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Theriogenology2009; 73(3); 343-357; doi: 10.1016/j.theriogenology.2009.09.018

Venous blood lactate evaluation in equine neonatal intensive care.

Abstract: The use of blood lactate concentration as an indicator of prognosis and disease severity has become a common practice in equine medicine, especially with the validation of handheld analyzers. However, few authors described lactate concentration in critically ill foals, and there are no published studies about the use of handheld analyzers in neonatal foals. In this study, for the first time in the equine neonate, we validated the Lactate Scout analyzer, both in healthy and in critically ill foals. The study also describes the normal range for blood lactate in 26 healthy neonatal foals during the first 72 h of life. Moreover, the utility of venous lactate measurement in 88 critically ill foals was determined, describing lactate values in the most common neonatal pathologies, evaluating serial blood lactate measurements, and investigating its prognostic value. The comparison with the enzymatic-colorimetric reference method showed that the Lactate Scout analyzer is reliable. The mean difference (bias +/-2SD) between the two methods was close to zero for all comparisons, and the SD of difference was +/-0.76 with a 95% confidence interval from -1.58 to 1.40 mmol/L. In healthy foals, blood lactate concentrations at birth and at 12h of life were statistically higher (P<0.01) than lactate concentrations measured at subsequent times. In critically ill foals, the highest lactate concentration at admission was found in hemorrhagic shock, septic shock, and complicated perinatal asphyxia syndrome (PAS). Our results showed that hyperlactatemia, although it does not provide diagnostic information, indicates the severity of illness and the need for an early and aggressive intervention. This could be very useful both during hospitalization and in the field to support veterinarians in making a decision about referral. Furthermore lactatemia proved to be a reliable prognostic parameter: In nonsurviving foals, hyperlactatemia persisted during the entire hospitalization, whereas in survivors there were no significant differences after 24h from admission. Because prognostic parameters have certain limitations, hyperlactatemia should not be used alone to decide whether to discontinue treatments in critically ill foals. A careful and complete clinical examination is always essential.
2010 Elsevier Inc. All rights reserved.
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Publication Date: 2009-12-03 PubMed ID: 19962183DOI: 10.1016/j.theriogenology.2009.09.018Google Scholar: Lookup
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Summary

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The research focuses on validating the use of the Lactate Scout analyzer in assessing blood lactate levels in neonatal foals, both healthy and critically ill ones. It establishes the normal blood lactate range for healthy foals within their first 72 hours of life and evaluates lactate levels in critically ill foals, showing that hyperlactatemia acts as an indicator of disease severity.

Validation of the Lactate Scout Analyzer

  • The study affirmed the reliability of the Lactate Scout analyzer in assessing blood lactate levels in neonatal foals by comparing it to the enzymatic-colorimetric reference method.
  • The observed mean difference (bias +/-2SD) between these two methods was almost zero in all comparisons, demonstrating the accuracy of the Lactate Scout analyzer.

Normal Range for Blood Lactate in Healthy Neonatal Foals

  • The research also established an average range for blood lactate in 26 healthy neonatal foals within their first 72 hours of life.
  • Blood lactate concentrations were statistically higher at birth and at 12 hours of life compared to subsequent measurements.

Utility of Venous Lactate Measurement in Critically Ill Foals

  • In the study, it was found that the highest lactate concentration at admission occurred in cases of hemorrhagic shock, septic shock, and complicated perinatal asphyxia syndrome (PAS) in foals.
  • Hyperlactatemia, or high levels of lactate in the blood, did not provide diagnostic information, but it indicated the severity of the illness and the necessity for early and aggressive intervention.

Prognostic Value of Venous Lactate Measurement

  • The research demonstrated that the level of lactatemia was a reliable prognostic parameter, as hyperlactatemia persisted throughout hospitalization in foals that did not survive, while it was not significant in survivors after 24 hours from admission.
  • Due to the inherent limitation of prognostic parameters, the study emphasized that hyperlactatemia alone should not be the deciding factor to discontinue treatments in critically ill foals.
  • Full and careful clinical examinations are always necessary in ensuring the well-being of the foal.

Cite This Article

APA
Castagnetti C, Pirrone A, Mariella J, Mari G. (2009). Venous blood lactate evaluation in equine neonatal intensive care. Theriogenology, 73(3), 343-357. https://doi.org/10.1016/j.theriogenology.2009.09.018

Publication

Theriogenology
ISSN: 1879-3231
NlmUniqueID: 0421510
Country: United States
Language: English
Volume: 73
Issue: 3
Pages: 343-357

Researcher Affiliations

Castagnetti, C
  • Veterinary Clinical Department, Faculty of Veterinary Medicine, Ozzano Emilia, Bologna, Italy. carolina.castagnetti@unibo.it
Pirrone, A
    Mariella, J
      Mari, G

        MeSH Terms

        • Animals
        • Animals, Newborn / blood
        • Blood Chemical Analysis / instrumentation
        • Blood Chemical Analysis / veterinary
        • Horse Diseases / diagnosis
        • Horses
        • Hospitals, Animal
        • Lactic Acid / blood
        • Prognosis

        Citations

        This article has been cited 24 times.
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