Plasma D-dimer concentration in sick newborn foals.
Abstract: Septicemia is associated with a systemic inflammatory response, hemostatic activation, and disseminated intravascular coagulopathy (DIC). Objective: Increased plasma d-dimer concentration occurs in septic neonates and can reliably detect sepsis or DIC, and predict death in ill neonatal foals. Methods: 40 septic, 41 nonseptic hospitalized foals, and 22 healthy neonates. Methods: Prospective observational clinical study. Blood samples were collected on admission, at 24-48 hours after admission, and at the time of discharge or euthanasia. Plasma d-dimer concentration, clotting times, antithrombin activity, and fibrinogen concentration were determined. Results: On admission, d-dimer concentration values were significantly higher in septic foals (median, 25-75th percentiles; 568, 245-2013 ng/mL) compared with the nonseptic and healthy groups (386, 175-559 and 313, 152-495 ng/mL, respectively), and in septic foals at the age of 2-7 days compared with similar-age nonseptic foals. By means of samples taken at 24-48 hours of hospitalization and a cut-off value of > 2000 ng/mL, D dimer concentration was significantly associated with the diagnosis of septicemia (odds ratio [OR] = 19.6, 95% confidence interval [95% CI] 1.9-203) and death (OR = 8.7, 95% CI 1.8-43). Owing to a high false-positive prediction rate (71%), a normal d-dimer concentration is better at eliminating the diagnosis of sepsis than an increased d-dimer concentration at predicting sepsis. Fifty percent of septic foals had a diagnosis of DIC, but d-dimer concentration was not significantly associated with the diagnosis of DIC. Conclusions: Septic foals showed a marked activation of coagulation and fibrinolytic systems and a high prevalence of DIC. Increased plasma d-dimer concentration is significantly associated with the diagnosis of sepsis.
Publication Date: 2008-02-27 PubMed ID: 18312557DOI: 10.1111/j.1939-1676.2008.0050.xGoogle Scholar: Lookup
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- Journal Article
Summary
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This study investigates the use of plasma D-dimer concentration as a reliable marker for identifying bacterial blood infection (septicemia) and blood clotting disorder (Disseminated Intravascular Coagulopathy, or DIC), and predicting mortality in newborn foals.
Objective and Methods
- The researchers aimed to determine if increased plasma D-dimer concentration could identify sepsis or DIC, and predict mortality in newborn foals. D-dimer is a type of protein fragment produced when a blood clot dissolves in the body. A high level of D-dimer could indicate the presence of a blood clot.
- A total of 103 newborn foals were included in the study, of which 40 were septic, 41 were non-septic but hospitalized, and 22 were healthy. The septic foals had generalized bacterial infection in their bloodstream (septicemia).
- Blood samples were collected from the foals on admission, 24-48 hours after admission, and at the time of discharge or euthanasia. These samples were used to determine plasma D-dimer concentration, clotting times, antithrombin activity, and fibrinogen concentration.
Results and Discussion
- On admission, D-dimer concentrations were significantly higher in septic foals, suggesting that plasma D-dimer concentration can be used as an indicator of sepsis in neonatal foals.
- However, the ability of D-dimer concentration to predict sepsis was limited by a significantly high false-positive prediction rate (71%). By this measure, a normal D-dimer concentration was better at eliminating the diagnosis of sepsis than an increased D-dimer was at predicting sepsis.
- A cut-off value of D-dimer >2000 ng/mL, taken 24-48 hours after hospitalization, was significantly associated with the diagnosis of septicemia and death. Hence, elevated plasma D-dimer levels were found to be an indicator of poor prognosis.
- The researchers also found that 50% of septic foals had DIC, but there was no significant association between D-dimer concentration and the diagnosis of DIC. This implies that although many septic foals experienced blood clotting disorders, the D-dimer level was not a reliable marker for detecting DIC.
Conclusion
- The study concluded that neonatal foals with sepsis showed marked activation of coagulation and fibrinolytic systems, and a high prevalence of DIC.
- Increased plasma D-dimer concentration was significantly associated with the diagnosis of sepsis, but not DIC, despite the high prevalence of DIC among septic foals.
Cite This Article
APA
Armengou L, Monreal L, Tarancón I, Navarro M, Ríos J, Segura D.
(2008).
Plasma D-dimer concentration in sick newborn foals.
J Vet Intern Med, 22(2), 411-417.
https://doi.org/10.1111/j.1939-1676.2008.0050.x Publication
Researcher Affiliations
- Servei de Medicina Interna Equina, Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Barcelona, Spain.
MeSH Terms
- Age Distribution
- Animals
- Animals, Newborn
- Disseminated Intravascular Coagulation / blood
- Disseminated Intravascular Coagulation / veterinary
- Female
- Fibrin Fibrinogen Degradation Products / metabolism
- Horse Diseases / blood
- Horses
- Logistic Models
- Male
- Odds Ratio
- Predictive Value of Tests
- Reproducibility of Results
- Sensitivity and Specificity
- Sepsis / blood
- Sepsis / veterinary
Citations
This article has been cited 6 times.- Honoré ML, Pihl TH, Busk-Anderson TM, Flintrup LL, Nielsen LN. Investigation of two different human d-dimer assays in the horse. BMC Vet Res 2022 Jun 15;18(1):227.
- Theuerkauf K, Obach-Schröck C, Staszyk C, Moritz A, Roscher KA. Activated platelets and platelet-leukocyte aggregates in the equine systemic inflammatory response syndrome. J Vet Diagn Invest 2022 May;34(3):448-457.
- Honoré ML, Pihl TH, Nielsen LN. A pilot study evaluating the Calibrated Automated Thrombogram assay and application of plasma-thromboelastography for detection of hemostatic aberrations in horses with gastrointestinal disease. BMC Vet Res 2021 Nov 8;17(1):346.
- Satué K, Gardon JC, Muñoz A. Clinical and laboratorial description of the differential diagnoses of hemostatic disorders in the horse. Iran J Vet Res 2020 Winter;21(1):1-8.
- Taylor S. A review of equine sepsis. Equine Vet Educ 2015 Feb;27(2):99-109.
- Brown JE, Noormohammadi AH, Courtman NF. Immunoreactivity of canine, feline, and equine D-dimer with antibodies to human D-dimer. J Vet Intern Med 2024 Jan-Feb;38(1):187-196.
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