Incidence and Significance of Cardiac Troponin I Release in Severe Trauma Patients

Édouard, A.; Felten, Marie-Louise; Hébert, Jean-Louis; Cosson, Claudine; Martin, Laurent; Benhamou, Dan

doi:10.1097/00000542-200412000-00004

Cited by 71 publications

(43 citation statements)

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“…On the other hand, Edouard et al [59] distinguished three groups of patients according to the time course of troponin I, three groups of patients were defined a priori: very transient (B12 h) and limited release (troponin I \ 2 lg/l), transient (B36 h) and significant release (troponin I C 2 lg/l), and sustained ([36 h) and significant release (troponin I [ 2 lg/l). Unfortunately, according to these authors, although a sustained and significant release of troponin I was frequently associated with chest trauma, a significant myocardial contusion may occur without troponin I release and, moreover, troponin I release does not have a prognostic value in trauma patients.…”

Section: Troponin I and Traumamentioning

confidence: 99%

Troponin I in the intensive care unit setting: from the heart to the heart

et al. 2008

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When measured in the plasma, cardiac troponins T (cTnT) and I (cTnI) are considered to be highly specific markers of myocardial cell damage; however, research has demonstrated that troponin elevation may associated with causes other than coronary artery disease. In the intensive care unit (ICU) setting, increased cTnI levels are quite common findings and when documented, even on admission, intensivists should bear in mind that this laboratory finding holds a prognostic role independent of the reason for ICU admission. The mechanism(s) (such as demand ischemia, myocardial strain, etc.) and not simply the cause (i.e., renal failure) of the increment in serum cTnI should be investigated to better tailor the therapeutical regimen in the single patient. In this review, we therefore consider the nonthrombotic causes of troponin elevation in the critical setting.

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Section: Troponin I and Traumamentioning

confidence: 99%

Troponin I in the intensive care unit setting: from the heart to the heart

et al. 2008

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“…Pregnancy was also a noninclusion criterion. The care of the patients was directed by the same existing protocols as previously described and was not modified by the study (20). Initially, volume loading was given to obtain a mean arterial pressure Ն70 mm Hg, a hemoglobin level Ն8 g/dL, a prothrombin time Յ16 secs, and a platelet count Ն75·10 9 platelets/L.…”

Section: Study Populationmentioning

confidence: 99%

Hydrocortisone increases the sensitivity to α1-adrenoceptor stimulation in humans following hemorrhagic shock*

Hoen

Mazoit

Asehnoune

et al. 2005

Critical Care Medicine

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“…However, several reports have thrown doubt on the usefulness of cTnI, BNP, and D-dimer. There have also been negative reports on the ability of cTnI for predicting the prognosis of trauma 17) and for detecting myocardial contusion 18,19) . Also, another report found that there was no relationship between the D-dimer level and the prognosis of ICU admitted patients 20) .…”

Section: Discussionmentioning

confidence: 99%

Relationship between the prognosis of emergency center patients and their biomarker levels on arrival

Yoshida

Hattori

Kashimi

et al. 2011

Nihon Kyukyu Igakukai Zasshi

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It is important to assess the severity of patients' conditions using various markers upon their arrival to emergency centers. In this study, we assessed the levels of B-type natriuretic peptide (BNP), cardiac troponin I (cTnI), D-dimer, Hb, T-Bil, BUN, and s-Cr for this purpose. Out of 1954 patients who were consecutively transferred to Kitasato University Hospital Emergency Center from June 2007 to June 2008, 1253 patients without cardiopulmonary arrest on arrival were assessed with regard to the relationship between their outcome and blood BNP, cTnI, D-dimer, Hb, T-Bil, BUN, and s-Cr levels on arrival. We divided the patients into two groups according to whether they died in hospital and whether the causes of their disease were intrinsic or extrinsic, and then made comparisons between groups. The blood concentrations of BNP, cTnI, D-dimer, T-Bil, BUN, and s-Cr were significantly high while that of Hb was significantly low in the hospital death group. In multivariate analysis, age, BNP, D-dimer, and T-Bil in the intrinsic group were found to be independent predictors of hospital death; whereas, D-dimer and T-Bil were found to be independent predictors of hospital death in the extrinsic group. In particular, the cardiogenic cases in the intrinsic cause group revealed a sensitivity of 93.3%, a specificity of 83.9%, a positive predictive value of 38.9%, and a negative predictive value of 99.1% with regard to hospital death using variables selected by the stepwise method. In the extrinsic cause group, D-dimer demonstrated a sensitivity of 83.3%, a specificity was 76.0%, a positive predictive value of 22.0%, and a negative predictive value of 98.3% for predicting hospital death with a cut-off value of 10.14µg/ml. The D-dimer level of patients upon their arrival to emergency rooms is an important factor for predicting patient prognosis. Although multiple factors were related to prognosis in the intrinsic cause group, a 10.14µg/ml D-dimer level may be a good indicator of high-risk patients. (JJAAM. 2011; 22: 245-54)

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Incidence and Significance of Cardiac Troponin I Release in Severe Trauma Patients

Abstract: Serial electrocardiogram recordings and troponin I assessments may be proposed for initial screening in high-risk trauma patients to detect anatomical cardiac injuries through the time course of circulating protein. Troponin I release does not have a prognosis value in trauma patients.

Cited by 71 publications

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Troponin I in the intensive care unit setting: from the heart to the heart

Troponin I in the intensive care unit setting: from the heart to the heart

Hydrocortisone increases the sensitivity to α1-adrenoceptor stimulation in humans following hemorrhagic shock*

Relationship between the prognosis of emergency center patients and their biomarker levels on arrival

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