High lactate levels have been evaluated in human and veterinary critically ill patients. Single lactate measurements at admission have been associated with outcome (survival versus nonsurvival) in critically ill humans and foals. The rate of decreasing lactate levels has been shown to be associated with improved outcome in humans with severe sepsis and septic shock, suggesting that serial lactate measurements could be a more reliable predictor of survival than a single measurement in foals. The authors hypothesized that lactate concentration and changes in lactate over time are associated with survival at 96 hours and discharge in neonatal foals. Additionally, lactate and changes in lactate over time correlate with blood culture results and blood pressure at admission.
This retrospective case review included 225 foals which were consecutively admitted to a Neonatal Intensive Care Unit. Foals under 30 days old had lactate levels measured at admission and at 24 and 48 hours. Blood pressure, blood culture status and outcome (survival versus nonsurvival at 96 hours and discharge) were recorded. Changes in lactate over time were calculated.
Measuring lactate levels at and initial evaluation and sequentially over time may be particularly useful to veterinarians managing critically ill neonatal foals, especially taking into account the increasing validation, availability and reliability of stall-side analyzers.
According to the authors, admission lactate levels, sequentially measured lactate levels and changes in lactate levels over time appear to be potential good prognostic indicators of survival versus nonsurvival in the critically ill foals.
This article was written by Wotman et al. under and it was published in 2009 by the American College of Veterinary Internal Medicine DOI: 10.1111/j.1939-1676.2009.0277.x
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