Sequential L-lactate concentration in hospitalised equine neonates: A prospective multicentre study.
Abstract: Evaluation of serial blood lactate concentrations [LAC] are of prognostic value for morbidity and mortality in critically ill human patients and neonatal foals, but have not been prospectively evaluated in a large multicentre study of critically ill neonatal foals. Objective: To prospectively evaluate the prognostic value of sequential [LAC] analysis in critically ill neonatal foals with risk of mortality. Methods: Prospective, observational study. Methods: Thirteen university and private equine referral hospitals enrolled 643 foals over the 2008 foaling season and [LAC] was measured at admission ([LAC]ADMIT ) and 24 ([LAC]24 ), 48 ([LAC]48 ), 72 ([LAC]72 ), 96 ([LAC]96 ) and 120 h ([LAC]120 ) after admission. [LAC] changes over time ([LAC]Δ) were calculated between sampling points. Results: Nonsurvivors had significantly greater [LAC]ADMIT , [LAC]24 and [LAC]48 compared with surviving foals (P<0.001). In nonsurviving foals [LAC]Δ did not decrease over time while survivors showed significant positive [LAC]Δ between [LAC]ADM -24 and all other time periods (P<0.001). Logistic regression analysis showed that the odds of survival decreased for each 1 mmol/l [LAC] increase at all time points for all critically ill foals, independent of major final diagnoses as potential confounders. Septic foals had significantly greater [LAC] at all time points compared with nonseptic foals (P<0.001) and [LAC]Δ in septic foals was significantly more positive (suggesting better clearance of lactate from the blood) only at [LAC]ADM -24 and [LAC]72-96 (P<0.01), while in nonseptic foals [LAC]Δ was significantly positive between [LAC]ADM -24 compared with all other time periods (P<0.001). Conclusions: Blood lactate concentration is a strong, independent biomarker used to predict mortality in critically ill foals. Lactate metabolism is impaired in nonsurviving and septic foals and [LAC]Δ can be utilised to identify patients at high risk for mortality.
© 2013 EVJ Ltd.
Publication Date: 2013-12-01 PubMed ID: 24304396DOI: 10.1111/evj.12165Google Scholar: Lookup
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- Journal Article
Summary
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The research article discusses a prospective study which evaluated the prognostic value of sequential blood lactate concentration, a biochemical marker of critical illness, in neonatal foals. The findings revealed a correlation between increased lactate concentration and mortality in critically ill foals, suggesting it could serve as an effective predictive tool for assessing foal health.
Research Objective and Methodology
- The study aimed to determine the prognostic value of serial blood lactate concentrations (referred to as [LAC]) in predicting mortality in critically ill newborn horses (foals).
- 643 foals from 13 different university and private referral equine hospitals were enrolled in the research, which occurred over the 2008 foaling season.
- The researchers measured the foals’ blood lactate concentrations upon their admission to the hospitals and then after 24, 48, 72, 96, and 120 hours.
- They also calculated changes in lactate concentration over time, referred to as [LAC]Δ, between these different time points.
Key Findings
- The study found that foals which did not survive exhibited significantly higher blood lactate levels at admission, after 24 hours and 48 hours compared to those that survived.
- Interestingly, lactate concentration in surviving foals tended to decrease significantly over time while no similar pattern was observed in foals that did not survive.
- The results showed that for each 1 mmol/l increase in blood lactate concentration at any point, the likelihood of survival decreased in all critically ill foals, regardless of their final diagnoses.
- Moreover, the study identified that septic foals (those with severe infections), showed significantly higher lactate levels at all time points when compared to non-septic foals.
Conclusions and Implications
- Based on their findings, the researchers concluded that blood lactate concentration is a valuable independent biomarker for predicting mortality in critically ill foals.
- They found that lactate metabolism is impacted in foals that do not survive and in those with sepsis, and that changes in lactate concentration over time can be used to identify patients at high risk for mortality.
- The results of this study could aid veterinarians in identifying at-risk neonatal foals and making informed decisions about their treatment plan.
Cite This Article
APA
Borchers A, Wilkins PA, Marsh PM, Axon JE, Read J, Castagnetti C, Pantaleon L, Clark C, Qura'n L, Belgrave R, Schwarzwald C, Levy M, Bedenice D, Saulez MN, Boston RC.
(2013).
Sequential L-lactate concentration in hospitalised equine neonates: A prospective multicentre study.
Equine Vet J Suppl(45), 2-7.
https://doi.org/10.1111/evj.12165 Publication
Researcher Affiliations
- University of Pennsylvania, USA; University of California, USA.
MeSH Terms
- Animals
- Animals, Newborn
- Critical Illness
- Horse Diseases / diagnosis
- Horses
- Humans
- Lactic Acid / blood
- Prospective Studies
- Sepsis / veterinary
Citations
This article has been cited 7 times.- Kerr CL, Keating SCJ, Arroyo LG, Viel L. Cardiopulmonary effects and recovery characteristics associated with 2 sedative protocols for assisted ventilation in healthy neonatal foals.. Can J Vet Res 2021 Oct;85(4):251-260.
- Di Lorenzo E, Rossi R, Ferrari F, Martini V, Comazzi S. Blood L-Lactate Concentration as an Indicator of Outcome in Roe Deer (Capreolus capreolus) Admitted to a Wildlife Rescue Center.. Animals (Basel) 2020 Jun 20;10(6).
- Sheats MK. A Comparative Review of Equine SIRS, Sepsis, and Neutrophils.. Front Vet Sci 2019;6:69.
- Wong DM, Ruby RE, Dembek KA, Barr BS, Reuss SM, Magdesian KG, Olsen E, Burns T, Slovis NM, Wilkins PA. Evaluation of updated sepsis scoring systems and systemic inflammatory response syndrome criteria and their association with sepsis in equine neonates.. J Vet Intern Med 2018 May;32(3):1185-1193.
- Trefz FM, Lorenz I, Lorch A, Constable PD. Clinical signs, profound acidemia, hypoglycemia, and hypernatremia are predictive of mortality in 1,400 critically ill neonatal calves with diarrhea.. PLoS One 2017;12(8):e0182938.
- Mizen K, Woodman J, Boysen SR, Wagg C, Greco-Otto P, Léguillette R, Roy MF. Effect of Dexamethasone on Resting Blood Lactate Concentrations in Horses.. J Vet Intern Med 2017 Jan;31(1):164-169.
- Dwyer A. Science-in-brief: clinical highlights from the American Association of Equine Practitioners 59th Annual Convention and Equine Veterinary Journal Supplement 45.. Equine Vet J 2014 May;46(3):259-61.
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