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Comparative Study
. 2006;10(5):R128.
doi: 10.1186/cc5040.

Myocardial injury in infants ventilated on the paediatric intensive care unit: a case control study

Simon J Clark  1 , Michael Eisenhut, Dorothea Sidaras, Stephen W Hancock, Paul Newland, Kent Thorburn
Affiliations
Comparative Study

Myocardial injury in infants ventilated on the paediatric intensive care unit: a case control study

Simon J Clark et al. Crit Care. 2006.

Abstract

Introduction: Cardiac troponin T (cTnT) has been used to assess prevalence of myocardial injury in critically ill children. The majority of studies investigated patients undergoing cardiac surgery. Myocardial injury has been associated with increased mortality. Our objectives were to investigate whether cTnT levels are elevated in infants without congenital heart disease admitted to the paediatric intensive care unit (PICU) and whether levels are associated with increased disease severity.

Methods: We measured cTnT in consecutive infants (<12 months old) without congenital heart disease admitted to the PICU and healthy infants. The Paediatric Index of Mortality (PIM) score was determined in patients on the PICU.

Results: We recruited 107 infants: 47 infants admitted to the PICU and 60 healthy controls. Controls were, with a median (interquartile range (IQR)) age of 20 (12 to 34) weeks, significantly older than cases, with a median age of 6.5 (0.3 to 20.6) weeks. CTnT levels were, with a median (IQR) of 18 (10 to 60) pg/ml, significantly higher in admissions to the PICU than in controls, with a median level of 10 (10 to 10) pg/ml (95th centile of 20 pg/ml) (p < 0.001). There was a significant positive correlation (r = 0.41, p = 0.004) between PIM score and cTnT levels. Admissions under one month old had higher cTnT levels than older patients (p = 0.013) but the PIM score was not significantly different between them. When corrected for age and weight the correlation of PIM and cTnT was no longer significant.

Conclusion: Infants on the PICU in the neonatal period have higher cTnT levels compared to older infants despite not having more severe disease.

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Figures

Figure 1
Figure 1
Box and whisker plots for cardiac troponin T values in neonatal and older intensive care admissions along with healthy infants. The boxes are the interquartile ranges, the whiskers are the 5th to 95th percentiles, with the heavy black line representing the median. *p = 0.006 compared with healthy infants; **p = 0.013 compared with older intensive care admissions; ***p < 0.001 compared with healthy infants.
Figure 2
Figure 2
Box and whisker plots for cardiac troponin T values in healthy neonates (data taken from [9]) and neonatal paediatric intensive care admissions. The boxes are the interquartile ranges, the whiskers are the 5th to 95th percentiles, with the heavy black line representing the median.
See this image and copyright information in PMC

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