The Systemic Inflammatory Response Syndrome and Predictors of Infection and Mortality in 1068 Critically Ill Newborn Foals.
Authors: Wilkins Pamela A, Wong David, Slovis Nathan M, Collins Niamh, Barr Bonnie S, MacKenzie Catriona, De Solis Cristobal Navas, Castagnetti Carolina, Mariella Jole, Burns Teresa, Perkins Gillian, Delvescovo Barbara, Sanchez L Chris, Kemper Ann M, Magdesian K Gary, Bedenice Daniela, Taylor Sandra D, Gold Jenifer, Dunkel Bettina, Pranzo Gene, Constable Peter D
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary This multicentre investigation of 1068 critically ill neonatal foals sought to establish whether systemic inflammatory response syndrome (SIRS) criteria—or individual SIRS components—could reliably predict the presence of microbial infection and survival outcomes, a question of significant clinical importance given that sepsis remains the primary cause of death in hospitalised foals. The research team collected data from multiple equine teaching hospitals, applying standardised SIRS diagnostic thresholds and evaluating how individual parameters (heart rate, respiratory rate, temperature, and leucocyte count) performed as prognostic indicators in a large neonatal cohort. The findings revealed specific SIRS components and combinations that demonstrated utility in stratifying infection risk and mortality prediction, though the overall diagnostic accuracy of SIRS criteria alone proved more limited than had been hoped, highlighting the necessity of integrating clinical judgement with additional diagnostic approaches. For practitioners managing critically ill foals, these results underscore that whilst SIRS provides a useful framework for identifying potentially septic cases warranting investigation, it should not be relied upon in isolation; targeted use of culture, inflammatory markers, and blood gas analysis remains essential for timely infection identification and treatment escalation. The study's large sample size and multicentre design strengthen the applicability of its findings to clinical practice across different equine hospital settings.
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Practical Takeaways
- •Understanding SIRS criteria and their individual components can help practitioners better identify and predict which critically ill foals are at risk for infection and poor outcomes
- •Early recognition of systemic inflammatory response combined with suspected or confirmed infection is critical for managing sepsis in neonatal foals, as sepsis is the leading cause of death in this population
- •This large-scale study provides evidence-based guidance on using inflammatory markers in clinical decision-making for critically ill newborn foals
Key Findings
- •Study evaluated SIRS criteria and individual components as predictors of infection and mortality in 1068 critically ill newborn foals
- •Sepsis defined as concurrent proven or suspected microbial infection with systemic inflammatory response syndrome in neonatal foals
- •Sepsis identified as the leading cause of morbidity and mortality in neonatal foals
- •Clinical utility of SIRS criteria and components for predicting infection and mortality outcomes in critically ill foals was assessed