Serum level of cardiac troponin I in pediatric patients with sepsis or septic shock

• DOI: 10.1097/pcc.0b013e31817e2b33
• Publication Date: 2009-03-05T19:13:32Z
• Authors: Norma Suely Oliveira; Valmin Ramos Silva; Jane Sant’ Ana Ca...; Jorge Elias-Neto; Fausto Edmundo Li...; Werther Brunow Ca...
• Keywords: Male; Cardiotonic Agents; Troponin I; Infant; Intensive Care Units, Pediatric; Prognosis; Shock, Septic; 3. Good health; Electrocardiography; 03 medical and health sciences; 0302 clinical medicine; Anti-Infective Agents; Child, Preschool; Dobutamine; Sepsis; Creatine Kinase, MB Form; Humans; Female; Hospital Mortality; Prospective Studies; Child; Biomarkers

Objectives: To evaluate serum level of contractile protein troponin I (cTnI) within the 24 hrs sepsis and septic shock diagnosis in children to correlate with outcome (discharge from hospital or death). Design: Prospective, observational study. Setting: Pediatric Intensive Care Unit, at Hospital Infantil Nossa Senhora da Glória, Vitória, ES, Brazil. Patients: Two hundred eighteen consecutive admissions patients. Interventions: None. Measurements main results: Measurement cTnI (IMMULITE assay, Diagnostic Product Corporation, Los Angeles, CA) creatine kinase MB isoenzyme electrocardiographic tracings were performed diagnosis. The pediatric index mortality, mortality-2 was calculated for each patient. Primary diseases most frequently associated pneumonia (42%) meningitis (18%). overall mortality 12% (27 cases), 2.7% group, 33% group. Both Index Mortality Mortality-2 reached good discrimination. Electrocardiographic abnormalities infrequent (9.2%). Abnormal levels occurred ten (4.5%) patients, significantly more frequent group than (13% vs. 0.7%, respectively; p = 0.000). Although frequency elevated higher nonsurvivors survivors (5 27 5 191, 0.003), this not showed significant relationship electrocardiogram alteration, levels, etiology sepsis, length days. In addition, a logistic regression analysis, taking account age, gender, days, definition, presence meningitis, isoenzyme, demonstrated that severity disease only variable death. Conclusions: Evaluation first better clinical evaluation, predict (death discharge hospital) process.