Serum troponin-I as an indicator of clinically significant myocardial injury in paediatric trauma patients
| Autor: | Jamie A. Seabrook, Dion Pepelassis, Gurinder Sangha, Douglas D. Fraser, Ilan Buffo-Sequeira |
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| Rok vydání: | 2012 |
| Předmět: |
Male
Cardiac function curve medicine.medical_specialty Resuscitation Time Factors Cardiac troponin Adolescent Pilot Projects Wounds Nonpenetrating Creatine Elevated serum Electrocardiography chemistry.chemical_compound Injury Severity Score Predictive Value of Tests Risk Factors Internal medicine Troponin I medicine Creatine Kinase MB Form Humans Child General Environmental Science biology business.industry Infant musculoskeletal system Troponin Surgery Heart Injuries chemistry Echocardiography Child Preschool cardiovascular system Cardiology biology.protein General Earth and Planetary Sciences Female Triage business Biomarkers |
| Zdroj: | Injury. 43:2046-2050 |
| ISSN: | 0020-1383 |
| DOI: | 10.1016/j.injury.2011.10.034 |
| Popis: | Myocardial injury is a cause of mortality in paediatric trauma, but it is often difficult to diagnose. The objectives of this pilot study were to (1) determine the prevalence of elevated cardiac troponin I (TnI) in paediatric trauma patients and (2) to determine whether elevated TnI correlates with clinically significant myocardial injury, defined as abnormalities on echocardiogram (ECHO) and/or electrocardiograms (ECG). To this end, we investigated a convenient sample size of 59 paediatric trauma patients with an Injury Severity Score (ISS)12. TnI and creatine kinase-MB (CK-MB) were measured on admission, at then at regular intervals until TnI had normalized. Patients with elevated TnI levels had an ECHO performed within 24h of admission and underwent daily ECGs until TnI normalized. Elevated serum TnI was found in n=16/59 (27%; 95% CI: 18-40%) patients and was associated with elevated CK-MB in all cases. Abnormal ECHOs were seen in 4/16 patients with elevated TnI, but peak TnI values did not correlate with abnormalities on ECHO (p=0.23). Only 1 patient had a clinically significant, albeit mild, decrease in cardiac function. All ECGs were normal. Patients with elevated TnI were more likely to be intubated (p=0.04), to have higher Injury Severity Scores (p=0.02), required more resuscitation fluid (p=0.001), and to have thoracic injuries (p0.001). Our data indicates that the prevalence of elevated TnI in paediatric trauma patients is 27%; and whilst elevated TnI reflects overall trauma severity, it is frequently elevated without a clinically significance myocardial injury. Hence, large scale studies are required to determine if an elevated threshold TnI value can be identified to accurately diagnose severe myocardial injury in paediatric trauma. |
| Databáze: | OpenAIRE |
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