Thesis
Relationship between tracheobronchoscopic score and bronchoalveolar lavage red blood cell number in the diagnosis of exercise induced pulmonary hemmorrhage in horses
Washington State University
Master of Science (MS), Washington State University
2018
Handle:
https://hdl.handle.net/2376/102190
Abstract
Exercise induced pulmonary hemorrhage (EIPH) is diagnosed and its severity assessed by post-exercise tracheobronchoscopic examination (TBE), and/or enumeration of erythrocytes (RBCs) in bronchoalveolar lavage fluid (BALF). TBE EIPH scores range from 0-4, with 0 indicating no EIPH. The overall objective of this study was to evaluate the relationship between BALF RBC and TBE EIPH scores and to determine which test is more accurate as a diagnostic test for EIPH. To do this, the correlation of TBE EIPH scores with BALF RBC numbers in 250 pairs of these data collected from 153 horses following barrel racing, and treadmill and racetrack exercise, was investigated. Although significant (p < 0.01), the correlation was weak (r2 = 0.20). Then, because of uncertainty as to whether the BALF RBC number can be affected by the BAL procedure itself, the effect of the BAL procedure on BALF RBC number was evaluated by performing 2 BALs 24 hours apart in 9 sedentary horses. No significant increase was observed in BALF RBC number as a consequence of the previous procedure (p = 0.23). Lastly, a BALF RBC threshold number that could be regarded as positive for EIPH was determined from a Bayesian analysis and the associated calculation of the F1-score. This number was 992 RBC/µl. Applying it as the gold standard to TBE scores and BALF RBC numbers from 102 sets of data collected post-supramaximal exercise from Thoroughbreds, sensitivity of TBE score was determined to be poor (59%; 95% confidence intervals: 49 - 68%), in contrast to that of the BALF RBC number ≥ 992/µl (93%; 95% confidence intervals: 88 – 96%). While false positives are extremely rare for TBE, false negatives are common and a TBE score of 0 should be followed by determination of BALF RBC number before a diagnosis of EIPH can be ruled out.
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Details
- Title
- Relationship between tracheobronchoscopic score and bronchoalveolar lavage red blood cell number in the diagnosis of exercise induced pulmonary hemmorrhage in horses
- Creators
- Maria Carolina Lopez Sanchez
- Contributors
- Warwick M. Bayly (Degree Supervisor)
- Awarding Institution
- Washington State University
- Academic Unit
- Veterinary Medicine, College of
- Theses and Dissertations
- Master of Science (MS), Washington State University
- Publisher
- Washington State University; [Pullman, Washington] :
- Identifiers
- 99900525201201842
- Language
- English
- Resource Type
- Thesis