Association of aldosterone and arginine vasopressin concentrations and clinical markers of hypoperfusion in neonatal foals.
Abstract: Critically ill foals often present to veterinary hospitals with impaired organ perfusion which can be demonstrated by increased blood L-lactate concentrations. As a compensatory mechanism to low blood pressure and electrolyte abnormalities, aldosterone and arginine vasopressin (AVP) are released to restore organ perfusion and function. Several studies have investigated the ability of blood L-lactate concentrations to predict severity of disease and outcome in critically ill human patients, adult horses and foals. However, information on the aldosterone and AVP response to hypoperfusion and its association with L-lactate concentrations in neonatal foals is limited. Objective: To determine the association between clinical hypoperfusion and endocrine markers of reduced tissue perfusion in normo- and hypoperfused foals. Methods: Prospective, multicentre, cross-sectional observational study. Methods: Blood samples were collected on admission from 72 clinically hypoperfused, 110 normoperfused (73 hospitalised and 37 healthy) foals of ≤4 days of age. Foals were considered clinically hypoperfused if they had L-lactate concentrations ≥2.5 mmol/l and one of the 3 following findings: heart rate >120 beats/min, packed cell volume (PCV) >0.44 l/l or azotaemia (increased creatinine and blood urea nitrogen [BUN]). Blood concentrations of aldosterone and AVP were determined by radioimmunoassays. Results: Aldosterone, AVP, creatinine and BUN concentrations and heart rate, PCV and blood osmolality were higher in clinically hypoperfused compared with normoperfused foals (P<0.05). Risk of hypoperfusion increased with the presence of hypothermic extremities (OR = 5.26) and with each one unit increase in albumin concentrations (OR = 3.5) (P<0.05). The proposed admission L-lactate cut-off value above which nonsurvival could be reliably predicted in hospitalised foals was 10.6 mmol/l with 82% of sensitivity and 74% of specificity. Conclusions: Hyperaldosteronaemia and hypervasopressinaemia as well as hypothermic extremities and increased albumin concentrations are potent predictors of hypoperfusion in hospitalised foals.
© 2015 EVJ Ltd.
Publication Date: 2015-02-22 PubMed ID: 25421257DOI: 10.1111/evj.12393Google Scholar: Lookup
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- Journal Article
- Multicenter Study
- Research Support
- Non-U.S. Gov't
Summary
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The research investigates the link between clinical hypoperfusion (an inadequate flow of blood to the body’s organs) and the release of compensatory hormones aldosterone and arginine vasopressin (AVP) in neonatal foals. The study also seeks to understand how these physiological responses are associated with blood L-lactate concentrations.
Objective and Methodology
- The research studied the relationship between clinical signs of impaired organ perfusion and specific endocrine responses in normal- and under-perfused newborn foals.
- A prospective, multicenter observational study was conducted involving blood samples collected from 72 clinically under-perfused and 110 normal-perfused (including 73 hospitalised and 37 healthy) foals aged 4 days or younger.
- Foals were identified as clinically under-perfused if their L-lactate concentrations were ≥2.5 mmol/l and they exhibited one of several specified clinical factors including heart rate >120 beats/min, packed cell volume (PCV) >0.44 l/l or azotemia (increased creatinine and blood urea nitrogen [BUN]).
- Blood concentrations of aldosterone and AVP were determined with radioimmunoassays.
Research Findings
- The study results demonstrated higher concentrations of aldosterone, AVP, creatinine and BUN in clinically under-perfused foals compared to those which were normoperfused.
- Additionally, heart rate, PCV, and blood osmolality also recorded higher readings in clinically under-perfused foals (significant at P<0.05).
- The research identified a couple of risk factors associated with hypoperfusion, namely the presence of hypothermic extremities (increased OR by 5.26) and a unit increase in albumin concentration (increased OR by 3.5).
- The study proposed an admission L-lactate cut-off value of 10.6 mmol/l, above which non-survival in hospitalised foals could be reliably predicted, with a sensitivity of 82% and a specificity of 74%.
Conclusions
- The study reported that an increased production of aldosterone and VP, presence of hypothermic extremities, and increased albumin concentration are strong indicators of hypoperfusion in hospitalised foals.
- The research adds to the limited information available on the aldosterone and AVP responses to impaired organ perfusion and their association with L-lactate concentrations in newborn foals.
Cite This Article
APA
Dembek KA, Hurcombe SD, Stewart AJ, Barr BS, MacGillivray KC, Kinee M, Elam J, Toribio RE.
(2015).
Association of aldosterone and arginine vasopressin concentrations and clinical markers of hypoperfusion in neonatal foals.
Equine Vet J, 48(2), 176-181.
https://doi.org/10.1111/evj.12393 Publication
Researcher Affiliations
- College of Veterinary Medicine, The Ohio State University, Columbus, USA.
- College of Veterinary Medicine, The Ohio State University, Columbus, USA.
- College of Veterinary Medicine, Auburn University, Alabama, USA.
- Rood and Riddle Equine Hospital, Lexington, Kentucky, USA.
- Hagyard Equine Medical Institute, Lexington, Kentucky, USA.
- Rood and Riddle Equine Hospital, Lexington, Kentucky, USA.
- Hagyard Equine Medical Institute, Lexington, Kentucky, USA.
- College of Veterinary Medicine, The Ohio State University, Columbus, USA.
MeSH Terms
- Aldosterone / blood
- Animals
- Animals, Newborn
- Arginine Vasopressin / blood
- Biomarkers
- Critical Illness
- Cross-Sectional Studies
- Female
- Horse Diseases / blood
- Horse Diseases / diagnosis
- Horses
- Hypotension / blood
- Hypotension / diagnosis
- Hypotension / veterinary
- Male
- Sepsis / blood
- Sepsis / veterinary
Citations
This article has been cited 4 times.- Swink JM, Rings LM, Snyder HA, McAuley RC, Burns TA, Dembek KA, Gilsenan WF, Browne N, Toribio RE. Dynamics of androgens in healthy and hospitalized newborn foals. J Vet Intern Med 2021 Jan;35(1):538-549.
- Wagoner AL, Shaltout HA, Fortunato JE, Diz DI. Distinct neurohumoral biomarker profiles in children with hemodynamically defined orthostatic intolerance may predict treatment options. Am J Physiol Heart Circ Physiol 2016 Feb 1;310(3):H416-25.
- Wilkins PA, Wong D, Slovis NM, Collins N, Barr BS, MacKenzie C, De Solis CN, Castagnetti C, Mariella J, Burns T, Perkins G, Delvescovo B, Sanchez LC, Kemper AM, Magdesian KG, Bedenice D, Taylor SD, Gold J, Dunkel B, Pranzo G, Constable PD. The Systemic Inflammatory Response Syndrome and Predictors of Infection and Mortality in 1068 Critically Ill Newborn Foals. J Vet Intern Med 2025 Mar-Apr;39(2):e70004.
- Gomez DE, Kamr A, Gilsenan WF, Burns TA, Mudge MC, Hostnik LD, Toribio RE. Endothelial glycocalyx degradation in critically ill foals. J Vet Intern Med 2024 Sep-Oct;38(5):2748-2757.
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