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1.
REASONS FOR PERFORMING STUDY: Blood lactate concentration has been shown to be a useful clinical indicator in human patients, but has not been formally investigated in critically ill foals. OBJECTIVE: To investigate the association of blood lactate with hospital survival, markers of cardiovascular status, metabolic acid base status, sepsis and systemic inflammatory response syndrome (SIRS). METHODS: A database containing clinical, haematological, plasma biochemical and hospital outcome data on neonatal foals referred to an intensive care unit in 2000-2001 was analysed. Seventy-two foals for which arterial lactate was measured at admission were included in the study. RESULTS: Sixty-one foals had an admission lactate concentration > 2.5 mmol/l. Admission lactate was statistically associated with hospital survival, mean arterial pressure, blood creatinine concentration, bacteraemia, anion gap, lactate concentration at 18-36 h after admission and evidence of SIRS, but not with packed cell volume or heart rate. Lactate at 18-36 h was also associated with survival and evidence of SIRS. Anion gap, base excess, base excess due to unidentified anions (BEua), simplified strong ion gap or bicarbonate correctly classified foals for presence of hyperlactaemia (> 5 mmol/l) in < or = 80% of animals. CONCLUSIONS: Admission blood lactate gives important prognostic information. Lactate should be measured rather than assumed from the anion gap, base excess, BEua, simplified strong ion gap or bicarbonate. POTENTIAL RELEVANCE: Blood lactate concentrations at admission are clinically relevant in neonatal foals and warrant further investigation. This should include the clinical value of measuring changes in lactate in response to treatment.  相似文献   

2.
Objective: To investigate the agreement between indirect oscillometric and direct blood pressure measurement in the equine neonate. Design: Prospective observational study. Setting: University Veterinary Teaching Hospital. Animals: Ten crossbred foals of 30–46 hours of age. Interventions: Six animals (Group 1) were anesthetized. Four animals (Group 2) were restrained on a mat. All animals were instrumented with a catheter in the greater metatarsal artery and an oscillometric blood pressure cuff over the coccygeal artery. Blood pressure was varied with dobutamine, phenylephrine, nitroprusside, and increased depth of anesthesia (Group 1) or dopamine (Group 2). Measurements and main results: Simultaneous direct and indirect blood pressure measurements were obtained from the greater metatarsal artery and the coccygeal artery, respectively. There was good agreement between the 2 methods for mean and diastolic blood pressures in both groups, but not for systolic pressure. The agreement was best in mean blood pressure of anesthetized foals (mean bias –1.07; limits of agreement – 9.39, 7.25 mmHg). Conclusions: Indirect oscillometry appears to be an acceptable method for measuring mean arterial blood pressure in both anesthetized and conscious neonatal foals, and may be a valid method of monitoring critically ill foals.  相似文献   

3.
Background: Coagulopathy is a potentially underrecognized complication of sepsis and septic shock in critically ill neonatal foals.
Hypothesis: Critically ill neonatal foals have abnormalities in coagulation that are associated with disease severity and outcome.
Animals: 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 and Clinical Importance: Coagulopathy commonly occurs in critically ill neonatal foals, especially those with sepsis and septic shock.  相似文献   

4.
Objective: To test the agreement between 3 common methods of glucose measurement in a population of critically ill foals presenting to a neonatal intensive care unit. Design: Prospective clinical study. Setting: University large animal hospital neonatal intensive care unit. Animals: Sequentially admitted critically ill neonatal foals <30 days of age. Interventions: Venous blood obtained from a jugular vein was used for determination of blood glucose concentration using point‐of‐care (POC) glucometry (GLU), a laboratory chemistry technique (CHEM) and a multi‐electrode blood gas analyzer (BG). Paired data were compared using Lin's concordance correlation, Pearson's correlation and robust regression. Bias and limits of agreement were investigated using the technique of Bland and Altman. Measurements and main results: Concordance was significant for all comparisons and was strongest for CHEM‐BG while weakest for GLU‐BG. Pearson's correlation was excellent for all comparisons: CHEM‐BG, 0.98; GLU‐BG, 0.94; GLU‐CHEM, 0.96. All comparisons had significant robust regression coefficients: CHEM‐BG, 0.99; GLU‐BG, 0.80; GLU‐CHEM, 0.79. For Bland–Altman analysis, mean differences (mean±SD, 95% limits of agreement) were: GLU‐BG (?33±18 mg/dL, ?68.6 to 1.5); GLU‐CHEM (?20±16 mg/dL, ?51.0 to 10.9); CHEM‐BG (13±11 mg/dL, ?8.7 to 34.7). Conclusions: This study demonstrates that glucometry has less than ideal agreement with a laboratory standard and another POC test, blood gas analysis. These differences may be clinically important and decisions regarding management of glucose concentrations in critically ill foals should be made with these differences in mind.  相似文献   

5.
Reasons for Performing Study: Critical illness is associated with hyperglycemia in humans, and a greater degree and duration of hyperglycemia is associated with nonsurvival. Hypoglycemia is also seen in critically ill humans, and is associated with nonsurvival. This might also be true in the critically ill foal.
Objectives: To investigate the association of blood glucose concentrations with survival, sepsis, and the systemic inflammatory response syndrome (SIRS).
Methods: Blood glucose concentrations at admission (515 foals) and 24 hours (159 foals), 36 hours (95), 48 hours (82), and 60 hours (45) after admission were analyzed. Logistic regression analyses were performed to investigate the association of glucose concentrations with survival, sepsis, a positive blood culture, or SIRS.
Results: 29.1% of foals had blood glucose concentrations within the reference range (76–131 mg/dL) at admission, 36.5% were hyperglycemic, and 34.4% were hypoglycaemic. Foals that did not survive to hospital discharge had lower mean blood glucose concentrations at admission, as well as higher maximum and lower minimum blood glucose concentrations in the 1st 24 hours of hospitalization, and higher blood glucose at 24 and 36 hours. Foals with blood glucose concentrations <2.8 mmol/L (50 mg/dL) or >10 mmol/L (180 mg/dL) at admission were less likely to survive. Hypoglycemia at admission was associated with sepsis, a positive blood culture, and SIRS.
Conclusions and Potential Relevance: Derangements of blood glucose concentration are common in critically ill foals. Controlling blood glucose concentrations may therefore be beneficial in the critically ill neonatal foal, and this warrants further investigation.  相似文献   

6.
Background: Transient hypothalamic-pituitary-adrenal (HPA) axis dysfunction occurs frequently in critically ill humans and impacts survival. The prevalence and impact of HPA axis dysfunction in critically ill neonatal foals are not well characterized.
Hypotheses: (1) HPA axis dysfunction occurs in hospitalized neonatal foals, and is characterized by inappropriately low basal serum cortisol concentration or inadequate cortisol response to exogenous adrenocorticotropic hormone (ACTH); (2) hospitalized foals with HPA axis dysfunction have more severe disease and are less likely to survive than hospitalized foals with normal HPA axis function.
Animals: Seventy-two hospitalized foals and 23 healthy age-matched foals.
Methods: Basal ACTH and cortisol concentrations were measured and a paired low-dose (10 μg)/high-dose (100 μg) cosyntropin stimulation test was performed at admission in hospitalized foals. HPA axis dysfunction was defined as (1) an inappropriately low basal cortisol concentration or (2) an inadequate increase in cortisol concentration (delta cortisol) after administration of cosyntropin, with cut-off values for appropriate basal and delta cortisol concentrations determined from results obtained in healthy age-matched foals.
Results: Forty-six percent of hospitalized foals had an inappropriately low basal cortisol concentration and 52% had an inadequate delta cortisol concentration after administration of the 100 μg dose of cosyntropin. An inadequate delta cortisol response to the high (100 μg) dose of cosyntropin was significantly correlated with shock and multiple organ dysfunction syndrome in hospitalized foals, and with decreased survival in a subgroup of septic foals.
Conclusions and Clinical Importance: HPA axis dysfunction occurs frequently in hospitalized neonatal foals, and negatively impacts disease severity and survival.  相似文献   

7.
Background: Direct colloid osmometry provides an objective assessment of the oncotic effects of crystalloid or colloidal fluid therapy, which is especially useful in monitoring fluid therapy of critically ill camelids due to their tendency toward nonspecific hypoproteinemia with increased risk of developing edema and ascites. Objectives: The aims of this study were to measure colloid osmotic pressure (COP) of alpacas and llamas, determine its correlation with concentrations of total protein (TP) and total solids (TS), as well as both albumin (A) and globulin (G) concentrations in the same model (A+G), and evaluate the effects of sample type and storage conditions on COP. Methods: Blood was collected from clinically healthy alpacas (n=23) and llamas (n=22) into heparin tubes. COP of fresh whole blood (COPFB) and plasma (COPFP) was determined using a membrane osmometer. For 20 alpacas, COP of refrigerated whole blood (COPRB) and frozen plasma (COPFrP) was also measured. Correlations between COPFB and TS, TP, and A+G concentrations were assessed by simple and multiple regression analysis to model potential predictors. Results: Median COPFB from alpacas (24.6 mmHg, range 19.3–28.1) was not significantly different from that of llamas (25.3 mmHg, range 22.5–33.7). Sample type or storage conditions did not affect COP. Measured COP had a strong positive linear correlation with TS, TP, and A+G concentrations in alpacas (r2=.7, .74, and .88, respectively). In llamas, COP correlated best with TS concentration (r2=.59), whereas correlation with TP and A+G concentrations was poor (r2=.19 and .25, respectively). Conclusion: COP can be measured using heparinized whole blood or plasma, either fresh or stored. Direct measurement is recommended whenever quantitative knowledge of COP is required in clinical or research setting. Further studies are needed to verify if the poor association of COP with TP found in this study can be generalized to llamas.  相似文献   

8.

Background

A variety of measures of l‐lactate concentration ([LAC]) in the blood of critically ill neonatal foals have shown utility as prognostic indicators. These measures, evaluating either the severity of hyperlactatemia or the duration of exposure to hyperlactatemia, perform fairly well and have correctly classified 75–80% of foals examined in several studies. The area under the l‐lactate concentration versus time curve (LAC Area) encompasses both severity and duration of hyperlactatemia and should improve correct classification of patient survival.

Hypothesis/Objectives

LAC Area is larger in nonsurviving critically ill neonatal foals.

Animals

Forty‐nine foals admitted for critical illness to 1 of 4 referral hospitals.

Methods

Whole blood was obtained at admission and 6, 12, 18, and 24 hours after admission for measurement of l‐lactate using a handheld lactate meter. LAC Area was calculated for: admission–6, 6–12, 12–18, 18–24 hours, and admission–24 hours using the trapezoidal method and summing the 6‐hours interval areas to determine total 24 hours area. Differences between survivors and nonsurvivors were determined using robust regression and Kruskal–Wallis testing, P < .05.

Results

LAC Area was significantly larger in nonsurviving foals (n = 9) than in surviving foals (n = 40) at all time periods examined.

Conclusions and Clinical Importance

Differences in LAC Area between surviving and nonsurviving critically ill neonatal foals are large and support further investigation of this method as an improved biomarker for survival in critically ill neonatal foals is indicated.  相似文献   

9.
Objective – To investigate the association between blood lactate concentration, measured at admission and following 12–36 hours of treatment, and age, diagnosis, and survival in neonatal foals. Design – Retrospective, observational study. Setting – Two equine referral hospitals. Animals – One hundred and twelve foals ≤96 hours of age were included. Interventions – Arterial or venous blood samples were obtained from all foals at admission and surviving foals at 12–36 hours. Measurements – The lactate concentration (LAC) was recorded at 2 time points: admission (LAC‐Admission) and 12–36 hours following treatment (LAC‐24 hours). Main Results – LAC decreased by 0.05 mmol/L for each increased hour of age at presentation. Premature/dysmature foals demonstrated increased odds of nonsurvival of 55% for each 1 mmol/L increase in LAC‐Admission while foals with major diagnoses of neonatal encephalopathy (NE), enteritis and ‘Other’ had increased odds of nonsurvival of 52%, 113%, and 247%, respectively, for each 1.0 mmol/L increase in LAC. Blood‐culture positive foals had significantly lower LAC than blood culture negative foals. LAC‐Admission and LAC‐24 hours were significantly larger in nonsurviving foals. LAC‐Admission of >6.9 mmol/L and LAC‐24 hours >3.2 mmol/L, respectively, correctly classified 85.6% and 94.1% of cases as survivors or nonsurvivors. No differences were found when the 24‐hour change in LAC was investigated in terms of outcome, age at admission, or major diagnosis; however, LAC‐24 hours remained significantly associated with survival. Conclusions – Admission or persistent hyperlactatemia is associated with a nonsurvival. Younger foals, premature/dysmature foals, and foals with neonatal encephalopathy had the largest LAC.  相似文献   

10.
BACKGROUND: Reference ranges for serum bile acids (SBA) concentration are well established in healthy adult horses. Increased values are indicative of hepatic disease. HYPOTHESES: SBA concentrations are significantly greater in the neonatal period compared with mature horses, and illness in the neonatal period will further increase SBA. ANIMALS: Ten healthy mature horses, 12 healthy foals, and 31 clinically ill foals. METHODS: Prospective cross-sectional study. Blood samples were obtained once from the mature horses, from healthy foals immediately after birth, at 2 days, and at 1, 2, 3, 4, and 6 weeks of age; and from ill foals less than 1 month of age at the time of admission to the Veterinary Teaching Hospital. SBA concentrations were determined enzymatically and by radioimmunoassay. Total and direct bilirubin and triglyceride concentrations were measured, as well as sorbitol dehydrogenase (SDH) and gamma-glutamyltransferase (GGT) activities. RESULTS: There was a significant negative correlation between age and SBA concentration. Compared with mature horses, SBA concentrations were significantly greater in healthy foals at each collection time over the first 6 weeks of life. Radioimmunoassay values were lower than enzymatic SBA values, with increasing bias as the mean difference between values increased. When comparing age-matched values between healthy and ill foals, there were no significant differences in SBA. None of the ill foals had a primary diagnosis of hepatic disease. There was no significant correlation between the SBA concentration and the bilirubin or triglyceride concentrations or the GGT activity. There was a significant direct correlation between increased SBA and serum SDH activity in healthy foals only. CONCLUSION AND CLINICAL IMPORTANCE: SBA concentrations in foals are significantly higher in the early neonatal period, underscoring the importance of using age-matched references when evaluating clinical pathology values during the neonatal period.  相似文献   

11.
This study compared the effects of IV administration of isotonic fluid therapy and colloidal fluid therapy in healthy neonatal foals. Fifteen healthy neonatal foals were used in a randomized blinded prospective clinical study. Foals were randomly assigned to receive a bolus of 20 mL/kg of tetrastarch (TES) or balanced crystalloid solution. Vital parameters, colloid osmotic pressure (COP), and various clinicopathologic variables were assessed prior to infusion and at various time points up to 120 h after infusion. The treatment group (TES) had a significant increase in both COP and percentage increase in COP at 1 and 3 h. The COP was significantly lower than baseline at 3 h in the control group. No significant changes were observed in coagulation parameters in either group. Tetrastarch was effective in increasing COP for 3 h after infusion and had no notable adverse clinical effects in this group of healthy foals. Further studies are warranted regarding optimal dosing and effects in clinically ill foals.  相似文献   

12.
Background: Sequential lactate concentration ([LAC]) measurements have prognostic value in that hospitalized humans and neonatal foals that have a delayed return to normolactatemia have greater morbidity and case fatality rate.
Hypothesis: Prognosis for survival is decreased in horses with a delayed return to normal [LAC].
Animals: Two hundred and fifty adult horses presented for emergency evaluation excepting horses evaluated because of only ophthalmologic conditions, superficial wounds, and septic synovitis without systemic involvement.
Methods: Prospective observational study. [LAC] was measured at admission and then at 6, 12, 24, 48, and 72 hours after admission. The change in [LAC] over time ([LAC]Δ T ) was calculated from changes in [LAC] between sampling points.
Results: Median [LAC] was significantly ( P < .001) higher at admission in nonsurvivors (4.10 mmol/L [range, 0.60–18.20 mmol/L]) when compared with survivors (1.30 mmol/L [range, 0.30–13.90 mmol/L]) and this difference remained at all subsequent time points. The odds ratio for nonsurvival increased from 1.29 (95% confidence interval 1.17–1.43) at admission to 49.90 (6.47–384) at 72 hours after admission for every 1 mmol/L increase in [LAC]. [LAC]Δ T was initially positive in all horses but became negative and significantly lower in nonsurvivors for the time periods between 24–72 hours (− 0.47, P = .001) and 48–72 hours (− 0.07, P = .032) when compared with survivors (0.00 at both time periods) consistent with lactate accumulation in nonsurvivors.
Conclusions and Clinical Importance: These results indicate that lactate metabolism is impaired in critically ill horses and [LAC]Δ T can be a useful prognostic indicator in horses.  相似文献   

13.
Background: Despite frequent clinical use, information about the pharmacokinetics (PK), clinical effects, and safety of butorphanol in foals is not available. Objectives: The purpose of this study was to determine the PK of butorphanol in neonatal foals after IV and IM administration; to determine whether administration of butorphanol results in physiologic or behavioral changes in neonatal foals; and to describe adverse effects associated with its use in neonatal foals. Animals: Six healthy mixed breed pony foals between 3 and 12 days of age were used. Methods: In a 3‐way crossover design, foals received butorphanol (IV and IM, at 0.05 mg/kg) and IV saline (control group). Butorphanol concentrations were determined by high‐performance liquid chromatography and analyzed using a noncompartmental PK model. Physiologic data were obtained at specified intervals after drug administration. Pedometers were used to evaluate locomotor activity. Behavioral data were obtained using a 2‐hour real‐time video recording. Results: The terminal half‐life of butorphanol was 2.1 hours and C0 was 33.2 ± 12.1 ng/mL after IV injection. For IM injection, Cmax and Tmax were 20.1 ± 3.5 ng/mL and 5.9 ± 2.1 minutes, respectively. Bioavailability was 66.1 ± 11.9%. There were minimal effects on vital signs. Foals that received butorphanol spent significantly more time nursing than control foals and appeared sedated. Conclusions and Clinical Importance: The disposition of butorphanol in neonatal foals differs from that in adult horses. The main behavioral effects after butorphanol administration to neonatal foals were sedation and increased feeding behavior.  相似文献   

14.
Objective – To determine if changes in viscoelastic variables are associated with abnormalities observed in the standard coagulation profile and patient outcome in foals with suspected septicemia. Design – Prospective clinical trial during 2003 and 2004 foal season. Setting – Neonatal intensive care unit at a veterinary teaching hospital. Animals – Thirty critically ill foals <72‐hour‐old admitted sequentially meeting criteria for systemic inflammatory response associated with infection. Interventions – Hemostatic evaluation, using standard coagulation testing and viscoelastic analysis, was performed at admission, 24 hours following admission, and 48 hours following admission in critically ill foals. Standard coagulation tests included platelet count, prothrombin time, activated partial thromboplastin time, fibrinogen, fibrin(ogen) degradation products, and antithrombin. Data collected from viscoelastic analysis included time to initial clot formation (ACT), clot rate, and platelet function. Signalment, blood culture results, clinicopathologic data, and outcome were collected from medical records. Equality of populations test was used to determine associations between coagulation tests and blood culture status/outcome, as well as between viscoelastic parameters and coagulopathy, blood culture status, and outcome. Logistic regression was used to quantify associations. A significance level of P<0.05 was used. Measurements and Main Results – Foals with decreasing clot rate (CR) over the sample period were more likely to be euthanized or die (P=0.02). Foals with prolonged ACT (P=0.03), and decreased CR at admission (P=0.047), were more commonly coagulopathic. Identification of coagulopathy on admission (P=0.02), or persistence of hemostatic dysfunction 48 hours later (P=0.04), was associated with death. Conclusions – Viscoelastic coagulation evaluation could be used in a neonatal intensive care unit setting to further characterize coagulopathy, and identify foals at higher risk for poor outcome.  相似文献   

15.
Background: Hepatic failure is one of the more common complications in foals requiring blood transfusion to treat neonatal isoerythrolysis. Iron intoxication is likely the cause of hepatic injury. Objectives: To determine the effects of deferoxamine on iron elimination in normal foals. Animals: Thirteen neonatal foals. Methods: Randomized‐controlled trial. At 1–3 days of age, foals received either 3 L of washed packed dam's red blood cells (RBC) or 3 L of saline IV once. Foals were treated with deferoxamine (1 g) or saline (5 mL) SC twice daily for 14 days. Foals were randomly assigned to 1 of 3 groups: RBC/deferoxamine (deferoxamine), RBC/saline (placebo), or saline/saline (control). Blood and urine samples and liver biopsy specimens were collected for measurement of hematological, biochemical, and iron metabolism variables. Results: There was a significant (P < .05) increase in hematocrit, RBC count, and hemoglobin in the groups transfused with packed RBC as compared with controls at all times. Biochemical variables and liver biopsy scores were not significantly different between groups at any time. Urine iron concentrations and fractional excretion of iron were significantly higher in deferoxamine treated foals. By 14 days after transfusion, liver iron concentrations in foals treated with deferoxamine (79.9 ± 30.9 ppm) were significantly lower than that of foals receiving placebo (145 ± 53.0 ppm) and similar to that of controls (44.8 ± 4.09 ppm). Conclusions and Clinical Importance: Deferoxamine enhances urinary iron elimination and decreases hepatic iron accumulation after blood transfusion in foals.  相似文献   

16.

Background

Bacterial sepsis remains a leading cause of morbidity and mortality in neonatal foals, but accurate diagnostic and prognostic markers are lacking. Adrenomedullin (AM) is a polypeptide with diverse biologic effects on the cardiovascular system that increases in septic humans and laboratory animals.

Hypotheses

Plasma AM concentration (p[AM]) is increased in septic neonatal foals compared to sick nonseptic and healthy control foals, and p[AM] is predictive of survival in septic neonatal foals.

Animals

Ninety critically ill (42 septic, 48 sick nonseptic) and 61 healthy foals <1 week of age.

Methods

A prospective observational clinical study was performed. Venous blood was collected from critically ill foals at admission and from healthy foals at 24 hours of age. Critically ill foals were categorized as septic or sick nonseptic based on blood culture results and sepsis score. Plasma [AM] was measured by using a commercially available ELISA for horses. Data were analyzed by using the Mann‐Whitney U‐test and P < .05 was considered significant.

Results

Plasma [AM] was not significantly different between septic and sick nonseptic foals (P = .71), but critically ill foals had significantly increased p[AM] compared to healthy controls (P < .0001). In critically ill foals, p[AM] was not predictive of survival (P = .051). A p[AM] cutoff concentration of 0.041 ng/mL provided a test sensitivity of 91% and specificity of 54% to predict illness.

Conclusions and Clinical Relevance

Plasma [AM] shows promise as a marker of health in neonatal foals, but p[AM] increases nonspecifically during perinatal illnesses and is not necessarily associated with sepsis.  相似文献   

17.
OBJECTIVE: To characterize intragastric pH profiles in critically ill foals and determine whether administration of ranitidine altered pH profiles. DESIGN: Prospective observational study. ANIMALS: 23 hospitalized neonatal foals < or = 4 days of age. PROCEDURE: Intragastric pH was measured continuously for up to 24 hours by use of an indwelling electrode and continuous data recording system. In 21 foals, ranitidine was administered IV. RESULTS: 10 foals had predominantly or exclusively alkaline profiles, 10 had profiles typical of those reported for healthy foals, with periods of acidity (hourly mean pH < 5.0 at least once), and 3 had atypical profiles with periods of acidity. All 10 foals that had intragastric pH profiles typical of healthy foals survived, whereas only 2 foals with alkaline profiles survived, and none of the foals with atypical profiles survived. The effects of ranitidine administration could not be assessed in 13 foals because of a high baseline intragastric pH. In 7 of the remaining 9, ranitidine administration resulted in an alkalinizing response, but this response was often of blunted duration. Ranitidine administration did not appear to alter the intragastric pH profile in the remaining 2 foals. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that hospitalized critically ill foals often have intragastric pH profiles different from those reported for healthy foals and may respond differently to ranitidine administration than do healthy foals. Many critically ill foals have continuously alkaline intragastric pH profiles, questioning the need for prophylactic administration of ranitidine in all critically ill foals.  相似文献   

18.

Objectives

To report red cell distribution width (RDW) values, to calculate RDW-to-platelet ratio (RPR), and to investigate a possible correlation of RDW and RPR index values in neonatal foals classified as healthy or at risk based on clinical information from a population of foals up to 24 hours of life.

Design

Retrospective study conducted from records and CBCs of foals born between June and November from 2018 to 2020 foaling seasons.

Setting

Breeding farm.

Animals

Three hundred and nine neonatal full-term Thoroughbred foals.

Interventions

None.

Measurements and Main Results

Foals were evaluated by a veterinarian within 15 minutes after birth, and a blood sample was collected within 24 hours of life. Based on clinical information, 88 of 309 foals (28.4%) were considered at risk of perinatal disease, and 201 were healthy. Mean gestational age for the foals was 346.3 ± 9.7 days. RDW values did not differ between groups. Gestational length demonstrated to have a negative correlation with RDW (r = –0.156, P = 0.005) and mean corpuscular volume (r = –0.135, P = 0.01), indicating a link of these variables to foal maturity. RPR index was higher for at-risk (0.073 ± 0.018) than for healthy foals (0.068 ± 0.014, P = 0.01).

Conclusion

RPR might be a promising early indicator of disease for the field triage of neonatal foals.  相似文献   

19.
Alterations in nitric oxide (NO)production may play a role in critical illness. Total serum nitrate/nitrite concentrations [SNN (uM/L)], the stable metabolites of NO, have been used as an indirect measure of NO in people, with increased concentrations reported in cases of critical illness. The relationship of nitric oxide (NO) to criticalillness in dgos is unknown. We tested the hypothesis that critically ill intensive care unit (ICU) canine illness in dogs is unknown. We tested the hypothesis that critically ill intesive care unit (ICU) canine patients would have increased SNN as compared to healthy dogs and non-critically ill dogs. An organ failure index score (OFI) was assigned to dogs admitted to the ICU to evaluate trends between disease severtiy and SNN. Critically ill dogs had significantly (p < 0.05) higher SNN (median 10.53) as compared to non-critically ill dogs (median 2.3) and healthy dogs (median 1.92). Critically ill dogs with the most severe disease (as based on OFI) had higher SNN concentrations. Survival of critically ill dogs with SNN of > 15 upon ICU admission (12% survival) was significantly less than survival of critically ill dogs with SNN ≤ 15 (91%) survival).l (Vet. Emerg. & Crit. Care, 9: 195–202, 1999)  相似文献   

20.
ObjectiveTo determine the pharmacokinetics and pharmacodynamics of the neurosteroid anaesthetic, alfaxalone, in neonatal foals after a single intravenous (IV) injection of alfaxalone following premedication with butorphanol tartrate.Study designProspective experimental study.AnimalsFive clinically healthy Australian Stock Horse foals of mean ± SD age of 12 ± 3 days and weighing 67.3 ± 12.4 kg.MethodsFoals were premedicated with butorphanol (0.05 mg kg?1 IV) and anaesthesia was induced 10 minutes later by IV injection with alfaxalone 3 mg kg?1. Cardiorespiratory variables (pulse rate, respiratory rate, direct arterial blood pressure, arterial blood gases) and clinical signs of anaesthetic depth were evaluated throughout anaesthesia. Venous blood samples were collected at strategic time points and alfaxalone plasma concentrations were assayed using liquid chromatography-mass spectrometry (LC/MS) and analysed by noncompartmental pharmacokinetic analysis.ResultsThe harmonic, mean ± SD plasma elimination half life (t½) for alfaxalone was 22.8 ± 5.2 minutes. The observed mean plasma clearance (Clp) and volume of distribution (Vd) were 19.9 ± 5.9 mL minute kg?1 and 0.6 ± 0.2 L kg?1, respectively. Overall, the quality of the anaesthetic inductions and recoveries was good and most monitored physiological variables were clinically acceptable in all foals, although some foals became hypoxaemic for a short period following recumbency. The mean durations of anaesthesia from induction to first movement and from induction to standing were 18.7 ± 7 and 37.2 ± 4.7 minutes, respectively.ConclusionsThe anaesthetic protocol used provided a predictable and consistent plane of anaesthesia in the five foals studied, with minimal cardiovascular depression. In foals, as in the adult horse, alfaxalone has a short elimination half life.Clinical relevanceAlfaxalone appears to be an adequate anaesthetic induction agent in foals and the pharmacokinetics suggest that, with continuous infusion, it might be suitable to provide more prolonged anaesthesia. Oxygen supplementation is recommended.  相似文献   

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