Venous lactate, pH and partial pressure of carbon dioxide levels as prognostic indicators in 110 premature calves with respiratory distress syndrome

Abstract

Hyperlactatemia, hypercapnia, low pH and low oxygen saturation (SatO) are commonly observed in premature calves. These clinical indicators are associated with increased mortality in preterm human newborns with respiratory distress syndrome (RDS). The aim of this study was to investigate the prognostic importance of venous pH, partial pressure of carbon dioxide (pCO) and lactate level and which parameters are related with mortality in premature calves with RDS. All premature calves (52 male/58 female) were admitted to clinic within 12-24 hours after birth and blood samples were also taken into heparinised plastic syringes from the jugular vein within 30 minutes following admission. Diagnosis of RDS was made by both clinical signs and blood gas results. For the evaluation of independent samples, t test was used to compare the venous blood gas indicators of surviving and non-surviving premature calves. Receiver operating characteristics curves were used to determine a cut-off value in terms of lactate and pCO measurements among non-surviving and surviving calves. Venous pH, pCO, SatO, base deficit, bicarbonate (HCO) and lactate levels showed a significant variance between surviving and non-surviving calves. Mean venous pH, pCO, SatO, lactate levels in non-surviving premature calves was 7.05, 78.9 mm Hg, 16.1 per cent and 9.50 mmol/l, respectively. Mean pH, pCO, SatO and lactate levels in surviving premature calves were 7.29, 56.3 mm Hg, 25.5 per cent and 5.1 mmol/l, respectively. The cut-off values for lactate and pCO were 7.5 mmol/l and 63.5 mm Hg, respectively. In conclusion, the results of the study show that venous blood lactate and pCO have prognostic importance in premature calves with RDS.

Use of a national identification database to determine the lifetime prognosis in cattle with necrotic laryngitis and the predictive value of venous pCO2

“…20 The observed positive association between venous pCO 2 and PCV could be a consequence of dehydration or chronic hypoxia in severely ill animals, but most likely was a consequence of chronic hypoxia Venous pCO 2 on hospital admission also has been identified as a predictive factor for mortality in calves with respiratory distress syndrome (surfactant deficiency). 21 Interestingly, the cut-off to optimally distinguish survivors from nonsurvivors in that calf study was 63.5 mm Hg, which is similar to the 64.5 mm Hg found in our study. However, the survival graphs of our study clearly show that pCO 2 and TCO 2 appear to influence survival in the long term (> 1 year postoperative).…”

“…Venous pCO 2 on hospital admission also has been identified as a predictive factor for mortality in calves with respiratory distress syndrome (surfactant deficiency) . Interestingly, the cut‐off to optimally distinguish survivors from nonsurvivors in that calf study was 63.5 mm Hg, which is similar to the 64.5 mm Hg found in our study.…”

“…Therefore, the reported sensitivity and specificity of pCO 2 or TCO 2 and age as survival predictors is provisional and confirmation on another dataset is advisable. Model accuracy might be improved in the future by studying predictors for the main identified mortality causes (eg, aspiration pneumonia, suffocation, and breathing stoma closure) or by including additional blood parameters (eg, lactate or cardiac biomarkers) . With these models, high‐risk patients can be identified, and measures to normalize pCO 2 before (eg, tracheotomy, treatment of underlying cardiopulmonary disease) and after (eg, wound care, and treatment of underlying cardiopulmonary disease) surgery can be taken to increase survival chances.…”

“…Model accuracy might be improved in the future by studying predictors for the main identified mortality causes (eg, aspiration pneumonia, suffocation, and breathing stoma closure) or by including additional blood parameters (eg, lactate or cardiac biomarkers). 21,26 With these models, high-risk patients can be identified, and measures to normalize pCO 2 before (eg, tracheotomy, treatment of underlying cardiopulmonary disease) and after (eg, wound care, and treatment of underlying cardiopulmonary disease) surgery can be taken to increase survival chances. Timely recognition of the disease and recognition of its severity by laryngoscopy are advisable to avoid animals being admitted for surgery in a hypercapnic state.…”

Clinical efficacy of combinations of nebulised fluticasone, salbutamol and furosemide on lung function in premature calves with respiratory distress syndrome

“…In the study of Beca and Scopes (1972), all preterms with lactate concentrations < 3.9 mmol/l survived but preterm human infants with rising lactate values died, even when initial values were normal. Yildiz et al (2017) reported that mean lactate concentrations were 9.5 mmol/l in non-surviving and 5.1 mmol/l in surviving premature calves with RDS. In the present study, premature calves with RDS which had lactate concentrations greater than 10 mmol/l died.…”