Prospective evaluation of coagulation in critically ill neonatal foals.
Abstract: Coagulopathy is a potentially underrecognized complication of sepsis and septic shock in critically ill neonatal foals. Objective: Critically ill neonatal foals have abnormalities in coagulation that are associated with disease severity and outcome. Methods: Foals <72 hours old admitted to a neonatal intensive care unit. Methods: Prospective, observational study. Blood was collected at admission, 24, and 48 hours for platelet count, prothrombin time, activated partial thromboplastin time, antithrombin activity and concentrations of fibrin degradation products, and fibrinogen in plasma from all foals. Results: Sixty-three foals were enrolled and classified as Septic Shock (12), Septic (28), and Other (23). At least 1 abnormal value was found in 18/28 (64%) samples from the Septic Shock group, 66/85 (78%) from the Septic group, and 30/59 (51%) from the Other group (P= .01). Coagulopathy (3 or more abnormal values) was present in 7/28 (25%) samples in the Septic Shock group, 14/85 (16%) samples in the Septic group, and 3/59 (5%) samples in the Other group (P= .0028). Clinically detectable bleeding occurred in 8/12 (67%) Septic Shock cases, 11/28 (39%) Septic cases, and 3/23 (13%) Other cases (P= .009). Foals in Septic Shock were 12.7 times more likely to have clinical evidence of bleeding than those in the Other group (95% CI 2.3-70, P= .004). Treatment with fluids or plasma did not have a detectable effect on coagulation values. Conclusions: Coagulopathy commonly occurs in critically ill neonatal foals, especially those with sepsis and septic shock.
Publication Date: 2009-01-30 PubMed ID: 19175735DOI: 10.1111/j.1939-1676.2008.0229.xGoogle Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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The research focuses on the frequent occurrence of coagulopathy, an abnormality in blood clotting, in critically ill newborn horses, particularly those suffering from severe infection or septic shock.
Objective and Methodology
- The aim of this study was to closely examine the link between coagulation abnormalities in critically ill newborn foals and the severity and outcome of their illness.
- This investigation was executed as a prospective, observational study in a neonatal intensive care unit.
- Participants were foals less than 72 hours old.
- Researchers collected blood at admission, after 24 hours, and after 48 hours, testing for various factors including, platelet count, prothrombin time, activated partial thromboplastin time, antithrombin activity, fibrin degradation product concentrations, and plasma fibrinogen.
Results
- 63 foals were part of the study and were categorized into three groups: Septic Shock (12), Septic (28), and Other (23).
- The research revealed at least one abnormal value in a majority of samples across all three groups.
- Coagulopathy, defined as having three or more abnormal values, was present in a substantial portion of both the Septic Shock and Septic groups, and slightly present in the Other group.
- Furthermore, clinically noticeable bleeding occurred most frequently in the Septic Shock group and least frequently in the Other group, showing a clear association with the severity of the condition.
- It was also found that Septic Shock patients were almost 13 times more likely to show clinical evidence of bleeding than those in the Other group.
- However, treatment with fluids or plasma did not exhibit a discernible effect on coagulation values.
Conclusions
- The study concludes that coagulopathy regularly occurs in critically ill newborn foals, particularly those battling severe infection and septic shock.
- This suggests the need for increased attention towards coagulopathy as a significant complication in this context.
Cite This Article
APA
Bentz AI, Palmer JE, Dallap BL, Wilkins PA, Boston RC.
(2009).
Prospective evaluation of coagulation in critically ill neonatal foals.
J Vet Intern Med, 23(1), 161-167.
https://doi.org/10.1111/j.1939-1676.2008.0229.x Publication
Researcher Affiliations
- Department of Clinical Studies, University of Pennsylvania, Philadelphia, PA, USA.
MeSH Terms
- Animals
- Animals, Newborn
- Blood Coagulation / physiology
- Critical Illness
- Female
- Hemorrhage / veterinary
- Horse Diseases / blood
- Horses
- Male
- Predictive Value of Tests
- Sensitivity and Specificity
- Sepsis / blood
- Sepsis / veterinary
- Shock, Septic / blood
- Shock, Septic / veterinary
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