Mizen K, Woodman J, Boysen S R, Wagg C, Greco-Otto P, Léguillette R, Roy M-F
Northside Veterinary Clinic, Lethbridge, AB, Canada.
Alpine Pet Hospital, Calgary, AB, Canada.
J Vet Intern Med. 2017 Jan;31(1):164-169. doi: 10.1111/jvim.14630. Epub 2016 Dec 25.
Blood lactate concentration is a marker of tissue perfusion and helps guide therapeutic interventions in critically ill horses. In both humans and dogs, administration of corticosteroids can increase blood lactate concentration, leading to type B hyperlactatemia. This effect could be a consequence of the impact of corticosteroids on glucose metabolism.
To investigate the effects of daily IM dexamethasone administration on blood lactate and glucose concentrations in horses.
Nine healthy adult horses.
A randomized, blinded, controlled, cross-over study design was used. Horses were randomly assigned to 1 of 2 groups, either receiving 0.05 mg/kg of dexamethasone IM or an equivalent volume of saline, daily for 7 days. Blood was collected to determine lactate and glucose concentrations at baseline, 2 hours after the daily injections and 24 hours after the last injection.
Dexamethasone treatment had a statistically significant effect on lactate (P = .006) and glucose (P = .033) concentrations. The least squares mean lactate concentration was 0.93 mmol/L (95% CI: 0.87-0.99) in the dexamethasone group compared to 0.71 mmol/L (95% CI: 0.70-0.73) for the saline group. A positive relationship between blood lactate and glucose concentrations was identified, with a 0.07 mmol/L (95% CI: 0.05-0.09) increase in lactate concentration per unit increase in glucose (P < .0001) concentration.
Dexamethasone induces statistically significant increases in blood lactate and glucose concentrations in healthy horses. Awareness of the potential for corticosteroids to induce type B hyperlactatemia might be important in the management of critically ill horses receiving dexamethasone.
血乳酸浓度是组织灌注的一个指标,有助于指导对危重病马的治疗干预。在人类和犬类中,给予皮质类固醇均可增加血乳酸浓度,导致B型高乳酸血症。这种效应可能是皮质类固醇对葡萄糖代谢产生影响的结果。
研究每日肌肉注射地塞米松对马血乳酸和葡萄糖浓度的影响。
9匹健康成年马。
采用随机、盲法、对照、交叉研究设计。将马随机分为2组,每组接受以下处理之一,即每日肌肉注射0.05mg/kg地塞米松或等量生理盐水,持续7天。在基线、每日注射后2小时以及最后一次注射后24小时采集血液,以测定乳酸和葡萄糖浓度。
地塞米松治疗对乳酸(P = 0.006)和葡萄糖(P = 0.033)浓度有统计学显著影响。地塞米松组的最小二乘平均乳酸浓度为0.93mmol/L(95%CI:0.87 - 0.99),而生理盐水组为0.71mmol/L(95%CI:0.70 - 0.73)。血乳酸和葡萄糖浓度之间呈正相关,葡萄糖浓度每增加一个单位,乳酸浓度增加0.07mmol/L(95%CI:0.05 - 0.09)(P < 0.0001)。
地塞米松可使健康马的血乳酸和葡萄糖浓度出现统计学显著升高。对于接受地塞米松治疗的危重病马,认识到皮质类固醇诱发B型高乳酸血症的可能性在管理中可能很重要。