Critical illness is associated with hyperglycemia in humans, and a greater degree and duration of hyperglycemia is associated with non-survival. Hypoglycemia is also seen in critically ill humans, and is associated with non-survival. This may be true in the critically ill foal. The objective of this study was to investigate the association of blood glucose concentrations with survival, sepsis, and the systemic inflammatory response syndrome (SIRS) in critically ill neonatal foals.
Blood glucose concentrations at admission (515 foals) and 24 hours (159 foals), 36 hours (95 foals), 48 hours (82 foals) and 60 hours (45 foals) after admission were analyzed. Logistic regression analyses were performed to investigate the association of glucose concentrations with survival, sepsis, a positive blood culture, or SIRS. At admission, 29% of foals had blood glucose concentrations within the reference range (75.6-131.4mg/dL), 36% were hyperglycemic and 34% were hypoglycemic. Foals that did not survive to hospital discharge had lower mean blood glucose concentrations at admission, as well as higher maximum and lower minimum blood glucose concentrations in the first 24 hours of hospitalization, and higher blood glucose at 24 and 36 hours. Foals with blood glucose concentrations less than 2.8mmol/L (50.4mg/dL) or greater than 10mmol/L (180mg/dL) at admission were less likely to survive. Hypoglycemia at admission was associated with sepsis, a positive blood culture, and SIRS.
Derangements of blood glucose concentration are common in critically ill foals. Controlling blood glucose concentrations may therefore be beneficial in the critically ill neonatal foal, and this warrants further investigation.