Lyle-Dugas J, Giguère S, Mallicote M F, Mackay R J, Sanchez L C
Hofmann Neonatal Intensive Care Unit, College of Veterinary Medicine, University of Florida, Gainesville, USA.
Veterinary Medical Center, University of Georgia, Athens, USA.
Equine Vet J. 2017 Mar;49(2):207-210. doi: 10.1111/evj.12553. Epub 2016 Mar 16.
Neonatal encephalopathy is the most common neurological abnormality identified in neonatal foals, but its clinical course has been rarely characterised.
To describe factors associated with nonsurvival in a population of foals diagnosed with neonatal encephalopathy.
Retrospective cross-sectional clinical study.
Cases were selected from equine neonatal (≤14 days of age) admissions between 1996 and 2007. Multivariable logistic regression was used to identify clinical parameters, laboratory variables and therapeutic interventions associated with nonsurvival.
A total of 94 foals were included in the study. Median age at admission was 12 h (range 0-96 h). The most frequently identified clinical signs included abnormal udder seeking (59%), abnormal suckle (55%), inability to stand (42%), abnormal gastrointestinal motility (37%), abnormal consciousness (34%) and seizure activity (22%). Overall, 75 (79.8%) foals survived to be discharged from the hospital and 19 foals died or were subjected to euthanasia. Variables significantly associated with nonsurvival in the multivariable model were serum total calcium concentration, serum activity of alkaline phosphatase, recumbency, number of concurrent diseases, and use of vasopressors/inotropes. The model correctly classified 92.0% of cases.
Overall survival was good and similar to previous reports. Vasopressors/inotropes were the only therapeutic intervention associated with nonsurvival, suggesting that persistent hypotension is associated with nonsurvival in the current population. Foals with concurrent disease, high total calcium and low alkaline phosphatase at admission, and that were recumbent or required treatment with vasopressors/inotropes during hospitalisation, were significantly less likely to survive.
新生驹脑病是新生马驹中最常见的神经异常疾病，但其临床病程鲜有描述。
描述诊断为新生驹脑病的马驹群体中与非存活相关的因素。
回顾性横断面临床研究。
病例选自1996年至2007年间收治的新生马驹（≤14日龄）。采用多变量逻辑回归分析来确定与非存活相关的临床参数、实验室指标和治疗干预措施。
本研究共纳入94匹新生马驹。入院时的中位年龄为12小时（范围0 - 96小时）。最常出现的临床症状包括异常寻找乳房（59%）、异常吸吮（55%）、无法站立（42%）、胃肠蠕动异常（37%）、意识异常（34%）和癫痫活动（22%）。总体而言，75匹（79.8%）马驹存活至出院，19匹马驹死亡或接受了安乐死。多变量模型中与非存活显著相关的变量为血清总钙浓度、碱性磷酸酶血清活性、躺卧状态、并发疾病数量以及血管加压药/正性肌力药的使用。该模型对92.0%的病例分类正确。
总体存活率良好，与既往报道相似。血管加压药/正性肌力药是唯一与非存活相关的治疗干预措施，提示持续性低血压与当前群体的非存活相关。入院时患有并发疾病、总钙水平高且碱性磷酸酶水平低、躺卧或住院期间需要使用血管加压药/正性肌力药治疗的马驹存活可能性显著降低。
