Calcium Regulating Hormones and Serum Calcium and Magnesium Concentrations in Septic and Critically Ill Foals and their Association with Survival

Hurcombe, Samuel D.A.; Toribio, Ramiro E.; Slovis, Nathan M.; Saville, William J.; Mudge, Margaret C.; MacGillivray, K.; Frazer, Michele L.

doi:10.1111/j.1939-1676.2009.0275.x

Cited by 41 publications

(37 citation statements)

References 59 publications

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“…Recent studies have documented that dysfunction of various endocrine systems is associated with sepsis and mortality in newborn foals (Hurcombe et al . 2008, 2009; Hart et al . 2009; Barsnick et al .…”

Section: Introductionmentioning

confidence: 99%

Presumptive nonthyroidal illness syndrome in critically ill foals

Himler

Hurcombe

Griffin

et al. 2012

Equine Veterinary Journal

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SummaryReasons for performing the study: Hypothalamic-pituitary-thyroid (HPT) axis dysfunction is associated with morbidity and mortality in critically ill people. To date, investigations of HPT axis in critically ill foals are limited. Objectives: To document the occurrence of low thyroid hormone concentrations (presumptive nonthyroidal illness syndrome; NTIS) in critically ill newborn foals and investigate whether NTIS is associated with severity of disease and outcome. Hypothesis: NTIS occurs frequently in foals with sepsis and is associated with sepsis score and outcome. Reverse T3 (rT3) concentrations will be increased in septic foals and highest in nonsurvivors. Methods: Thyroid hormones (total and free thyroxine [TT4 and fT4], total and free tri-iodothyronine [TT3 and fT3], reverse T3 [rT3]) were prospectively measured in healthy, sick nonseptic and septic foals. Clinical and laboratory information was retrieved from the medical records. Hormones were measured by validated radioimmunoassays. Results: Concentrations of all thyroid hormones except rT3 (P = 0.69) were decreased in septic and sick nonseptic foals (P<0.01). Reductions in hormone concentrations were associated with an increased sepsis score (P<0.01). Nonsurviving septic foals had lower TT4, fT4, TT3 and fT3 concentrations than surviving septic foals (P<0.01). rT3 concentrations were higher in nonsurviving septic premature foals than surviving septic premature foals (P<0.05). Conclusions: NTIS (euthyroid sick syndrome) is frequently observed in critically ill and premature foals, and associated with severity of disease and mortality. Potential relevance: More research is needed to better understand the mechanism of this finding and determine whether manipulation of the HPT axis or thyroid replacement therapy could be beneficial.

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Section: Introductionmentioning

confidence: 99%

Presumptive nonthyroidal illness syndrome in critically ill foals

Himler

Hurcombe

Griffin

et al. 2012

Equine Veterinary Journal

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“…Although large‐scale veterinary epidemiological studies are uncommon, a substantial proportion of the critically ill veterinary population is estimated to be septic . The case fatality rate associated with sepsis in a variety of veterinary species is reported to approach 50%, emphasizing the need for a greater understanding of the pathophysiology of sepsis to improve therapeutic practices …”

mentioning

confidence: 99%

The Immunopathology of Sepsis: Pathogen Recognition, Systemic Inflammation, the Compensatory Anti‐Inflammatory Response, and Regulatory T Cells

Lewis

Chan

Pinheiro

et al. 2012

Veterinary Internal Medicne

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Sepsis, the systemic inflammatory response to infection, represents the major cause of death in critically ill veterinary patients. Whereas important advances in our understanding of the pathophysiology of this syndrome have been made, much remains to be elucidated. There is general agreement on the key interaction between pathogen‐associated molecular patterns and cells of the innate immune system, and the amplification of the host response generated by pro‐inflammatory cytokines. More recently, the concept of immunoparalysis in sepsis has also been advanced, together with an increasing recognition of the interplay between regulatory T cells and the innate immune response. However, the heterogeneous nature of this syndrome and the difficulty of modeling it in vitro or in vivo has both frustrated the advancement of new therapies and emphasized the continuing importance of patient‐based clinical research in this area of human and veterinary medicine.

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“…Low plasma levels of ionized calcium were found in severe colic, gastrointestinal inflammation and induced endotoxemia [24] [25]. In foals, in which sepsis is one of the main causes of death in the neonatal period, hypocalcemia has also been correlated to the severity of disease [26]. On the other hand, Pusterla et al [7] found no significant differences in mRNA expression for IL-1ß, IL-6 and PCT between healthy and septic foals.…”

Section: Discussionmentioning

confidence: 99%

Procalcitonin—A Useful Biomarker for Pneumonia Associated with <i>Rhodococcus equi</i>?

Barton¹,

Rieger²,

Teschner³

et al. 2016

MRI

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Background: Procalcitonin, a precursor protein of the hormone calcitonin, is a sensitive marker for sepsis in human medicine, which is used for diagnosis of bacterial pneumonia in adults and neonates to initiate antibiotic therapy. Objectives: In this study, procalcitonin was evaluated as a potential biomarker for Rhodococcus equi associated pneumonia. Methods: In four foals procalcitonin was measured at four time-points (day 0 before antibiotic therapy, day 1, 3 and 5/6 during therapy) in plasma using an equine specific ELISA. Inclusion criteria for the study were a positive sepsis score, ultrasonographic evidence of pulmonary abscesses in addition >8 cm, a positive microbiology out of tracheobronchial secretion and positive response to antibiotic treatment (azithromycin 10 mg/kg BDW 24q PO and rifampicin 10 mg/kg BDW 12q PO) within a weak including improvement of clinical status and reduction of ultrasonographic score <8 cm. Results: Procalcitonin concentrations remained below the working range of the ELISA (25 -1000 ng/ml) in all but one sample. Conclusions: Procalcitonin cannot be regarded a useful biomarker in pneumonia associated with Rhodococcus equi.

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Calcium Regulating Hormones and Serum Calcium and Magnesium Concentrations in Septic and Critically Ill Foals and their Association with Survival

Cited by 41 publications

References 59 publications

Presumptive nonthyroidal illness syndrome in critically ill foals

Presumptive nonthyroidal illness syndrome in critically ill foals

The Immunopathology of Sepsis: Pathogen Recognition, Systemic Inflammation, the Compensatory Anti‐Inflammatory Response, and Regulatory T Cells

Procalcitonin—A Useful Biomarker for Pneumonia Associated with <i>Rhodococcus equi</i>?

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Calcium Regulating Hormones and Serum Calcium and Magnesium Concentrations in Septic and Critically Ill Foals and their Association with Survival

Cited by 41 publications

References 59 publications

Presumptive nonthyroidal illness syndrome in critically ill foals

Presumptive nonthyroidal illness syndrome in critically ill foals

The Immunopathology of Sepsis: Pathogen Recognition, Systemic Inflammation, the Compensatory Anti‐Inflammatory Response, and Regulatory T Cells

Procalcitonin—A Useful Biomarker for Pneumonia Associated with &lt;i&gt;Rhodococcus equi&lt;/i&gt;?

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Procalcitonin—A Useful Biomarker for Pneumonia Associated with <i>Rhodococcus equi</i>?