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Association of admission L-lactate concentration in hospitalised equine neonates with presenting complaint, periparturient events, clinical diagnosis and outcome: A prospective multicentre study


Borchers, A; Wilkins, P A; Marsh, P M; Axon, J E; Read, J; Castagnetti, C; Pantaleon, L; Clark, C; Qura'n, L; Belgrave, R; Trachsel, D; Levy, M; Bedenice, D; Saulez, M N; Boston, R C (2012). Association of admission L-lactate concentration in hospitalised equine neonates with presenting complaint, periparturient events, clinical diagnosis and outcome: A prospective multicentre study. Equine Veterinary Journal, 44(Supp 41):57-63.

Abstract

REASONS FOR PERFORMING THE STUDY:

Admission L-lactate concentration is a useful and commonly measured biomarker not previously prospectively evaluated in a large multicentre study of critically ill neonatal foals.
OBJECTIVES:

To evaluate overall outcome and the association of survival and L-lactate concentration at admission ([LAC](ADMIT) ) by periparturient history, presenting complaint and clinicians' major diagnosis for ill neonatal foals.
METHODS:

Thirteen university and private equine referral hospitals enrolled 643 foals over the 2008 foaling season. Case details, historical, clinical and clinicopathological data were entered into standardised spreadsheets then unified for analysis.
RESULTS:

Overall survival was 79% (505/643). Risk of nonsurvival increased with each 1 mmol/l increase in [LAC](ADMIT) (odds ratio 1.14, P<0.001). Mean arterial pressure had a small (r(2) = 19.1) but significant (P<0.001) association with [LAC](ADMIT) . Foals experiencing known dystocia or premature placental separation had increased [LAC](ADMIT) (P<0.001). Single umbilical problems (excluding uroperitoneum), meconium impaction only and failure of passive transfer of immunity only had 100% survival. Six clinicians' major diagnoses had increased odds of nonsurvival for each 1 mmol/l increase in [LAC](ADMIT) : 'sepsis'; 'unspecified enterocolitis'; 'unspecified colic'; 'unspecified trauma'; 'immune related (not failure of passive transfer of immunity)' and 'respiratory only'.
CONCLUSIONS AND POTENTIAL RELEVANCE:

Survival of critically ill foals is good but varies with peripartum history, presenting complaint and clinicians' major diagnosis. L-lactate concentration at admission proves its utility as a valuable prognostic biomarker in neonatal foals and its utility appears to vary with peripartum history and clinicians' major diagnosis.

Abstract

REASONS FOR PERFORMING THE STUDY:

Admission L-lactate concentration is a useful and commonly measured biomarker not previously prospectively evaluated in a large multicentre study of critically ill neonatal foals.
OBJECTIVES:

To evaluate overall outcome and the association of survival and L-lactate concentration at admission ([LAC](ADMIT) ) by periparturient history, presenting complaint and clinicians' major diagnosis for ill neonatal foals.
METHODS:

Thirteen university and private equine referral hospitals enrolled 643 foals over the 2008 foaling season. Case details, historical, clinical and clinicopathological data were entered into standardised spreadsheets then unified for analysis.
RESULTS:

Overall survival was 79% (505/643). Risk of nonsurvival increased with each 1 mmol/l increase in [LAC](ADMIT) (odds ratio 1.14, P<0.001). Mean arterial pressure had a small (r(2) = 19.1) but significant (P<0.001) association with [LAC](ADMIT) . Foals experiencing known dystocia or premature placental separation had increased [LAC](ADMIT) (P<0.001). Single umbilical problems (excluding uroperitoneum), meconium impaction only and failure of passive transfer of immunity only had 100% survival. Six clinicians' major diagnoses had increased odds of nonsurvival for each 1 mmol/l increase in [LAC](ADMIT) : 'sepsis'; 'unspecified enterocolitis'; 'unspecified colic'; 'unspecified trauma'; 'immune related (not failure of passive transfer of immunity)' and 'respiratory only'.
CONCLUSIONS AND POTENTIAL RELEVANCE:

Survival of critically ill foals is good but varies with peripartum history, presenting complaint and clinicians' major diagnosis. L-lactate concentration at admission proves its utility as a valuable prognostic biomarker in neonatal foals and its utility appears to vary with peripartum history and clinicians' major diagnosis.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:05 Vetsuisse Faculty > Veterinary Clinic > Equine Department
Dewey Decimal Classification:570 Life sciences; biology
630 Agriculture
Language:English
Date:2012
Deposited On:16 Apr 2012 08:33
Last Modified:05 Apr 2016 15:45
Publisher:Equine Veterinary Journal
ISSN:0425-1644
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1111/j.2042-3306.2011.00509.x

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