Preliminary investigation of the area under the L-lactate concentration-time curve (LACArea) in critically ill equine neonates.
Abstract: A variety of measures of L-lactate concentration ([LAC]) in the blood of critically ill neonatal foals have shown utility as prognostic indicators. These measures, evaluating either the severity of hyperlactatemia or the duration of exposure to hyperlactatemia, perform fairly well and have correctly classified 75-80% of foals examined in several studies. The area under the L-lactate concentration versus time curve (LACArea) encompasses both severity and duration of hyperlactatemia and should improve correct classification of patient survival. Objective: LACArea is larger in nonsurviving critically ill neonatal foals. Methods: Forty-nine foals admitted for critical illness to 1 of 4 referral hospitals. Methods: Whole blood was obtained at admission and 6, 12, 18, and 24 hours after admission for measurement of L-lactate using a handheld lactate meter. LACArea was calculated for: admission-6, 6-12, 12-18, 18-24 hours, and admission-24 hours using the trapezoidal method and summing the 6-hours interval areas to determine total 24 hours area. Differences between survivors and nonsurvivors were determined using robust regression and Kruskal-Wallis testing, P < .05. Results: LACArea was significantly larger in nonsurviving foals (n = 9) than in surviving foals (n = 40) at all time periods examined. Conclusions: Differences in LACArea between surviving and nonsurviving critically ill neonatal foals are large and support further investigation of this method as an improved biomarker for survival in critically ill neonatal foals is indicated.
Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.
Publication Date: 2015-03-31 PubMed ID: 25818220PubMed Central: PMC4895514DOI: 10.1111/jvim.12559Google Scholar: Lookup
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- Journal Article
- Multicenter Study
Summary
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The research focuses on the testing and evaluation of the L-lactate concentration in the blood of critically ill neonatal foals. It aims to use this measure as a prognostic tool and assesses how the severity and duration of increased lactate concentration could help in predicting patient survival.
Objective
- The main objective of the study is to investigate whether the LACArea (area under the L-lactate concentration versus time curve) is larger in non-surviving critically ill neonatal foals. The LACArea measurement encapsulates both the severity and exposure time to hyperlactatemia (high lactate levels).
Method
- In the study, blood samples from 49 neonatal foals who were admitted for critical illness to one of four referral hospitals were collected. The study collected whole blood at admission and at intervals of 6, 12, 18, and 24 hours after admission.
- The team used a handheld lactate meter for the measurement of L-lactate. They calculated the LACArea for various time intervals such as admission-6 hours, 6-12 hours, 12-18 hours, 18-24 hours, and admission-24 hours. The area calculation used the trapezoidal method, summing up the areas every 6 hours to measure the total 24 hours area.
- The research team then studied the differences between the survivors and non-survivors applying robust regression and Kruskal-Wallis testing, considering a P-value of less than .05 as statistically significant.
Results
- From the study, it was observed that the LACArea was significantly larger in non-surviving foals (n=9) when compared to surviving foals (n=40) across all time periods examined.
Conclusions
- The notable differences in LACArea between surviving and non-surviving critically ill neonatal foals suggest that this method could serve as a beneficial biomarker. The researchers concluded that more investigation is needed on this method, indicating that it might improve survival predictions in critically ill neonatal foals.
Cite This Article
APA
Wilkins PA, Sheahan BJ, Vander Werf KA, Castagnetti C, Hardy J, Schoster A, Boston RC.
(2015).
Preliminary investigation of the area under the L-lactate concentration-time curve (LACArea) in critically ill equine neonates.
J Vet Intern Med, 29(2), 659-662.
https://doi.org/10.1111/jvim.12559 Publication
Researcher Affiliations
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL.
MeSH Terms
- Animals
- Animals, Newborn
- Area Under Curve
- Biomarkers / blood
- Critical Illness
- Horse Diseases / blood
- Horse Diseases / metabolism
- Horses
- Lactic Acid / blood
- Survival Analysis
References
This article includes 10 references
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Citations
This article has been cited 5 times.- Hijikata M, Higa M, Ichijo T, Hirose T. A comparison of meal tolerance test and oral glucose tolerance test for predicting insulin therapy in patients with gestational diabetes. Food Nutr Res 2021;65.
- Fuse Y, Higa M, Miyashita N, Fujitani A, Yamashita K, Ichijo T, Aoe S, Hirose T. Effect of High β-glucan Barley on Postprandial Blood Glucose and Insulin Levels in Type 2 Diabetic Patients. Clin Nutr Res 2020 Jan;9(1):43-51.
- Labonté J, Dubuc J, Roy JP, Buczinski S. Prognostic Value of Cardiac Troponin I and L-Lactate in Blood of Dairy Cows Affected by Downer Cow Syndrome. J Vet Intern Med 2018 Jan;32(1):484-490.
- 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.
- Ramos GV, Titotto AC, da Costa GB, Ferraz GC, de Lacerda-Neto JC. Determination of speed and assessment of conditioning in horses submitted to a lactate minimum test-alternative approaches. Front Physiol 2024;15:1324038.
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