Cardiac troponin I as a predictor of respiratory failure in children hospitalized with respiratory syncytial virus (RSV) infections: a pilot study.
This pilot study was performed to assess the use of cardiac troponin I to predict respiratory failure in children admitted to the hospital with respiratory syncytial virus (RSV) infections. We enrolled a prospective convenience sample of children under 5 years of age who were admitted to our university-based, tertiary care children's hospital from December 1, 2000, to February 1, 2002, with RSV infections. A cardiac troponin I was drawn at admission. We assessed the test characteristics for positive cardiac troponin I (defined as >0.3 ng/mL, the manufacturer's upper limit of normal) in correctly identifying children who had respiratory failure as evidenced by the need for endotracheal intubation. Twenty-five children from 9 days to 38 months of age were included. Ten children had a positive cardiac troponin I and 3 of these children had respiratory failure. A positive cardiac troponin I demonstrated a sensitivity of 100%, specificity 68%, positive predictive value of 30%, negative predictive value of 100%, and accuracy of 72%. The area under the receiver operating characteristic curve was 0.939 (95% confidence interval, 0.820-1.0), suggesting a high degree of discriminatory power in selecting children with respiratory failure. A sample size calculation revealed that a follow-up study of 359 patients is needed before the clinical use of cardiac troponin I for this purpose.
Department of Emergency Medicine, Division of Pediatric Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, Loma Linda, California 92354, USA. Jmoynihan@att.net
James A
JA
Moynihan
Lance
L
Brown
Ruchir
R
Sehra
Paul A
PA
Checchia
D015415:Biomarkers / Q000097:blood; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000097:blood / Q000175:diagnosis* / Q000821:virology; D018357:Respiratory Syncytial Virus Infections / Q000097:blood / Q000175:diagnosis*; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D019210:Troponin I / Q000032:analysis*
D015415:Biomarkers; D019210:Troponin I