Resumen
Los potros neonatos son susceptibles a enfermedades potencialmente mortales. Por tanto, es importante identificar marcadores que permitan predecir la supervivencia de estos pacientes, e iniciar el tratamiento adecuado para cada caso. Este estudio fue realizado en el Centro de Perinatología Equina Foal Care ubicado en Cajicá, Cundinamarca. Se revisaron y analizaron las historias clínicas de 106 potros que ingresaron a hospitalización entre septiembre de 2019 y diciembre de 2020 para evaluar el valor predictivo de los parámetros de gases sanguíneos y electrolitos frente a la supervivencia de potros neonatos hospitalizados. Se utilizaron diferentes pruebas estadísticas como la prueba de Kolmogorov Smirnov, U de Mann-Whitney, regresión logística binaria, pruebas de chi cuadrado, odds ratio y análisis de la curva de características del operador del receptor (ROC). Se observó que el desorden ácido-básico más común al ingreso a hospitalización fue la acidosis metabólica (37/106), y el desequilibrio electrolítico más frecuente fue la hipocalcemia (89/106). La variable más significativamente relacionada con la supervivencia fue el pH > 7,35 (p = ,007; OR = 0,288; IC = 95 %, 0,117-0,706). Los factores de riesgo asociados con la no supervivencia de los potros fueron pH < 7,35, lactato > 4,5 y glucosa < 119,5 mg/dl.Referencias
MacDonald, Franco MS, Oliver OJ. Enfermedades de los potros neonatos y su epidemiología: una revisión. Rev Med Vet. 2015;(29): 91-105. Disponible en: https://doi.org/10.19052/mv.3449
Axon JE, Palmer JE. Clinical pathology of the foal. Vet Clin North Am Equine Pract. 2008;24(2): 357-385. Disponible en: https://doi.org/10.1016/j.cveq.2008.03.005
Salgueiro R, Alfonso A, Gomes M, Vela C, Sudano MJ, Oba E, et al. Electrolyte, blood gas and electrocardiographic profile of neonatal foals in the first 48 hours of life. Acta Sci Vet. 2015;43: 1321.
Bazzano M, Giudice E, Di Pietro S, Piccione G. Vital parameters in newborn thoroughbred foals during the first week of life. Int J Anesthesiol Res. 2014;2(2): 27-30. Disponible en: https://doi.org/10.14205/2310-9394.2014.02.02.1
Curcio B, Nogueira CE. Newborn adaptations and healthcare throughout the first age of the foal. Anim Reprod. 2012;9(3): 182-187. Disponible en: https://www.animal-reproduction.org/article/5b5a6056f7783717068b46db
Knottenbelt D, Holdstock N, Madigan J. Equine Neonatalogy Medicine and Surgery. Austin: Elsevier; 2004.
García S, Masri M. Neonatología Equina. 1a ed. Vol. 53. Buenos Aires: Inter-Médica; 2010.
Dembek KA, Hurcombe SD, Frazer ML, Morresey PR, Toribio RE. Development of a likelihood of survival scoring system for hospitalized equine neonates using generalized boosted regression modeling. PLoS One. 2014;9(10): 1-7. Disponible en: https:/doi.org/10.1371/journal.pone.0109212
Cruz RKS, Alfonso A, Souza FF, Oba E, Padovani CR, Ramos PRR, et al. Evaluation of neonatal vitality and blood glucose, lactate and cortisol concentrations in foals of the Paint Horse breed. Pesqui Vet Bras. 2017;37(8): 891-896. Disponible en: https://www.scielo.br/j/pvb/a/9FSj47rhrt8VgPgNDJVvdjg/?lang=en
Giguère S, Weber EJ, Sanchez LC. Factors associated with outcome and gradual improvement in survival over time in 1065 equine neonates admitted to an intensive care unit. Equine Vet J. 2017;49(1): 45-50. Disponible en: https://doi.org/10.1111/evj.12536
Swain O’Fallon EA. Emergency Management of Equid Foals in the Field. Vet Clin North Am Equine Pract. 2021;37(2): 407-420. Disponible en: https://doi.org/10.1016/j.cveq.2021.04.009
Bohlin A, Saegerman C, Hoeberg E, Sånge A, Nostell K, Durie I, et al. Evaluation of the foal survival score in a Danish-Swedish population of neonatal foals upon hospital admission. J Vet Intern Med. 2019;33(3): 1507-1513. Disponible en: https://doi.org/10.1111/jvim.15487
Castagnetti C, Veronesi MC. Prognostic factors in the sick neonatal foal. Vet Res Commun. 2008;32(Suppl 1): S87–91. Disponible en: https://doi.org/10.1007/s11259-008-9097-z
Rohrbach BW, Buchanan BR, Drake JM, Andrews FM, Bain FT, Byars DT, et al. Use of a multivariable model to estimate the probability of discharge in hospitalized foals that are 7 days of age or less. J Am Vet Med Assoc. 2006;228(11): 1748-1756. Disponible en: https://doi.org/10.2460/javma.228.11.1748
Bedenice D, Avila B, Paradis MR. Comparative evaluation of clinical findings and prognostic outcome parameters in hospitalized, critically ill neonatal foals and crias. J Vet Emerg Crit Care. 2021;31(5): 619-628. Disponible en: https://doi.org/10.1111/vec.13093
Dos Santos RS, Corrêa MN, De Araújo LO, Pazinato FM, Feijó LS, Curcio BR, et al. Avaliação hematológica e hemogasométrica de potros nascidos de éguas com placentite ascendente. Arq Bras Med Vet Zootec. 2017;69(1): 48-56. Disponible en: https://doi.org/10.1590/1678-4162-8565
Abraham M, Bauquier J. Causes of equine perinatal mortality. Vet J. 2021;273: 105675. Disponible en: https://doi.org/10.1016/j.tvjl.2021.105675
Saulez MN, Gummow B, Slovis NM, Byars TD, Frazer M, Macgillivray K, et al. Admission clinicopathological data, length of stay, cost and mortality in an equine neonatal intensive care unit. J S Afr Vet Assoc. 2007;78(3): 153-157. Disponible en: https://doi.org/10.4102/jsava.v78i3.308
Viu J, Armengou L, Ríos J, Cesarini C, Jose-Cunilleras E. Acid base imbalances in ill neonatal foals and their association with survival. Equine Vet J. 2015;49(1): 51-57. Disponible en: https://doi.org/10.1111/evj.12542
Kincade CN, Davis I. Considerations in assessment and care of the high risk neonatal foal. Iowa State Univ Vet. 1992;54(2): 85-89.
Carluccio A, Contri A, Gloria A, Veronesi MC, Sfirro MP, Parrillo S, et al. Correlation between some arterial and venous blood gas parameters in healthy newborn Martina Franca donkey foals from birth to 96 hours of age. Theriogenology. 2017;87: 173-178. Disponible en: https://doi.org/10.1016/j.theriogenology.2016.08.021
Rieser TM. Arterial and venous blood gas analyses. Top Companion Anim Med. 2013;28(3): 86-90. Disponible en: http://dx.doi.org/10.1053/j.tcam.2013.04.002
Jeawon S, Katz LM, Galvin NP, Fogarty UM, Duggan VE. Determination of reference intervals for umbilical cord arterial and venous blood gas analysis of healthy Thoroughbred foals. Theriogenology. 2018;118: 1-6. Disponible en: https://doi.org/10.1016/j.theriogenology.2018.05.024
Radcliffe RM, Buchanan BR, Cook VL, Divers TJ. The clinical value of whole blood point-of-care biomarkers in large animal emergency and critical care medicine. J Vet Emerg Crit Care. 2015;25(1): 138-151. Disponible en: https://doi.org/10.1111/vec.12276
Jaramillo C, Ramírez LM, Arias MP, Álvarez ID. Gases sanguíneos, electrolitos, variables metabólicas y determinantes del estado ácido-base en un grupo de Caballos Criollos Colombianos. Rev la Fac Med Vet y Zootec. 2016;63(1): 20-29.
Sławuta P, Noszczyk-Nowak A, Nowakowski H. Acid-base balance parameters and a value of anion gap of arterial and venous blood in Malopolski horses. Pol J Vet Sci. 2010;13(4): 581-585. Disponible en: https://doi.org/10.2478/v10181-010-0003-6
Stämpfli HR, Schoster A, Constable PD. Clinical utility of serum biochemical variables for predicting acid-base balance in critically ill horses. Vet Clin Pathol. 2014;43(4): 547-556. Disponible en: https://doi.org/10.1111/vcp.12200
Rehm M, Conzen P, Peter K, Finsterer U. Das Stewart-Modell „Moderner“ Ansatz zur Interpretation des Säure-Basen-Haushalts. Anaesthesist. 2004;4: 347-357.
Gomez DE, Arroyo LG, Stämpfli HR, Cruz LE, Oliver OJ. Physicochemical interpretation of acid-base abnormalities in 54 adult horses with acute severe colitis and diarrhea. J Vet Intern Med. 2013;27(3): 548-553. Disponible en: https://doi.org/10.1111/jvim.12071
Viu J, Jose-Cunilleras E, Armengou L, Cesarini C, Tarancón I, Rios J, et al. Acid-base imbalances during a 120 km endurance race compared by traditional and simplified strong ion difference methods. Equine Vet J Suppl. 2010;42(Suppl 38): 76-82. Disponible en: https://doi.org/10.1111/j.2042-3306.2010.00213.x
Smith BP. Medicina Interna de Grandes Animales. 4a ed. Barcelona: Elsevier; 2010.
Viu J, Armengou L, Ríos J, Muñoz A, Jose-Cunilleras E. Simplified strong ion difference approach to acid-base balance in healthy foals. J Vet Emerg Crit Care. 2016;26(4): 549-558. Disponible en: https://doi.org/10.1111/vec.12488
Neil K. How to use lactate in equine practice. Aust Equine Vet. 2008;27(4): 34-48. Disponible en: https://www.ava.com.au/library-resources/library/ava-scientific-journals/aev/2008/how-to-use-lactate-in-equine-practice/
Borchers A, Wilkins PA, Marsh PM, Axon JE, Read J, Castagnetti C, et al. Association of admission L-lactate concentration in hospitalised equine neonates with presenting complaint, periparturient events, clinical diagnosis and outcome: A prospective multicentre study. Equine Vet J. 2012;44(Suppl 41): 57-63. Disponible en: https://doi.org/10.1111/j.2042-3306.2011.00509.x
Southwood LL. Practical Guide to Equine Colic. John Wiley & Sons; 2012. Disponible en: https://doi.org/10.1002/9781118704783
Berlin D, Aroch I. Concentrations of ionized and total magnesium and calcium in healthy horses: Effects of age, pregnancy, lactation, pH and sample type. Vet J. 2009;181(3): 305-311. Disponible en: http://dx.doi.org/10.1016/j.tvjl.2008.03.014
Vengust M. Hypercapnic respiratory acidosis: A protective or harmful strategy for critically ill newborn foals? Can J Vet Res. 2012;76(4): 275-280. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3460606/
Sanchez LC, Giguère S, Lester GD. Factors associated with survival of neonatal foals with bacteremia and racing performance of surviving Thoroughbreds: 423 Cases (1982-2007). J Am Vet Med Assoc. 2008;233(9): 1446-1452. Disponible en: https://doi.org/10.2460/javma.233.9.1446
Hurcombe SDA, Toribio RE, Slovis N, Kohn CW, Refsal K, Saville W, et al. Blood arginine vasopressin, adrenocorticotropin hormone, and cortisol concentrations at admission in septic and critically ill foals and their association with survival. J Vet Intern Med. 2008;22(3): 639-647. Disponible en: https://doi.org/10.1111/j.1939-1676.2008.0090.x
Collins NM, Carrick JB, Russell CM, Axon JE. Hypernatraemia in 39 hospitalised foals: clinical findings, primary diagnosis and outcome. Aust Vet J. 2018;96(10): 385-389. Disponible en: https://doi.org/10.1111/avj.12749
Collins NM, Axon JE, Carrick JB, Russell CM, Palmer JE. Severe hyponatraemia in foals: clinical findings, primary diagnosis and outcome. Aust Vet J. 2016;94(6): 186-191. Disponible en: https://doi.org/10.1111/avj.12446
Hollis AR, Furr MO, Magdesian KG, Axon JE, Ludlow V, Boston RC, et al. Blood glucose concentrations in critically ill neonatal foals. J Vet Intern Med. 2008;22(5): 1223-1227. Disponible en: https://doi.org/10.1111/j.1939-1676.2008.0174.x
Barsnick RJIM, Hurcombe SDA, Smith PA, Slovis NM, Sprayberry KA, Saville WJA, et al. Insulin, Glucagon, and Leptin in Critically Ill Foals. J Vet Intern Med. 2011;25(1): 123-131. Disponible en: https://doi.org/10.1111/j.1939-1676.2010.0636.x
Corley KTT, Donaldson LL, Furr MO. Arterial lactate concentration, hospital survival, sepsis and SIRS in critically ill neonatal foals. Equine Vet J. 2005;37(1): 53-59. Disponible en: https://doi.org/10.2746/0425164054406856
Swink JM, Rings LM, Snyder HA, McAuley RC, Burns TA, Dembek KA, et al. Dynamics of androgens in healthy and hospitalized newborn foals. J Vet Intern Med. 2020;35(1): 538-549. Disponible en: https://doi.org/10.1111/jvim.15974
Kamr AM, Dembek KA, Reed SM, Slovis NM, Zaghawa AA, Rosol TJ, et al. Vitamin D metabolites and their association with calcium, phosphorus, and PTH concentrations, severity of illness, and mortality in hospitalized equine neonates. PLoS One. 2015;10(6): 1-14. Disponible en: https://doi.org/10.1371/journal.pone.0127684
West E, Bardell D, Senior JM. Comparison of the EPOC and i-STAT analysers for canine blood gas and electrolyte analysis. J Small Anim Pract. 2014;55(3): 139-144. Disponible en: https://doi.org/10.1111/jsap.12177
Elmeshreghi TN, Grubb TL, Greene SA, Ragle CA, Wardrop JA. Comparison of Enterprise Point-of-Care and Nova Biomedical Critical Care Xpress analyzers for determination of arterial pH, blood gas, and electrolyte values in canine and equine blood. Vet Clin Pathol. 2018;47(3): 415-424. Disponible en: https://doi.org/10.1111/vcp.12635
Bardell D, West E, Mark Senior J. Evaluation of a new handheld point-of-care blood gas analyser using 100 equine blood samples. Vet Anaesth Analg. 2017;44(1): 77-85. Disponible en: https://doi.org/10.1111/vaa.12392
Peiró JR, Borges AS, Gonçalves RC, Mendes LCN. Evaluation of a portable clinical analyzer for the determination of blood gas partial pressures, electrolyte concentrations, and hematocrit in venous blood samples collected from cattle, horses, and sheep. Am J Vet Res. 2010;71(5): 515-521. Disponible en: https://doi.org/10.2460/ajvr.71.5.515
Viesselmann LC, Videla R, Flatland B. Verification of the Heska Element Point-of-Care blood gas instrument for use with venous blood from alpacas and llamas, with determination of reference intervals. Vet Clin Pathol. 2018;47(3): 435-447. Disponible en: https://doi.org/10.1111/vcp.12628
Kirsch K, Detilleux J, Serteyn D, Sandersen C. Comparison of two portable clinical analyzers to one stationary analyzer for the determination of blood gas partial pressures and blood electrolyte concentrations in horses. PLoS One. 2019;14(2): 1-14. Disponible en: https://doi.org/10.1371/journal.pone.0211104
Guedes A. Blood gases. En: Pusterla N, Higgins J (eds.), Interpretation of Equine Laboratory Diagnostics. 1a ed. John Wiley & Sons, Inc.; 2017. p. 57-65.
Stoneham S. Foal Nursing. En: Coumbe K (ed.), Equine Veterinary Nursing. 2a ed. Iowa: Wiley-Blackwell; 2012. p. 286-302.
Häubi C, Moreno-Santillán A, De León-Ponce MD, Briones-Vega CG, Meneses-Calderón J, Orenday-Aréchinga ME, et al. Teoría ácido-básico de Stewart, un nuevo paradigma en medicina crítica. Rev Mex Anestesiol. 2006;29(4): 240-244. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=10233
Constable P. Clinical Assessment of Acid-Base Status: Comparison of the Henderson-Hasselbalch and Strong Ion Approaches. Vet Clin Pathol. 2000;29(4): 115-128. Disponible en: https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1939-165X.2000.tb00241.x
Sirker AA, Rhodes A, Grounds RM, Bennett ED. Acid - base physiology: the 'traditional' and the 'modern' approaches. Anaesthesia. 2002;57(4): 348-356. Disponible en: https://doi.org/10.1046/j.0003-2409.2001.02447.x
Quintard H, Hubert S, Ichai C. Qu’apporte le modèle de Stewart à l’interprétation des troubles de l’équilibre acide–base? What is the contribution of Stewart’s concept in acid-base disorders analysis? Ann Franç d’Anesth Réanim. 2007;26(5): 423-433. Disponible en: https://doi.org/10.1016/j.annfar.2007.02.012
Hodgson DR. Blood Gas and Acid-Base Changes in the Neonatal Foal. Vet Clin North Am Equine Pract. 1987;3(3): 617-629. Disponible en: http://dx.doi.org/10.1016/S0749-0739(17)30667-3
Gomez DE, Biermann NM, Sanchez LC. Physicochemical Approach to Determine the Mechanism for Acid-Base Disorders in 793 Hospitalized Foals. J Vet Intern Med. 2015;29(5): 1395-1402. Disponible en: https://doi.org/10.1111/jvim.13590
Gayle JM, Cohen ND, Chaffin MK. Factors associated with survival in septicemic foals: 65 cases (1988-1995). J Vet Intern Med. 1998;12(3): 140-146. Disponible en: https://doi.org/10.1111/j.1939-1676.1998.tb02109.x
Paradise M. Equine Neonatal Medicine: A Case-Based Approach. Philadelphia: Elsevier; 2006
Castagnetti C, Pirrone A, Mariella J, Mari G. Venous blood lactate evaluation in equine neonatal intensive care. Theriogenology. 2010;73(3): 343-357. Disponible en: https://doi.org/10.1016/j.theriogenology.2009.09.018
Tennent-Brown B. Blood lactate measurement and interpretation in critically ill equine adults and neonates. Vet Clin North Am Equine Pract. 2014;30(2): 399-413. Disponible en: https://doi.org/10.1016/j.cveq.2014.04.006
Allen SE, Holm JL. Lactate: physiology and clinical utility. J Vet Emerg Crit Care. 2008;18(2): 123-132. Disponible en: https://doi.org/10.1111/j.1476-4431.2008.00286.x
Henderson ISF. Diagnostic and prognostic use of L-lactate measurement in equine practice. Equine Vet Educ. 2013;25(9): 468-475. Disponible en: https://doi.org/10.1111/eve.12033
Barton M, Hart KA. Clinical pathology in the foal. Vet Clin North Am Equine Pract. 2020;36(1): 73-85. Disponible en: https://doi.org/10.1016/j.cveq.2019.11.003
Pirrone A, Mariella J, Gentilini F, Castagnetti C. Amniotic fluid and blood lactate concentrations in mares and foals in the early postpartum period. Theriogenology. 2012;78(6): 1182-1189. Disponible en: http://dx.doi.org/10.1016/j.theriogenology.2012.02.032
Reed S, Bayly W, Sellon D. Equine Internal Medicine. 3a ed. St. Louis: Elsevier; 2010.
Austin SM. Assessment of the equine neonate in ambulatory practice. Equine Vet Educ. 2013;25(11): 585-589. Disponible en: https://doi.org/10.1111/eve.12064
Palabras clave
neonato
supervivencia
gases sanguíneos
electrolitos
metabolitos