Blood lactate measurement and interpretation in critically ill equine adults and neonates.

This study explores the use of blood lactate concentration as a predictive factor in equine medicine. While often useful, this indicator fails to fully differentiate between survivors and non-survivors. The authors suggest that serial measurements, reflecting both the amount and duration of high lactate levels, could offer more accurate predictions.

Objective and Methodology

• The objective of the study was to explore the accuracy and viability of blood lactate concentration as a prognostic indicative factor in equine medical cases. More specifically, it aimed to determine whether the magnitude and duration of high lactate levels — or ‘hyperlactatemia’ — could give valuable insight into disease pathogenesis and suggest suitable therapeutic routes.
• The research probably involved the use of blood lactate measurements taken from both adult horses and neonatal foals. These blood samples would have been analyzed to determine lactate concentrations, and the results compared against the eventual survival outcomes of the subjects.

Findings and Analysis

• The study found that admission lactate concentration — or the concentration of lactate in the horses’ blood at the time of medical admission — is a widely-utilized prognostic indicator in equine medicine. However, it was noted that this measurement often fails to fully distinguish between surviving and non-surviving horses.
• Furthermore, it was found that horses with high admission lactate concentrations typically see these levels return to normal within 12 to 24 hours. This may indicate that a single lactate measurement may not be enough to predict a patient’s outcome, and that additional or early recovery is a positive sign.
• For neonatal foals, lactate concentrations were found to naturally be higher than in adult horses for the first 24 to 72 hours of their lives. This could suggest that different lactate levels are normal at different ages, and that age should be taken into account when interpreting lactate concentrations.
• The research suggests that collecting serial measures of lactate — that is, measuring the lactate concentrations repeatedly over time — can give valuable additional information. This would reflect both the magnitude and duration of hyperlactatemia, potentially enabling more precise prognostication, a deeper understanding of the disease process, and guidance for therapeutic options.

Implications and Conclusion

• The findings of this research could impact how blood lactate concentration is used as a prognostic tool in equine medicine. Instead of relying solely on admission lactate concentration, it proposes a more comprehensive monitoring of lactate levels over time, along with the recognition that normal lactate levels can differ based on a horse’s age.
• The research implies that the use of serial lactate measurements could both improve the accuracy of prognosis, as well as provide additional insight into the disease process. This could lead to the improvement of therapeutic interventions, leading to better patient outcomes.