title: Association of admission L-lactate concentration in hospitalised equine neonates with presenting complaint, periparturient events, clinical diagnosis and outcome: a prospective multicentre study.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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 (r2 = 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
  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.
authors.affiliation: University of Pennsylvania, Pennsylvania, USA.
authors.forename: A
authors.initials: A
authors.lastname: Borchers
authors.forename: P A
authors.initials: PA
authors.lastname: Wilkins
authors.forename: P M
authors.initials: PM
authors.lastname: Marsh
authors.forename: J E
authors.initials: JE
authors.lastname: Axon
authors.forename: J
authors.initials: J
authors.lastname: Read
authors.forename: C
authors.initials: C
authors.lastname: Castagnetti
authors.forename: L
authors.initials: L
authors.lastname: Pantaleon
authors.forename: C
authors.initials: C
authors.lastname: Clark
authors.forename: L
authors.initials: L
authors.lastname: Qura'n
authors.forename: R
authors.initials: R
authors.lastname: Belgrave
authors.forename: D
authors.initials: D
authors.lastname: Trachsel
authors.forename: M
authors.initials: M
authors.lastname: Levy
authors.forename: D
authors.initials: D
authors.lastname: Bedenice
authors.forename: M N
authors.initials: MN
authors.lastname: Saulez
authors.forename: R C
authors.initials: RC
authors.lastname: Boston
mesh_terms: D000818:Animals; D000831:Animals, Newborn / Q000097:blood*; D005260:Female; D006734:Horse Diseases / Q000097:blood*; D006736:Horses; D006762:Hospitals, Animal; D019344:Lactic Acid / Q000097:blood*; D036801:Parturition; D011247:Pregnancy; D016896:Treatment Outcome
chemical_list: D019344:Lactic Acid