Portions of these data were presented in abstract at the 2010 American College of Veterinary Internal Medicine Forum and the 2010 International Veterinary Emergency and Critical Care Symposium.
ANALYTICAL CLINICAL STUDIES
Sequential L-lactate concentration in hospitalised equine neonates: A prospective multicentre study
Article first published online: 5 DEC 2013
© 2013 EVJ Ltd
Equine Veterinary Journal
Special Issue: 59th Annual Convention of the American Association of Equine Practitioners. Guest Editors: B. Ball, A. Pease, D. Sellon and N. White. Editor: J. Moore. Publication of this supplement was supported by the American Association of Equine Practitioners
Volume 45, Issue Supplement S45, pages 2–7, December 2013
How to Cite
Borchers, A., Wilkins, P. A., Marsh, P. M., Axon, J. E., Read, J., Castagnetti, C., Pantaleon, L., Clark, C., Qura'n, L., Belgrave, R., Schwarzwald, C., Levy, M., Bedenice, D., Saulez, M. N. and Boston, R. C. (2013), Sequential L-lactate concentration in hospitalised equine neonates: A prospective multicentre study. Equine Veterinary Journal, 45: 2–7. doi: 10.1111/evj.12165
- Issue published online: 5 DEC 2013
- Article first published online: 5 DEC 2013
- Manuscript Accepted: 25 JUN 2013
- Manuscript Received: 5 MAR 2013
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.
To prospectively evaluate the prognostic value of sequential [LAC] analysis in critically ill neonatal foals with risk of mortality.
Prospective, observational study.
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 120 h ([LAC]120) after admission. [LAC] changes over time ([LAC]Δ) were calculated between sampling points.
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 1 mmol/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).
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.