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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Sequential L-lactate concentration in hospitalised equine neonates: A prospective multicentre study
Equine Veterinary Journal, Volume 45, No. S45, Year 2013
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Description
Summary: Reasons for performing study: Evaluation 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. Objectives: To prospectively evaluate the prognostic value of sequential [LAC] analysis in critically ill neonatal foals with risk of mortality. Study design: Prospective, observational study. Methods: Thirteen 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]Δ) were calculated between sampling points. Results: Nonsurvivors had significantly greater [LAC]ADMIT, [LAC]24 and [LAC]48 compared with surviving foals (P<0.001). In nonsurviving foals [LAC]Δ did not decrease over time while survivors showed significant positive [LAC]Δ 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]Δ 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]Δ was significantly positive between [LAC]ADM-24 compared with all other time periods (P<0.001). Conclusions: Blood 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]Δ can be utilised to identify patients at high risk for mortality. © 2013 EVJ Ltd.
Authors & Co-Authors
Borchers, A.
United States, Philadelphia
University of Pennsylvania
United States, Holtville
University of California
Wilkins, P. A.
United States, Philadelphia
University of Pennsylvania
United States, Urbana
University of Illinois Urbana-champaign
Marsh, P. M.
United States, Lexington
Hagyard Equine Medical Institute
Axon, J. E.
Australia, Scone
Scone Equine Hospital
Read, J.
United States, Ocala
Equine Medical Center of Ocala
Castagnetti, C.
Italy, Bologna
Alma Mater Studiorum Università Di Bologna
Pantaleon, L.
United States, Versailles
Woodford Equine Hospital
Clark, C.
United States, Ocala
Peterson Smith Equine Hospital
Qura'n, L.
United States, Urbana
University of Illinois Urbana-champaign
Belgrave, R.
United States, Ringoes
Mid-atlantic Equine Medical Center
Schwarzwald, C.
Switzerland, Zurich
Universität Zürich
Lévy, Michael Zachary
United States, West Lafayette
Purdue University
Bedenice, D.
United States, Grafton
Cummings School of Veterinary Medicine
Saulez, Montague N.
South Africa, Pretoria
University of Pretoria
Boston, R. C.
United States, Philadelphia
University of Pennsylvania
Statistics
Citations: 28
Authors: 15
Affiliations: 14
Identifiers
Doi:
10.1111/evj.12165
ISSN:
04251644
e-ISSN:
20423306
Research Areas
Maternal And Child Health
Study Design
Cohort Study
Study Approach
Quantitative