically ill neonatal foals in hospitals. The study aims to explore if a correlation exists between blood lactate concentration and conditions such as sepsis and systemic inflammatory response syndrome (SIRS). Its results suggest that checking foal’s blood lactate level upon admission to a hospital could supply essential prognostic information.
Objective and Methods
- The primary aim of this study was to analyze the relationship between blood lactate and foal hospital survival, markers of cardiovascular status (like mean arterial pressure and heart rate), metabolic acid base status, sepsis, and systemic inflammatory response syndrome (SIRS).
- The researchers used data from a database consisting of clinical, haematological, plasma biochemical and hospital outcome details regarding neonatal foals admitted to an intensive care unit during the years 2000-2001.
- The researchers included 72 foals in their study, all of which had arterial lactate measured upon admission.
Results
- Out of the chosen subjects, 61 foals had an admission lactate concentration greater than 2.5 mmol/l.
- The study found a statistical relationship between lactate concentration upon admission and factors such as hospital survival, mean arterial pressure, blood creatinine concentration, bacteraemia, anion gap, lactate concentration 18-36 hours after admission, and evidence of SIRS.
- Factors like heart rate or packed cell volume, however, showed no substantial relationship with foals’ lactate concentration level upon admission.
- Lactate measured between the 18-36 hour period after admission also showed significant association with hospital survival and evidence of SIRS.
- Other factors such as anion gap, base excess, base excess due to unidentified anions (BEua), simplified strong ion gap or bicarbonate could correctly classify foals for presence of hyperlactaemia in 80% or fewer cases.
Conclusions
- The researchers concluded that measuring blood lactate at admission provides important prognostic information about the condition and survival probabilities of foals.
- It was deduced that lactate should be directly measured instead of assumed from other factors such as anion gap, base excess, BEua, simplified strong ion gap or bicarbonate.
- Finally, the researchers suggested that blood lactate concentration upon hospital admission is clinically relevant for neonatal foals and deserves further research, including examination of the clinical benefits of monitoring changes in lactate concentration in response to treatment.
Cite This Article
APA
Corley KT, Donaldson LL, Furr MO.
(2005).
Arterial lactate concentration, hospital survival, sepsis and SIRS in critically ill neonatal foals.
Equine Vet J, 37(1), 53-59.
https://doi.org/10.2746/0425164054406856 Publication
Researcher Affiliations
- Equine Referral Hospital, Royal Veterinary College, North Mymms, Hertfordshire AL9 7TA, UK.
MeSH Terms
- Acid-Base Equilibrium
- Animals
- Animals, Newborn
- Blood Gas Analysis / veterinary
- Critical Illness
- Horse Diseases / blood
- Horse Diseases / diagnosis
- Horse Diseases / mortality
- Horses
- Lactic Acid / blood
- Predictive Value of Tests
- Sepsis / blood
- Sepsis / diagnosis
- Sepsis / mortality
- Sepsis / veterinary
- Severity of Illness Index
- Survival Analysis
- Systemic Inflammatory Response Syndrome / blood
- Systemic Inflammatory Response Syndrome / diagnosis
- Systemic Inflammatory Response Syndrome / mortality
- Systemic Inflammatory Response Syndrome / veterinary
- Time Factors
Citations
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