Hypothalamic-pituitary-adrenal axis dysfunction in hospitalized neonatal foals.
J Vet Intern Med
; 23(4): 901-12, 2009.
Article
em En
| MEDLINE
| ID: mdl-19496914
ABSTRACT
BACKGROUND:
Transient hypothalamic-pituitary-adrenal (HPA) axis dysfunction occurs frequently in critically ill humans and impacts survival. The prevalence and impact of HPA axis dysfunction in critically ill neonatal foals are not well characterized. HYPOTHESES (1) HPA axis dysfunction occurs in hospitalized neonatal foals, and is characterized by inappropriately low basal serum cortisol concentration or inadequate cortisol response to exogenous adrenocorticotropic hormone (ACTH); (2) hospitalized foals with HPA axis dysfunction have more severe disease and are less likely to survive than hospitalized foals with normal HPA axis function. ANIMALS Seventy-two hospitalized foals and 23 healthy age-matched foals.METHODS:
Basal ACTH and cortisol concentrations were measured and a paired low-dose (10 microg)/high-dose (100 microg) cosyntropin stimulation test was performed at admission in hospitalized foals. HPA axis dysfunction was defined as (1) an inappropriately low basal cortisol concentration or (2) an inadequate increase in cortisol concentration (delta cortisol) after administration of cosyntropin, with cut-off values for appropriate basal and delta cortisol concentrations determined from results obtained in healthy age-matched foals.RESULTS:
Forty-six percent of hospitalized foals had an inappropriately low basal cortisol concentration and 52% had an inadequate delta cortisol concentration after administration of the 100 microg dose of cosyntropin. An inadequate delta cortisol response to the high (100 microg) dose of cosyntropin was significantly correlated with shock and multiple organ dysfunction syndrome in hospitalized foals, and with decreased survival in a subgroup of septic foals. CONCLUSIONS AND CLINICAL IMPORTANCE HPA axis dysfunction occurs frequently in hospitalized neonatal foals, and negatively impacts disease severity and survival.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Sistema Hipófise-Suprarrenal
/
Doenças dos Cavalos
/
Sistema Hipotálamo-Hipofisário
Tipo de estudo:
Risk_factors_studies
Limite:
Animals
Idioma:
En
Revista:
J Vet Intern Med
Assunto da revista:
MEDICINA INTERNA
/
MEDICINA VETERINARIA
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Estados Unidos