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马的败血性肺炎伴低钠血症。

Hyponatremia in horses with septic pneumopathy.

机构信息

College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.

Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA.

出版信息

J Vet Intern Med. 2022 Sep;36(5):1820-1826. doi: 10.1111/jvim.16522. Epub 2022 Aug 23.

Abstract

BACKGROUND

Hyponatremia is common in horses with bacterial pleuropneumonia, but no further characterization of this abnormality has been reported.

OBJECTIVES

Describe admission plasma sodium concentration ([Na]) in horses with septic pneumopathy and evaluate any association of plasma [Na] with markers of systemic inflammation.

ANIMALS

Medical records of horses >1 month of age that between 2008 and 2021 had a transtracheal aspirate (TTA) performed, abnormal TTA cytology, positive TTA culture, pulmonary disease on ultrasonography, radiography or both, and plasma [Na] assessed by direct ion-selective-electrode (dISE). Horses with concurrent diarrhea or azotemia were excluded.

METHODS

Clinical and clinicopathological variables of interest between hypo- and normonatremic horses were compared. Spearman correlation and Fisher exact tests were used to identify significant associations (P < .05).

RESULTS

Twenty of 35 horses had hyponatremia (median, 132 mmol/L; 25-75th interquartile range [IQR], 129.7-133.1 mmol/L; reference range, 134.2-138.4 mmol/L). A higher proportion of horses with systemic inflammatory response syndrome (SIRS) had hyponatremia (P = .01). Hyponatremic patients had higher mean plasma fibrinogen concentration (461 ± 160.5 mg/dL; P = .01) and higher rectal temperature (38.8 ± 0.7°C; P = .02) than normonatremic horses. Negative correlations were found between plasma [Na] and fibrinogen (P = .001; ρ = -0.57) concentrations and between plasma [Na] and rectal temperature (P = .001; ρ = -0.51). Presence or absence of pleural effusion did not influence severity of hyponatremia. Mean duration of hospitalization was longer (P = .04) in hyponatremic horses (9.8 ± 6.6 days).

CONCLUSIONS AND CLINICAL IMPORTANCE

Hyponatremia at admission is associated with the presence of inflammation, SIRS, and with longer duration of hospitalization.

摘要

背景

低钠血症在患有细菌性胸膜肺炎的马中很常见,但尚未对这种异常进行进一步描述。

目的

描述患有败血性肺炎的马入院时的血浆钠浓度([Na]),并评估血浆[Na]与全身炎症标志物之间的任何关联。

动物

2008 年至 2021 年间进行了经气管抽吸术(TTA)、TTA 细胞学异常、TTA 培养阳性、超声、放射学或两者均有肺部疾病,且通过直接离子选择性电极(dISE)评估血浆[Na]的>1 月龄马。排除同时患有腹泻或氮质血症的马。

方法

比较低钠血症和正常钠血症马的临床和临床病理变量。使用 Spearman 相关和 Fisher 确切检验来确定显著关联(P<.05)。

结果

35 匹马中有 20 匹患有低钠血症(中位数 132mmol/L;25-75 百分位区间[IQR] 129.7-133.1mmol/L;参考范围 134.2-138.4mmol/L)。患有全身性炎症反应综合征(SIRS)的马中,低钠血症的比例更高(P=.01)。低钠血症患者的平均血浆纤维蛋白原浓度(461±160.5mg/dL;P=.01)和直肠温度(38.8±0.7°C;P=.02)更高。血浆[Na]与纤维蛋白原(P=.001;ρ=-0.57)浓度和与直肠温度(P=.001;ρ=-0.51)呈负相关。胸腔积液的存在与否并不影响低钠血症的严重程度。低钠血症马的住院时间更长(P=.04;9.8±6.6 天)。

结论和临床意义

入院时的低钠血症与炎症、SIRS 的存在以及住院时间的延长有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/20d9/9511076/a325f62bac7f/JVIM-36-1820-g001.jpg

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