Laktat – ein neuer Parameter im Laborprofil des Hundes?

Zusammenfassung

Ziel der Studie war festzustellen, inwiefern die Bestimmung von Laktat als Parameter für die Mortalität bei kranken und traumatisierten Hunden unter Praxisbedingungen sinnvoll ist. Material und Methoden: Bei der als Feldversuch konzipierten Studie wurden vom 31.01.2006 bis zum 02.10.2007 bei den in der Praxis anfallenden Blutproben internistischer und chirurgischer Patienten zusätzlich die Plasmalaktatwerte bestimmt. Eine Selektion erfolgte nicht und es gab keine Kontrollgruppen. Bei 181 Hunden fanden 210 Laktatmessungen statt. Die Werte wurden vollautomatisch in einem Trockenchemie-Analysesystem (Gerät VetTest 8008^® der Firma Idexx) ermittelt. Ergebnisse: Die Laktatwerte der verstorbenen Patienten lagen deutlich höher als die der überlebenden Hunde. Erhöhte Laktatwerte traten insbesondere in Zusammenhang mit Herz-Kreislauf-Störungen, gastrointestinalen Erkrankungen und Sepsis auf. Schlussfolgerung und klinische Relevanz: Die Laktatbestimmung lässt sich unter Praxisbedingungen einfach durchführen, wobei Verlaufsmessungen aussagekräftiger sind als Einzel-messungen. Sinkt der Laktatwert innerhalb der ersten 24 Stunden nach Behandlungsbeginn nicht oder steigt er sogar noch an, besteht eine schlechte Prognose.

Summary

Objective: The aim of the study was to evaluate if lactate measurement is a useful predictor of mortality in ill and traumatized dogs under field conditions. Material and methods: Between January 31st, 2006 and October 2nd, 2007 plasma lactate levels were measured additionally to the routine blood parameter panels of surgical and internal patients in a field trial. Patients were not preselected and there was no control group. In a total of 181 dogs 210 lactate measurements were run automatically using a dry chemistry analyzer (VetTest 8008^®, Idexx). Results: Lactate levels were clearly higher in the deceased dogs than in the survivers. Particularly the groups of patients with heart and cir-culation disturbances, gastrointestinal diseases and sepsis displayed increased lactate levels. Conclusion and clinical relevance: Even under practice conditions lactate can easily be measured. Continuous measurements are more predictive than single ones. Prognosis is poor if the lactate concentration does not decrease or even increases during the first 24 hours after beginning of therapy.

Schlüsselwörter

Azidose - Risikopatienten - Laktatmessung - Hypoperfusion - Glykolyse

Key words

Acidosis - high-risk-patients - lactate measurement - hypoperfusion - glycolysis

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