Acid-base imbalances and the association of blood-gas variables, electrolytes, and biochemical analytes with outcome in hospitalized calves undergoing abdominal surgery.

Abstract

BACKGROUND: Surgical abdominal emergencies in calves are associated with a guarded prognosis and have the potential for complex metabolic derangements including acid-base imbalances. OBJECTIVES: To perform a comprehensive analysis of acid-base status and to assess the prognostic relevance of preoperative clinicopathologic variables in calves undergoing abdominal surgery. ANIMALS: Hospital-based study samples of 535 (dataset 1; DS1) and 83 calves (dataset 2; DS2). METHODS: Retrospective (DS1) and prospective (DS2) case series. RESULTS: In DS1, acidemia (pH <7.33) was present in 49.9%, whereas alkalemia (pH >7.37) was present in 30.7% of calves. Plasma L-lactate, chloride, and serum inorganic phosphorus concentration accounted for 51.9%, 11.6% and 9.4% of the variation of venous blood pH, respectively. Classification tree analysis indicated that a negative outcome (death or euthanasia during hospitalization) was associated with venous pO&#x2009;&#x2264;33.6&#x2009;mm&#x2009;Hg, anion gap >18.3 and&#x2009;>22.9&#xa0;mEq/L, serum albumin concentration&#x2009;&#x2264;36.5 and&#x2009;&#x2264;29.4&#xa0;g/L, serum urea concentration&#x2009;>4.4&#x2009;mmol/L, and plasma ionized calcium concentration&#x2009;&#x2264;1.26&#x2009;mmol/L. The area under the receiver operating characteristic curve of this model was 0.85 (95% CI: 0.82-0.89, P&#x2009;<&#x2009;.001) and the resulting sensitivity and specificity for the prediction of nonsurvival at the optimal probability cut-point of 0.5 was 89.8% and 65.7%, respectively. In DS2 the model had a similar sensitivity and specificity of 90.5% and 70%, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: Clinicopathologic imbalances and associated changes of acid-base status are common in calves with surgical abdominal emergencies and have clinical utility for the prediction of a negative postoperative outcome.