Doğal Gelişen Şiddetli Sepsisli ve Septik Şoklu Buzağılarda Pıhtılaşma Bozuklukları ve Kardiyak Biyomarkırlarının Değerlendirilmesi

Abstract

Sepsis sırasında pıhtılaşma anormallikleri ve miyokardiyal hasarı sıklıkla ortaya çıkmaktadır. Bu çalışmanın amacı septik neonatal buzağılarda pıhtılaşma parametrelerini ve kardiyak spesifik biyobelirteçleri belirlenen aralıklarla değerlendirmekti. 20 adet sepsisli buzağı ve 10 adet sağlıklı buzağı dahil edildi. Pıhtılaşma parametreleri için prothrombin zamanı (PT), active edilmiş parsiyel tromboplastin zamanı (APTT), D-dimer, fibrinojen, antitrombin III (AT III), trombosit ve kardiyak biyobelirteçler için kardiyak troponin (cTn) I, T ve kreatin kinaz-MB (CK-MB) sepsisli buzağılarda tedavi öncesi, 24. ve 72. saatlerinde iki sefer ve sağlıklı buzağılarda tek sefer olarak değerlendirildi. Pıhtılaşma parametrelerinin sonuçları, PT ve APTT sürelerinde tedavi öncesinden 72. saate kadar önemli bir artış ve AT III ve fibrinojende tedavi öncesinden 72. saate kadar önemli biraz azalma belirlendi. Sepsisli buzağılarda kardiyak troponin T ve CK-MB 72 saatte anlamlı olarak yükseldiği tespit edildi. PT, APTT, fibrinojen ile kardiyak troponin T arasında korelasyon olduğu belirlendi. Sonuç olarak, kardiyak hasar, yaygın damar için pıhtılaşmanın (YDP) hiperkoagülasyon aşamasında gelişebilir ve bu durum cTn T ve CK-MB yükselmesine ve prognozun kötü olmasına yol açabilmektedir.

Keywords

• sepsis
• Biyobelirteçler
• Miyokard
• Yaygın damar içi pıhtılaşma

Evaluation of Coagulation Abnormalities and Cardiac Biomarkers in Calves with Naturally Occurring Severe Sepsis or Septic Shock

Abstract

Coagulation abnormalities and myocardial injury frequently occur during sepsis. The aim of the present study was to evaluate the coagulation parameters and cardiac-specific biomarkers at set intervals in septic neonatal calves. Ten healthy calves and 20 septic calves were included in the study. For detecting coagulation parameters prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimer, fibrinogen, antithrombin III (AT III), thrombocyte and, for cardiac biomarkers cardiac troponin (cTn) I, T, and creatine kinase-MB (CK-MB) were evaluated on admission, 24 and 72 hours later in septic calves and once in healthy calves. The results of coagulation parameters showed a significant elevation of PT and APTT times from the time of admission until the 72nd hour and a significant reduction of AT III and fibrinogen from the time of admission until the 72nd hour. Cardiac troponin T was high in the 72nd hour, and CK-MB was high in the time of admission, 24th and 72nd hours in septic calves compare to the healthy calves. There was a correlation between PT, APTT, fibrinogen with cardiac troponin T. In conclusion, cardiac damage can develop during the hypercoagulable state of disseminated intravascular coagulation (DIC), and maybe it is responsible for the elevation of cTnT and CK-MB and worse outcome in neonatal septic calves.

Keywords

• sepsis
• Biomarker
• Disseminated intravascular coagulation
• Myocardium

References

1. Ammann P, Pfisterer M, Fehr T, Rickli H (2004). Raised cardiac troponins. Br Med J, 328, 1028-1029.
2. Anas AA, Wiersinga WJ, de Vos AF, van der Poll T (2010). Recent insights into the pathogenesis of bacterial sepsis. Neth J Med, 68, 147e52.
3. Aydogdu U, Yildiz R, Guzelbektes H, Coskun A, Sen I (2016). Cardiac biomarkers in premature calves with respiratory distress syndrome. Acta Vet Hung, 64, 38-46.
4. Barton MH, Morris DD, Norton N, Prasse KW (1998). Hemostatic and fibrinolytic indices in neonatal foals with presumed septicemia. J Vet Intern Med, 12, 26-35.
5. Caldin M, Furlanello T, Lubas G (2000). Validation of an immunoturbidimetric D-dimer assay in canine citrated plasma. Vet Clin Pathol, 29, 51-54.
6. Constable PD, Hinchcliff KW, Done SH, Grünberg W (2016). Veterinary Medicine: A Textbook of the Diseases of Cattle, Sheep, Goats and Horses, 11th edition, St. Louis, MO.
7. de Laforcade AM, Freeman LM, Shaw SP, Brooks MB, Rozanski EA, Rush JE (2003). Hemostatic changes in dogs with naturally occurring sepsis. J Vet Intern Med, 17, 674-679.
8. ER C, OK M (2015). Levels of cardiac biomarkers and coagulation profiles in dogs with parvoviral enteritis. Kafkas Univ Vet Fak Derg, 21, 383-388.

9. Erturk A, Durgut MK, Naseri A, Ok M (2018). Echocardiography, Ultrasonography and Laboratory Findings of Left Ventricular Systolic Dysfunction and Right-Sided Congestive Heart Failure in A Neonatal Calf. CDVS, 1, 145-149.
10. Gökçe G, Gökçe Hİ, Erdoğan HM, Güneş V, Citil M (2006). Investigation of the coagulation profile in calves with neonatal diarrhoea. Turk J Vet Anim Sci, 30, 223-227.
11. Gunes V, Atalan G, Citil M, Erdogan H M (2008). Use of cardiac troponin kits for the qualitative determination of myocardial cell damage due to traumatic reticuloperitonitis in cattle. Vet Rec, 162, 514-517.
12. Hardaway RM, Williams CH, Vasquez Y (2001). Disseminated intravascular coagulation in sepsis. Semin Thromb Hemost, 27, 577e83.
13. Ince ME, Turgut K, Akar A, Naseri A, Sen I, Süleymanoglu H, Ertan M, Sagmanligil V (2019). Prognostic importance of tissue Doppler imaging of systolic and diastolic functions in dogs with severe sepsis and septic shock. Acta Vet Hung, 67, 517-528.
14. Irmak K, Sen I, Cöl R, Birdane FM, Güzelbektes H, Civelek T, Yιlmaz A, Turgut K (2006). The evaluation of coagulation profiles in calves with suspected septic shock. Vet Res Commun, 30, 497-503.
15. Kenney EM, Rozanski EA, Rush JE, deLaforcade-Buress AM, Berg JR, Silverstein DC, Montealegre CD, Jutkowitz LA, Adamantos S, Ovbey DH, Boysen SR, Shaw SP (2010). Association between outcome and organ system dysfunction in dogs with sepsis: 114 cases (2003–2007). J Am Vet Med Assoc, 236, 83-87.
16. Levi M (2013). Pathogenesis and management of peripartum coagulopathic calamities (disseminated intravascular coagulation and amniotic fluid metabolism). Thromb Res, 131, S32-S34.
17. Liu YC, Yu MM, Shou ST, Chai YF (2017). Sepsis-induced cardiomyopathy: mechanisms and treatments. Front Immunol, 8, 1021.
18. Martin GS, Mannino DM, Eaton S, Moss M (2003). The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med, 348, 1546e54.
19. Mehta NJ, Khan IA, Gupta V, Jani K, Gowda RM, Smith PR (2004). Cardiac troponin I predicts myocardial dysfunction and adverse outcome in septic shock. Int J Cardiol, 95, 13-17.
20. Morris DD (1996). Alterations in clotting profile. In: Large Animal Internal Medicine. Smith BP. Ed. Mosby, Missuri, USA.
21. Naseri A, Ider M, Ok M (2017). Sustained polymorphic ventricular tachycardia in a calf. Eurasian J Vet Sci, 33, 130-132.
22. Naseri A, Sen I, Turgut K, Guzelbektes H, Constable PD (2019). Echocardiographic assessment of left ventricular systolic function in neonatal calves with naturally occurring sepsis or septic shock due to diarrhea. Res Vet Sci, 126, 103-112.
23. Naseri A, Turgut K, Sen I, Ider M, Akar A (2018). Myocardial depression in a calf with septic shock. Vet Rec Case Rep, 6, e000513.
24. Peek SF, Apple FS, Murakami MA, Crump PM, Semrad SD (2008). Cardiac isoenzymes in healthy Holstein calves and calves with experimentally induced endotoxemia. Can J Vet Res, 72, 356.
25. Slack JA, McGuirk SM, Erb HN, Lien L, Coombs D, Semrad SD, Riseberg A, Marques F, Darien B, Fallon L, Burns P (2005). Biochemical markers of cardiac injury in normal, surviving septic, or nonsurviving septic neonatal foals. J Vet Intern Med, 19, 577-580.
26. Sobiech P, Rękawek W, Ali M, Targoński R, Żarczyńska K, Snarska A, Stopyra A (2013). Changes in blood acid-base balance parameters and coagulation profile during diarrhea in calves. Pol J Vet, 16, 543-549.
27. Taylor S (2015). A review of equine sepsis. Equine Vet Educ, 27, 99-109.
28. Turgut K (2000). Veteriner Klinik Laboratuvar Teşhis. 2. baskı. Konya, Bahçıvanlar Basım San AŞ.
29. Varga A, Schober KE, Holloman CH, Stromberg PC, Lakritz J, Rings DM (2009). Correlation of serum cardiac troponin I and myocardial damage in cattle with monensin toxicosis. J Vet Intern Med, 23,1108-1116.
30. Wada H, Matsumoto T, Yamashita Y (2014). Diagnosis and treatment of disseminated intravascular coagulation (DIC) according to four DIC guidelines. J Intensive Care Med, 2, 15.
31. Wong CK, White HD (2005). Implications of the new definition of myocardial infarction, Postgrad Med J, 81, 552-5.