Читать книгу Manual of Equine Anesthesia and Analgesia - Группа авторов - Страница 64

 Hyperlactatemia (>2 mmol/l)Type AIs due to inadequate tissue perfusion and oxygen depletion.e.g. hypovolemia, septic shock, anemia.Type BIs associated with increased lactate production in patients with underlying diseases, but with normal tissue perfusion.Type B1Is associated with sepsis, neoplasia, endocrine disease, hepatic disease, and renal failure.Type B2Is associated with a number of toxins and pharmaceuticals.e.g. salicylates, epinephrine, norepinephrine, bicarbonate.Type B3Results from genetic metabolic abnormalities.e.g. glycogen storage disease.

 L‐lactateIt is produced by mammalian cells, and can be used as a marker of hypoxia or decreased tissue perfusion.It is the form of lactate measured by POC analyzers.In colic cases, a high lactate concentration in blood and peritoneal fluid is indicative of a surgical lesion.In horses with colic, increases in L‐lactate concentrations in the peritoneal fluid and plasma are associated with intestinal ischemia and increased mortality.L‐lactate measurement has potential application for diagnosis, monitoring, and prognostication.

 D‐lactate (not routinely measured)It is a stereoisomer of mammalian L‐lactate.It is not produced by mammalian cells.Rather, it is product of bacterial fermentation.D‐lactate is not metabolized in mammals.D‐lactate produced in the gut can be measured unchanged in peripheral blood.D‐lactate concentrations in the blood may increase in patients with intestinal ischemia.In colic cases, plasma D‐lactate is poorly correlated with plasma L‐lactate.On the other hand, peritoneal D‐lactate concentration has a strong correlation with peritoneal L‐lactate.Furthermore, peritoneal fluid D‐lactate is highly sensitive in detecting horses with strangulating obstructions of the intestine.