Association of hyperlactatemia with age,diagnosis, and survival in equine neonates |
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| Authors: | Imogen SF Henderson BVSc Robert P Franklin DVM DACVIM Pamela A Wilkins DVM PhD DACVIM DACVECC Raymond C Boston PhD |
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| Institution: | 1. Royal (Dick) School of Veterinary Studies, Easter Bush Veterinary Centre, Roslin, Midlothian EH25 9RG, Scotland,;2. Equine Medical Center of Ocala, Ocala, FL 34482,;3. Department of Clinical Studies, Sections of Medicine and Emergency, Critical Care and Anesthesia, Kennett Square, PA, and;4. Department of Clinical Studies, Section of Biostatistics, School of Veterinary Medicine, New Bolton Center, University of Pennsylvania, Kennett Square, PA |
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| Abstract: | 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. |
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| Keywords: | critical care equine neonatal intensive care foal prognosis |
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