Sequential L-lactate concentration in hospitalised equine neonates: A prospective multicentre study

被引：23

作者：

Borchers, A. ^{[1
]}

Wilkins, P. A. ^{[1
]}

Marsh, P. M.

Axon, J. E. ^{[2
]}

Read, J. ^{[3
]}

Castagnetti, C. ^{[4
]}

Pantaleon, L. ^{[5
]}

Clark, C. ^{[6
]}

Qura'n, L. ^{[7
]}

Belgrave, R. ^{[8
]}

Schwarzwald, C. ^{[9
]}

Levy, M. ^{[10
]}

Bedenice, D. ^{[11
]}

Saulez, M. N. ^{[12
]}

Boston, R. C. ^{[1
]}

机构：

[1] Univ Penn, Philadelphia, PA 19104 USA

[2] Scone Equine Hosp, Scone, NSW, Australia

[3] Equine Med Ctr Ocala, Ocala, FL USA

[4] Univ Bologna, I-40126 Bologna, Italy

[5] Woodford Equine Hosp, Versailles, KY 40383 USA

[6] Peterson Smith Equine Hosp, Ocala, FL 34474 USA

[7] Univ Illinois, Chicago, IL 60680 USA

[8] Mid Atlantic Equine Med Ctr, Ringoes, NJ USA

[9] Univ Zurich, CH-8006 Zurich, Switzerland

[10] Purdue Univ, Indiana, PA USA

[11] Tufts Cummings Sch Vet Med, North Grafton, MA 01536 USA

[12] Univ Pretoria, ZA-0002 Pretoria, South Africa

来源：

EQUINE VETERINARY JOURNAL | 2013年 / 45卷

关键词：

horse; metabolism; mortality; monitoring; sepsis; GASTRIC DILATATION-VOLVULUS; BLOOD LACTATE; PROGNOSTIC VALUE; PLASMA LACTATE; ORGAN FAILURE; SERUM LACTATE; SEVERE SEPSIS; CLINICAL-DIAGNOSIS; MORTALITY; PREDICTOR;

D O I：

10.1111/evj.12165

中图分类号：

S85 [动物医学（兽医学）];

学科分类号：

0906 ;

摘要：

Reasons for performing studyEvaluation 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. ObjectivesTo prospectively evaluate the prognostic value of sequential [LAC] analysis in critically ill neonatal foals with risk of mortality. Study designProspective, observational study. MethodsThirteen 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 120h ([LAC](120)) after admission. [LAC] changes over time ([LAC]) were calculated between sampling points. ResultsNonsurvivors had significantly greater [LAC](ADMIT), [LAC](24) and [LAC](48) compared with surviving foals (P<0.001). In nonsurviving foals [LAC] did not decrease over time while survivors showed significant positive [LAC] between [LAC](ADM-24) and all other time periods (P<0.001). Logistic regression analysis showed that the odds of survival decreased for each 1mmol/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] 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] was significantly positive between [LAC](ADM-24) compared with all other time periods (P<0.001). ConclusionsBlood 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] can be utilised to identify patients at high risk for mortality.

引用

页码：2 / 7

页数：6

共 41 条

[1] MULTICENTER STUDY OF EARLY LACTATE CLEARANCE AS A DETERMINANT OF SURVIVAL IN PATIENTS WITH PRESUMED SEPSIS [J].