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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Vet+Intern+Med
2015 ; 29
(5
): 1395-402
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Physicochemical Approach to Determine the Mechanism for Acid-Base Disorders in
793 Hospitalized Foals
#MMPMID26256847
Gomez DE
; Biermann NM
; Sanchez LC
J Vet Intern Med
2015[Sep]; 29
(5
): 1395-402
PMID26256847
show ga
BACKGROUND: The quantitative effect of strong electrolytes, unmeasured strong
anions (UAs), pCO2, and plasma protein concentrations in determining plasma pH
can be demonstrated using the physicochemical approach. Plasma anion gap (AG) and
strong ion gap (SIG) are used to assess UAs in different species. HYPOTHESES:
Strong ions are a major factor influencing changes in plasma pH of hospitalized
foals. AG and SIG accurately predict severe hyper-L-lactatemia ([L-lac(-)] > 7
mmol/L). ANIMALS: Seven hundred and ninety three hospitalized foals < 7 days old.
METHODS: Retrospective study. The relationship between measured pH and
physicochemical variables, and the relationship between plasma [L-lac(-)] and AG
and SIG, were determined using regression analyses. Optimal AG and SIG cut points
to predict hyper-L-lactatemia were identified using an ROC curve analysis.
RESULTS: Combined, the measured strong ion difference and SIG accounted for
54-69% of the changes in the measured arterial pH of hospitalized foals. AG and
SIG were significantly associated with plasma [L-lac(-)] (P < .0001). The
receiver operator characteristics (ROC) AUC of AG and SIG for prediction of
severe hyper-L-lactatemia were 0.89 (95%CI, 0.8-0.95; P < .0001) and 0.90 (95%CI,
0.81-0.96; P < .0001), respectively. Severe hyper-L-lactatemia was best predicted
by AG > 27 mmol/L (sensitivity 80%, 95%CI, 56-94, specificity 85%, 95%CI, 73-93;
P < .0001) and SIG <-15 mmol/L (sensitivity 90%, 95%CI, 68-98; specificity 80%;
95%CI, 68-90; P < .0001). CONCLUSION AND CLINICAL RELEVANCE: Altered
concentrations of strong ions (Na(+), K(+), Cl(-)) and UAs were the primary cause
of acidemia of hospitalized foals. AG and SIG were good predictors of
hyper-L-lactatemia and could be used as surrogate tests.
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