Validation of a Rapid Bronchoalveolar Lavage Fluid Colorimetric Evaluation for Assessing the Severity of Exercise-Induced Pulmonary Hemorrhage in Horses in Field Conditions.
Abstract: Diagnosis and assessment of severity of exercise-induced pulmonary hemorrhage (EIPH) relies on postexercise visualization of fresh blood in the airways via tracheobronchoscopic examination (TBE) and/or counting erythrocytes in bronchoalveolar lavage fluid (BALFRBC). Determining the BALFRBC is more sensitive than TBE but its usefulness is hampered by the need to have BALFRBC counted at a laboratory. We explored the feasibility of evaluating the severity of EIPH by using a color chart comprised of five shades of red and matching those colors with the color of BALF immediately following collection. To validate the technique, sets of ten BALF samples with known BALFRBC numbers were created and randomly shown to two groups of 18 observers who independently matched the color of the BALF with one of the shades of red displayed on the screen of a smartphone. Interobserver and intra-observer agreements regarding colors were > 0.9. The utility of the color chart was further validated under field conditions at two barrel racing events where 63 BALF samples were collected from 21 horses and BALF color was graded independently by three observers. The number of BALFRBC in the 63 samples ranged from 25-1,100,000/μL. EIPH was diagnosed in 39 samples based on the detection of color, and all 5 colors were matched multiple times with BALF samples. Overall, the color of the BALF was related to the number of BALFRBC. Colorimetric evaluation of BALF represents a practical and reliable option for rapid postexercise assessment of the presence and severity of EIPH.
Copyright © 2020 Elsevier Inc. All rights reserved.
Publication Date: 2020-10-08 PubMed ID: 33276915DOI: 10.1016/j.jevs.2020.103284Google Scholar: Lookup
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- Journal Article
- Bronchoalveolar Lavage
- Clinical Pathology
- Clinical Study
- Colorimetric Analysis
- Diagnosis
- Diagnostic Technique
- Disease
- Disease Diagnosis
- Disease Severity
- Equine Health
- Erythrocytes
- Exercise-Induced Pulmonary Hemorrhage
- Field Study
- Hemorrhage
- Horses
- Laboratory Methods
- Observational Study
- Pulmonary Health
- Respiratory Health
- Veterinary Care
- Veterinary Medicine
Summary
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This study aims to validate a new rapid method for assessing the severity of exercise-induced pulmonary hemorrhage (EIPH) in horses through colorimetric evaluation of bronchoalveolar lavage fluid (BALF), rather than traditional laboratory-based evaluation of erythrocytes count.
Research objectives and approach
- The researchers aimed at establishing a more practical, reliable, and rapid method for evaluating horse EIPH.
- The study was exploratory in nature and was conducted to validate a color chart method with five shades of red for assessing the severity of EIPH.
- The potential effectiveness of the color chart was first assessed in a controlled environment using known BALF samples, before being validated in real-world situations, specifically at two barrel racing events.
Methodology
- The study was conducted in two stages.
- In the initial phase, they used ten sets of BALF samples with known erythrocyte counts.
- These samples were shown to two groups of 18 observers who independently matched the color of the BALF to one of the shades of red displayed on a smartphone screen.
- In the second phase, the team collected 63 BALF samples from 21 horses during real-life barrel racing events and assessed their color based on the chart.
Results
- The interobserver and intra-observer agreement regarding colors were > 0.9, indicating good consistency between observers.
- EIPH was diagnosed in 39 of the 63 sampled horses based on color detection.
- The conclusion showed that the number of erythrocytes in the BALF was related to the color of the BALF, confirming that colorimetric evaluation of BALF can be a practical and reliable method for rapid postexercise assessment of horse EIPH.
Implications
- The findings of this study open the possibility for a quick and reliable assessment of EIPH even in field conditions and without the need for costly and time-consuming laboratory analyses.
- This might improve the management of horses showing signs of EIPH during or after exercise thereby promoting their health and performance.
Cite This Article
APA
Warlick LM, Léguillette R, Kogan C, Gold JR, Bayly WM.
(2020).
Validation of a Rapid Bronchoalveolar Lavage Fluid Colorimetric Evaluation for Assessing the Severity of Exercise-Induced Pulmonary Hemorrhage in Horses in Field Conditions.
J Equine Vet Sci, 95, 103284.
https://doi.org/10.1016/j.jevs.2020.103284 Publication
Researcher Affiliations
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA.
- Faculty of Veterinary Medicine, Department of Veterinary Clinical and Diagnostic Services, University of Calgary, Calgary, Alberta, Canada.
- Center for Interdisciplinary Statistical Education and Research, Washington State University, Pullman, WA.
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA.
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA. Electronic address: wmb@wsu.edu.
MeSH Terms
- Animals
- Bronchoalveolar Lavage Fluid
- Colorimetry / veterinary
- Hemorrhage / diagnosis
- Hemorrhage / veterinary
- Horse Diseases / diagnosis
- Horses
- Physical Conditioning, Animal
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