Discussion on Research Summary: Blood Glucose in Critically Ill Foals
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Robert N. Oglesby DVM
Moderator
Username: dro
Post Number: 21974
Registered: 1-1997
| | Posted on Thursday, Dec 18, 2008 - 8:51 am: |   |
This is not surprising information but gives us hard numbers to work with for both prognosing critically ill foals and at what point should aggressive therapy for normoglycemia (normal blood glucose levels) should be instituted. When the foals blood glucose levels get below 50 or above 180 prognosis for survival is lessened. It is unknown if aggressive management to return to normal glucose levels will effect survival but it is logical expecially in the case of low glucose levels. From a diagnostic standpoint low blood glucose is suggestive of septicemia.
DrO
J Vet Intern Med. 2008 Sep-Oct;22(5):1223-7. Epub 2008 Aug 6.
Blood glucose concentrations in critically ill neonatal foals.
Hollis AR, Furr MO, Magdesian KG, Axon JE, Ludlow V, Boston RC, Corley KT.
New Bolton Center, Kennett Square, PA, USA.
REASONS FOR PERFORMING STUDY: Critical illness is associated with hyperglycemia in humans, and a greater degree and duration of hyperglycemia is associated with nonsurvival. Hypoglycemia is also seen in critically ill humans, and is associated with nonsurvival. This might also be true in the critically ill foal. OBJECTIVES: To investigate the association of blood glucose concentrations with survival, sepsis, and the systemic inflammatory response syndrome (SIRS). METHODS: Blood glucose concentrations at admission (515 foals) and 24 hours (159 foals), 36 hours (95), 48 hours (82), and 60 hours (45) after admission were analyzed. Logistic regression analyses were performed to investigate the association of glucose concentrations with survival, sepsis, a positive blood culture, or SIRS. RESULTS: 29.1% of foals had blood glucose concentrations within the reference range (76-131 mg/dL) at admission, 36.5% were hyperglycemic, and 34.4% were hypoglycaemic. Foals that did not survive to hospital discharge had lower mean blood glucose concentrations at admission, as well as higher maximum and lower minimum blood glucose concentrations in the 1st 24 hours of hospitalization, and higher blood glucose at 24 and 36 hours. Foals with blood glucose concentrations <2.8>10 mmol/L (180 mg/dL) at admission were less likely to survive. Hypoglycemia at admission was associated with sepsis, a positive blood culture, and SIRS. CONCLUSIONS AND POTENTIAL RELEVANCE: Derangements of blood glucose concentration are common in critically ill foals. Controlling blood glucose concentrations may therefore be beneficial in the critically ill neonatal foal, and this warrants further investigation.
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