Prospective Evaluation of Coagulation in Critically Ill Neonatal Foals

Prospective Evaluation of Coagulation in Critically Ill Neonatal Foals

Background: Coagulopathy is a potentially underrecognized complication of sepsis and septic shock in critically ill neonatal foals. Hypothesis: Critically ill neonatal foals have abnormalities in coagulation that are associated with disease severity and outcome. Animals: Foals <72 hours old admit...

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Published in:Journal of veterinary internal medicine Vol. 23; no. 1; pp. 161 - 167
Main Authors: Bentz, A.I., Palmer, J.E., Dallap, B.L., Wilkins, P.A., Boston, R.C.
Format: Journal Article
Language:English
Published: Malden, USA Blackwell Publishing Inc 01-01-2009
Subjects:
Animals
Animals, Newborn
Blood Coagulation - physiology
Coagulopathy
Critical Illness
Female
Hemorrhage - veterinary
Horse Diseases - blood
Horses
Male
Predictive Value of Tests
Sensitivity and Specificity
Sepsis
Sepsis - blood
Sepsis - veterinary
Septic shock
Shock, Septic - blood
Shock, Septic - veterinary
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Summary:Background: Coagulopathy is a potentially underrecognized complication of sepsis and septic shock in critically ill neonatal foals. Hypothesis: Critically ill neonatal foals have abnormalities in coagulation that are associated with disease severity and outcome. Animals: Foals <72 hours old admitted to a neonatal intensive care unit. Methods: Prospective, observational study. Blood was collected at admission, 24, and 48 hours for platelet count, prothrombin time, activated partial thromboplastin time, antithrombin activity and concentrations of fibrin degradation products, and fibrinogen in plasma from all foals. Results: Sixty‐three foals were enrolled and classified as Septic Shock (12), Septic (28), and Other (23). At least 1 abnormal value was found in 18/28 (64%) samples from the Septic Shock group, 66/85 (78%) from the Septic group, and 30/59 (51%) from the Other group (P= .01). Coagulopathy (3 or more abnormal values) was present in 7/28 (25%) samples in the Septic Shock group, 14/85 (16%) samples in the Septic group, and 3/59 (5%) samples in the Other group (P= .0028). Clinically detectable bleeding occurred in 8/12 (67%) Septic Shock cases, 11/28 (39%) Septic cases, and 3/23 (13%) Other cases (P= .009). Foals in Septic Shock were 12.7 times more likely to have clinical evidence of bleeding than those in the Other group (95% CI 2.3–70, P= .004). Treatment with fluids or plasma did not have a detectable effect on coagulation values. Conclusions and Clinical Importance: Coagulopathy commonly occurs in critically ill neonatal foals, especially those with sepsis and septic shock.
Bibliography:istex:149976E4AE9D54A032692C53614A2669C0663C43
ark:/67375/WNG-8S6HW0KC-6
ArticleID:JVIM229
Dr Bentz is presently affiliated with the Biology Department, College of General Studies, University of Pennsylvania, Kennett Square, PA. Dr Wilkins is presently affiliated with the Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL. A portion of these data were presented in abstract at the 2005 International Veterinary Emergency and Critical Care Meeting in Atlanta, Georgia and the 2005 Havemeyer Foundation Workshop on Uterine Infection in Mares and Women: A Comparative Study II in Hilton Head, South Carolina.
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ISSN:0891-6640
1939-1676
DOI:10.1111/j.1939-1676.2008.0229.x