重度颅脑损伤的气道监测护理干预

目的:探讨气道监测护理干预对重症颅脑外伤患者预后的影响。方法:回顾分析2010年1月-2012年1月重症颅脑外伤入住我院ICU病房均行气管切开机械通气的患者189例,随机分为两组,对照组和干预组,其中对照组采用常规护理方法进行护理,干预组在常规护理的基础上加强气道监测护理干预,观察比较两组患者ICU治疗时间、肺部感染情况、呼吸机使用时间、ICU花费等情况。结果:两组患者比较:干预组肺部感染控制情况明显优于对照组(x2=4.006,P<0.05),考虑差异有统计学意义。干预组患者呼吸机使用时间及ICU治疗时间均较对照组时间缩短(t=12.9,3.82,3.95 P<0.05),有统计学差异。结论:合理的的气道监测护理能有效减少患者肺部疾病感染等并发症发生率,促进患者病情恢复,临床上值得推广。     

经鼻盲探气管插管在抢救呼吸衰竭病人中的应用

目的比较经鼻盲探气管插管和气管切开在抢救呼吸衰竭病人的治疗效果。方法回顾性对比分析同期ICU住院病人采用经鼻盲探气管插管或气管切开建立人工气道后的病情转归,使用呼吸机后血气纠正时间,使用呼吸机时间,留置气管导管时间,平均住院时间及操作并发症。结果经鼻盲探气管插管组拔管率42.9%(9/21例),拔管成功率100%(9/9例);气管切开组拔管率60.7%(17/28例),拔管成功率76.5%(13/17例),两组间比较无显著性差异(P<0.05)。使用呼吸机后血气纠正时间无明显差别,但经鼻盲探气管插管组使用呼吸机时间,留置气管导管时间,平均住院时间均短于气管切开组(P<0.05)。气管切开组操作导致的并发症发生率46.4%(13/28例),而经鼻盲探气管插管组操作导致的并发症发生率23.8%(5/21例),明显少于前者(P<0.01)。结论经鼻盲探气管插管操作简便、实用,能减少并发症,缩短使用呼吸机时间,留置气管导管时间及住院时间,在抢救呼吸衰竭病人中较气管切开术有更好的临床应用价值。     

嗜麦芽窄食单胞菌感染的临床特征、高危因素及预后分析

目的了解嗜麦芽窄食单胞菌感染的临床特点、危险因素、预后及耐药现状,为有效预防和治疗该病原菌感染提供依据。方法收集2013年11月至2014年4月浙江大学医学院附属第一医院收治的129例细菌培养为嗜麦芽窄食单胞菌患者的临床资料进行回顾性统计分析。结果 129例细菌培养确诊嗜麦芽窄食单胞菌感染患者平均年龄（65.1±17.0）岁,包括下呼吸道感染和非呼吸道感染患者分别为100例和29例,下呼吸道感染患者存在原发肺部疾病的患病率、ICU入住率、气管切开比例、广谱抗生素的使用率、患病年龄等均高于非呼吸道感染患者（P〈0.05）。而非呼吸道感染患者的外科手术、无菌腔内置管比例及免疫抑制剂使用率高于下呼吸道感染患者（P〈0.05）。嗜麦芽窄食单胞菌感染后选择敏感抗生素治疗的患者的死亡率明显低于未选择敏感抗生素的患者（15.0%/30.4%,P〈0.05）。结论原发肺部疾病、入住ICU、气管切开、广谱抗生素使用、年龄大是下呼吸道感染嗜麦芽窄食单胞菌的高危因素,外科手术、无菌腔内置管、免疫抑制剂使用是非呼吸道感染嗜麦芽窄食单胞菌的高危因素。使用敏感抗生素可以降低嗜麦芽窄食单胞菌感染患者的死亡率。     

呼吸机相关革兰阴性菌肺炎的多重耐药性及危险因素分析

目的:研究呼吸机相关多重耐药阴性菌肺炎的感染特点及危险因素.方法:回顾性分析本院呼吸内科ICU2005年至2009年呼吸机相关革兰阴性菌肺炎80例的临床资料,了解其病原体构成及药物敏感性,通过Logistic回归分析呼吸机相关多重耐药阴性菌肺炎感染的危险因素.结果:铜绿假单胞菌、不动杆菌属、肺炎克雷伯菌、大肠埃希菌和嗜麦芽窄食单胞菌等为主要革兰阴性致病菌,各和株(除嗜麦芽窄食单胞菌外)除对美罗培南、头孢哌酮/舒巴坦有较好的敏感性外,对其他抗生素均耐药明显.机械通气时间(≥5d)、入住ICU(＞7d)、抗生素的联用和频繁的更改是多重耐药菌产生的独立危险因素.结论:革兰阴性菌是呼吸机相关性肺炎(VAP)感染的主要病原体且大多呈现多重耐药.减少机械通气时间、严格掌握入住ICU指征和规范抗生素的使用,可以预防多重耐药菌的感染.     

脑卒中昏迷患者气管切开后并发肺部感染的病原菌分布及预防对策

目的:探讨脑卒中昏迷患者气管切开后并发肺部感染的病原菌分布及危险因素,并提出预防措施。方法:回顾性分析2016年1月至2017年2月我院收治的脑卒中昏迷患者96例,分析脑卒中昏迷患者肺部感染发生率及病原菌分布情况,同时采用单因素和多因素logistic回归分析肺部感染的危险因素,从而提出相应的预防措施。结果:96例脑卒中昏迷患者气管切开术后肺部感染的发生率为48.96%(47/96);共分离培养病原菌104株,包括革兰阴性菌69株(66.35%)、革兰阳性菌20株(19.23%)和真菌15株(14.42%);单因素分析结果显示,脑卒中昏迷患者气管切开术后肺部感染与年龄、基础疾病、气管切开时间、卧床时间、使用广谱抗菌药物、吸烟史、人工气道、吸痰次数及雾化吸入次数密切相关(P0.05),而与患者性别、体重、脑卒中类型无关(P0.05);多因素logistic回归分析结果显示,年龄45岁、合并患有基础疾病、气管切开时间5 d、使用广谱抗菌药物、吸烟史及建立人工气道均为脑卒中昏迷患者气管切开术后肺部感染的危险因素(P0.05),ROC分析结果为:气管切开时间的临界点(阈值C)是4.3天,其灵敏度和特异度将分别为0.851和0.918。结论:脑卒中昏迷患者气管切开后并发肺部感染的病原菌以革兰阴性菌为主,年龄45岁、合并患有基础疾病、气管切开时间5 d、使用广谱抗菌药物、吸烟史及建立人工气道能够导致脑卒中昏迷患者气管切开术后发生肺部感染,并且气管切开时间超过4.3天,脑卒中昏迷患者肺部感染的风险将大大增加,应根据病原学特征及其危险因素,采取针对性措施,降低肺部感染的发病风险。     

仙居县ICU病房铜绿假单胞菌感染调查及耐药性分析

目的了解铜绿假单胞菌在仙居县ICU病房内感染现状及其对临床常用抗菌药物的耐药情况,为铜绿假单胞菌感染的防治提供依据。方法对2011-2013年仙居县人民医院ICU患者下呼吸道感染铜绿假单胞菌药敏情况进行分析,对泛耐药菌株感染危险因素进行单因素分析。结果 622株铜绿假单胞菌对常用的抗生素有不同程度的耐药性,耐药率分别为:哌拉西林28.41%、哌拉西林/他唑巴坦24.84%、阿米卡星8.57%、环丙沙星17.32%、庆大霉素11.23%、左旋氧氟沙星22.36%、妥布霉素3.73%、头孢他啶36.75%、头孢吡肟32.00%、头孢哌酮/舒巴坦15.38%、亚胺培南39.83%、美洛培南37.36%。铜绿假单胞菌是ICU患者下呼吸道感染的主要致病菌,位居第二位,检出率为19.92%。广谱抗生素的应用、气管插管/气管切开、多器官功能障碍综合征是ICU泛耐药铜绿假单胞菌感染主要的危险因素,泛耐药比例为:广谱抗生素的应用78.57%、气管插管/气管切开76.19%、MODS 76.19%。结论铜绿假单胞菌易引发ICU病房下呼吸道感染,且耐药现象严重,易产生泛耐药,临床应根据药敏结果合理用药,控制耐药株的流行。     

动态监测血清降钙素原水平在优化全身性感染患者抗菌治疗策略中的价值

目的:评估动态监测血清降钙素原水平(PCT)在优化全身性感染患者抗菌治疗策略中的价值。方法:选取2015年4月~2015年12月全身性感染患者85例,随机分为常规组42例和PCT组43例。常规组按照《抗菌药物临床应用指导原则(2015年版)》决定抗生素疗程;PCT组在抗生素治疗后第3、5、7、10、14 d监测血清PCT水平,若PCT0.25 ng/mL停用抗生素、PCT≥0.25 ng/mL继续使用抗生素。分别比较两组患者间一般情况、传统全身炎症性反应指标及抗生素使用的种类、时间、费用以及预后的差异。结果:两组患者间治疗前后传统全身炎症性反应指标无明显差异(P0.05);两组患者间常用的抗生素种类并无明显统计学差异(P0.05);PCT组患者抗生素使用的天数为(9.9±3.9)d,明显少于常规组的(13.9±5.2)d,差异有统计学意义(P0.05);PCT组患者抗生素日均费用为(422.39±139.9)元,明显低于常规组的(514.78±155.2)元,差异有统计学意义(P0.05);两组患者间停用抗生素后14天后全身感染复发率以及28天病死率无明显统计学差异(P0.05)。但PCT组患者总住ICU时间明显少于常规组,差异有统计学意义(P0.05)。结论:动态监测血清PCT水平在优化全身性感染患者抗菌治疗策略中具有重要价值。     

重症监护病房长期机械通气患者撤机困难的原因及死亡影响因素分析

目的:探讨重症监护病房(ICU)长期机械通气患者撤机困难的原因及撤机死亡的影响因素。方法:对2015年6月至2018年10月我院收治的80例长期机械通气患者的临床资料进行回顾性分析,按照患者撤机结果分为撤机成功组52例和撤机困难组28例,根据患者存活情况分为存活组59例和死亡组21例。比较各组临床资料,分析撤机困难的原因及撤机死亡的影响因素。结果:撤机困难组年龄、心功能不全比例、多器官功能障碍(MODS)比例、呼吸机相关肺炎(VAP)比例、肝功能不全比例、肾功能不全比例、血尿素氮显著高于撤机成功组,机械通气时间、气管切开时间显著长于撤机成功组,血清白蛋白显著低于撤机成功组(P0.05)。死亡组年龄、合并糖尿病比例、心功能不全比例、MODS比例、VAP比例、肝功能不全比例、肾功能不全比例、血尿素氮显著高于存活组,机械通气时间、气管切开时间显著长于存活组,血清白蛋白显著低于存活组(P0.05)。多因素Logistic回归分析显示:年龄、合并糖尿病、MODS、VAP、机械通气时间、气管切开时间、血清白蛋白是ICU长期机械通气患者撤机死亡的影响因素(P0.05)。结论:患者治疗期间发生脏器功能不全或器官功能衰竭、机械通气时间较长、气管切开时间较长、营养状态较差是长期机械通气患者撤机困难的主要原因,年龄、合并糖尿病、MODS、VAP、机械通气时间、气管切开时间、血清白蛋白是ICU长期机械通气患者撤机死亡的影响因素。     

伴下呼吸道多重耐药菌感染的 慢性阻塞性肺病患者病原菌分布及危险因素分析

目的 探讨伴下呼吸道多重耐药菌感染的慢性阻塞性肺病(COPD)患者病原菌分布及其危险因素。方法 选取2017年1月至2018年6月我院收治的138例COPD伴下呼吸道感染患者作为研究对象,根据下呼吸道分泌物是否分离出多重耐药菌将患者分为多重耐药组(MDR组,71例)和非多重耐药组(NMDR组,67例)。采用全自动细菌鉴定仪对菌种进行鉴定,采用K-B纸片法进行药敏试验,并分析多重耐药菌感染的危险因素。结果 多重耐药组患者共分离出84株病原菌,其中革兰阴性菌所占比例最高,为58.33%;革兰阳性菌与真菌分别占22.62%和19.05%。MDR组与NMDR组患者在COPD分级、住院时间、机械通气治疗、侵入性操作、长期使用糖皮质激素、长期使用抗菌药物及糖尿病史方面差异均有统计学意义(P0.05)。多因素Logistic回归分析显示机械通气治疗、侵入性操作、使用糖皮质激素、长期使用抗菌药物及糖尿病史是多重耐药菌感染的独立危险因素(P0.05)。结论 COPD伴下呼吸道多重耐药菌感染病原菌以革兰阴性菌为主,机械通气治疗、侵入性操作、长期使用糖皮质激素、长期使用抗菌药物及糖尿病史是发生感染的独立危险因素。建议根据病原菌种类选择相应的敏感药物,并采取针对危险因素的有效措施。     

真菌致呼吸机相关性肺炎的危险因素分析

目的：探讨真菌致呼吸机相关性肺炎的危险因素。方法：回顾性分析本院RICU和ICU2009年至2012年呼吸机相关性肺炎患者98例的临床资料,分为真菌性呼吸机相关性肺炎（FVAP）组和非真菌性呼吸机相关性肺炎（NFVAP）组,比较两组真菌感染的易患因素,采用单因素G（2检验）及多因素Logistic回归进行统计学分析。结果：急性生理学及慢性健康状况评分（APACHEII）、使用MV时间（〉7d）、住院时间（〉15d）、血白蛋白〈25g、合并糖尿病、联合使用抗生素、频繁更换抗生素（〉2次／周）是导致真菌性呼吸机相关性肺炎的危险因素,其中血白蛋白〈25g、联合使用抗生素、频繁更换抗生素（〉2次／周）是导致真菌性呼吸机相关性肺炎的独立危险因素。结论：患者血白蛋白〈25g、联合使用抗生素、频繁更换抗生素（〉2次／周）是导致真菌性呼吸机相关性肺炎的独立危险因素。     

Degradation and conversion of somatostatin in normal and diabetic rats in vivo and in vitro

Plasma somatostatin-like immunoreactivity in the portal and jugular veins of streptozotocin diabetic rats was compared with that in normal control rats. In the diabetic group, somatostatin levels in the portal (p less than 0.05) and jugular (p less than 0.01) veins were both elevated compared with those in the control group. Moreover, the degree of elevation was greater in the jugular vein than in the portal vein. To further investigate the role of the liver in the clearance of somatostatin-28 in vivo, 2 micrograms of somatostatin-28 was administered as a bolus into the external jugular vein of intact and functionally hepatectomized rats. The mean half-time of somatostatin-28 was significantly longer in intact diabetic rats than in controls (p less than 0.05). The functional hepatectomy did not cause a significant difference in the half-time in diabetic rats but made it longer in control rats. These results suggest that the longer half-time of somatostatin-28 in diabetic rats in vivo is due to its slower hepatic clearance. The hepatic clearance of somatostatin-28 and somatostatin-14 was further studied in vitro using a recirculating liver perfusion method. The hepatic clearance of 1.2 nM of either somatostatin-28 or somatostatin-14 was significantly lower in diabetic rats than in controls (p less than 0.01). This indicates that elevated plasma somatostatin levels in diabetic rats are caused at least in part by decreased hepatic clearance of somatostatin.(ABSTRACT TRUNCATED AT 250 WORDS)     

Production of arsine and methylarsines in soil and in culture

Arsenate, arsenite, monomethylarsonate, and dimethylarsinate were added to different soils, and evolution of gaseous arsenical products was determined over 3 weeks. Arsine was produced in all three soils from all substrates, whereas methylarsine and dimethylarsine were produced only from methylarsonate and dimethylarsinate, respectively. At least three times more arsine than dimethylarsine was produced in soil incubated with dimethylarsinate. Resting cell suspensions of Pseudomonas and Alcaligenes produced arsine as the sole product when incubated anaerobically in the presence of arsenate or arsenite. In all instances, no trimethylarsine was observed, nor could any evidence be shown for the methylation of any arsenical substrate in soil or in culture. It was concluded that reduction to arsine, not methylation to trimethylarsine, was the primary mechanism for gaseous loss of arsenicals from soil.     

Growth and mitogenic effects of arylphorin in vivo and in vitro

In insects, developmental responses are organ- and tissue-specific. In previous studies of insect midgut cells in primary tissue cultures, growth-promoting and differentiation factors were identified from the growth media, hemolymph, and fat body. Recently, it was determined that the mitogenic effect of a Manduca sexta fat body extract on midgut stem cells of Heliothis virescens was due to the presence of monomeric alpha-arylphorin. Here we report that in primary midgut cell cultures, this same arylphorin stimulates stem cell proliferation in the lepidopterans M. sexta and Spodoptera littoralis, and in the beetle Leptinotarsa decemlineata. Studies using S. littoralis cells confirm that the mitogenic effect is due to free alpha-arylphorin subunits. In addition, feeding artificial diets containing arylphorin increased the growth rates of several insect species. When tested against continuous cell lines, including some with midgut and fat body origins, arylphorin had no effect; however, a cell line derived from Lymantria dispar fat body grew more rapidly in medium containing a chymotryptic digest of arylphorin.     

Antiplatelet and antithrombotic activities of purpurogallin in vitro and in vivo

Enzymatic oxidation of pyrogallol was efficiently transformed to an oxidative product, purpurogallin (PPG). Here, the anticoagulant activities of PPG were examined by monitoring activated partial thromboplastin time (aPTT), prothrombin time (PT), and the activities of thrombin and activated factor X (FXa). And, the effects of PPG on expression of plasminogen activator inhibitor type 1 (PAI-1) and tissue-type plasminogen activator (t-PA) were evaluated in tumor necrosis factor (TNF)-α activated human umbilical vein endothelial cells (HUVECs). Treatment with PPG resulted in prolonged aPTT and PT and inhibition of the activities of thrombin and FXa, as well as inhibited production of thrombin and FXa in HUVECs. In addition, PPG inhibited thrombin-catalyzed fibrin polymerization and platelet aggregation. PPG also elicited anticoagulant effects in mice. In addition, treatment with PPG resulted in significant reduction of the PAI-1 to t-PA ratio. Collectively, PPG possesses antithrombotic activities and offers a basis for development of a novel anticoagulant. [BMB Reports 2014; 47(7): 376-381]     

Growth and reproduction of Arabidopsis thaliana in relation to storage of starch and nitrate in the wild-type and in starch-deficient and nitrate-uptake-deficient mutants

We have investigated the interactions between resource assimilation and storage in rosette leaves, and their impact on the growth and reproduction of the annual species Arabidopsis thaliana. The resource balance was experimentally perturbed by changing (i) the external nutrition, by varying the nitrogen supply; (ii) the assimilation and reallocation of resources from rosette leaves to reproductive organs, by cutting or covering rosette leaves at the time of early flower bud formation, and (iii) the internal carbon and nitrogen balance of the plants, by using isogenic mutants either lacking starch formation (PGM mutant) or with reduced nitrate uptake (NU mutant). When plants were grown on high nitrogen, they had higher concentrations of carbohydrates and nitrate in their leaves during the rosette phase than during flowering. However, these storage pools did not significantly contribute to the bulk flow of resources to seeds. The pool size of stored resources in rosette leaves at the onset of seed filling was very low compared to the total amount of carbon and nitrogen needed for seed formation. Instead, the rosette leaves had an important function in the continued assimilation of resources during seed ripening, as shown by the low seed yield of plants whose leaves were covered or cut off. When a key resource became limiting, such as nitrogen in the NU mutants and in plants grown on a low nitrogen supply, stored resources in the rosette leaves (e.g. nitrogen) were remobilized, and made a larger contribution to seed biomass. A change in nutrition resulted in a complete reversal of the plant response: plants shifted from high to low nutrition exhibited a seed yield similar to that of plants grown continuously on a low nitrogen supply, and vice versa. This demonstrates that resource assimilation during the reproductive phase determines seed production. The PGM mutant had a reduced growth rate and a smaller biomass during the rosette phase as a result of changes in respiration caused by a high turnover of soluble sugars ( Caspar et al. 1986 ; W. Schulze et al. 1991 ). During flowering, however, the vegetative growth rate in the PGM mutant increased, and exceeded that of the wild-type. By the end of the flowering stage, the biomass of the PGM mutant did not differ from that of the wild-type. However, in contrast to the wild-type, the PGM mutant maintained a high vegetative growth rate during seed formation, but had a low rate of seed production. These differences in allocation in the PGM mutant result in a significantly lower seed yield in the starchless mutants. This indicates that starch formation is not only an important factor during growth in the rosette phase, but is also important for whole plant allocation during seed formation. The NU mutant resembled the wild-type grown on a low nitrogen supply, except that it unexpectedly showed symptoms of carbohydrate shortage as well as nitrogen deficiency. In all genotypes and treatments, there was a striking correlation between the concentrations of nitrate and organic nitrogen and shoot growth on the one hand, and sucrose concentration and root growth on the other. In addition, nitrate reductase activity (NRA) was correlated with the total carbohydrate concentration: low carbohydrate levels in starchless mutants led to low NRA even at high nitrate supply. Thus the concentrations of stored carbohydrates and nitrate are directly or indirectly involved in regulating allocation.     

Development and comparison of in vivo and in vitro models for endometritis in cows and mares

In order to investigate pathogenic mechanisms of acute endometritis in cows and mares, we established an in vivo model in both species. Based on the results of an in vitro transmigration system, human recombinant interleukin-8 (rhIL-8; 1.25 microg per mare and 5 microg per cow in 50 ml phosphate-buffered saline) was used to attract polymorphonuclear neutrophil granulocytes (PMNs) into the uteri. Peak numbers of uterine neutrophils were attracted after 6h, in both cows and mares. On average, mares responded more sensitively than cows, with 15 times higher numbers of rhIL-8-attracted uterine neutrophils (72+/-8 x 10(7)cells). In contrast to in vitro studies, in vivo migrated neutrophils (uterine neutrophils) of both species displayed a significantly reduced MHC class I expression. Expression of the CD11a molecule was significantly enhanced on equine uterine neutrophils but downregulated on bovine cells. Compared with untreated autologous peripheral neutrophils, both uterine and in vitro migrated neutrophils showed no alteration of phagocytic capacity. The ability to generate reactive oxygen species (ROS) was significantly upregulated in bovine and equine uterine neutrophils. This was also observed after in vitro migration of equine neutrophils, whereas ROS generation by bovine neutrophils was significantly depressed. In summary, the concept of inducing endometritis directly by local application of human interleukin-8 has been reliably successful in cows and mares. The model permits the analysis of PMN migration into the uterus under defined and controlled conditions. The observed differences between cows and mares with respect to phenotypical and functional characteristics of in vivo attracted uterine cells point to species-related features of neutrophil migration. In vitro transmigrated bovine and equine cells partially differ in phenotype and function from uterine neutrophils. Therefore, the in vitro transmigration assay cannot completely represent the in vivo endometritis model described here.     

Interactions of cadmium and selenium in rat plasma in vivo and in vitro

⁷⁵Se and ¹⁰⁹Cd tracers were used to study the binding of Se and Cd to plasma proteins at various SeO₃^2? doses and times up to 24 h after the simultaneous subcutaneous administration of SeO₃^2? and CdCl₂ to adult male rats. The simultaneous injection of CdCl₂ and SeO₃^2? markedly increased both Se and Cd plasma levels over that in control animals. Gel permeation chromatography of plasma indicated that at all times up to 24 h Cd and Se were bound in an atomic ratio of approx. 1 : 1 in 330 000 and 130 000 dalton fractions. From 4 to 24 h, Cd and Se appeared in the 420 000 dalton fraction, also with an atomic ratio of approx. 1 : 1. The 330 000 dalton molecules appeared to have a maximal binding capacity for the Cd-Se complex at a concentration of approx. 30 μmol/ml of plasma, while the 130 000 and 420 000 dalton molecules show a higher binding capacity. Studies in vitro revealed that SeO₃^2? does not interact directly with Cd and plasma proteins. It is metabolized by erythrocytes to a form that interacts in an atomic ratio of 1 : 1 with Cd to form a protein-bound complex of 130 000 daltons.     

Concentrations of altrenogest in plasma of mares and foals and in allantoic and amniotic fluid at parturition

Treatment with the progestin altrenogest is widely used in pregnant mares. The fact that foals born from healthy mares treated with altrenogest until term suffered from neonatal problems raises the question of direct effects of altrenogest on vital functions in the neonate. We have therefore investigated altrenogest concentrations in maternal and neonatal blood plasma and in fetal fluids. Pregnant mares were treated with altrenogest orally once daily (0,088 mg/kg bodyweight, n = 7) or left untreated (n = 8) from 280 d of gestation until foaling. Altrenogest concentration was determined in plasma of the mares, their foals and in amniotic and allantoic fluid. The concentration of altrenogest in plasma from treated mares (2.6 ± 1.0 ng/mL) was significantly lower than in plasma from their foals immediately after birth (5.6 ± 1.9 ng/mL; p < 0.05), but was significantly higher than in their fetal fluids (amniotic fluid: 0.4 ± 0.1 ng/mL; p < 0.05; allantoic fluid: 3.0 ± 1.5 ng/mL). Altrenogest was undetectable in maternal and fetal plasma and fetal fluids of control pregnancies at all times. Altrenogest concentration in plasma of foals from treated mares was strongly correlated to the altrenogest concentration in plasma of their dams (r = 0.938, p < 0.001) and in amniotic (r = 0.886, p < 0.001) and allantoic fluid (r = 0.562, p < 0.05). A significant decrease in altrenogest concentration between the time periods 0-15 min, 30-120 min, and 180-360 min after parturition was seen in the plasma from foals born to altrenogest-treated mares. In conclusion, our data demonstrate that altrenogest reaches the equine fetus at high concentrations.