title: Early prognostic significance of umbilical cord troponin I in critically ill newborns. Prospective study with a control group.
abstract: OBJECTIVE
  To determine the value of cord blood cardiac troponin I levels (cTnl) as an early prognostic factor in critically ill newborns, and to compare cord cTnl levels with the prognostic value of the score for neonatal acute physiology (SNAP).
  
  
  METHODS
  Cord arterial samples were collected routinely for blood gas analysis, and cord venous samples for cTnl and cardiac-specific creatine kinase assay. The study group (n=109) comprised critically ill newborns who required mechanical ventilation. The control group (n = 96) comprised newborns who were either completely healthy (n = 48) or were followed in a level I neonatal care unit due to moderate-severity problems.
  
  
  RESULTS
  The critically ill newborns had significantly higher cTnl levels than control babies (median [min-max] 1.4 [0-13] vs. 0 [0-1.8] ng/mL, respectively; P<0.001). In critically ill newborns, non-survivors had significantly higher cTnl levels than survivors (median [min-max] 6.6 [1.3-13.0] vs. 1.3 [0-8.0] ng/mL, respectively; P<0.001). Receiver-operator curve analysis revealed that, compared with SNAP, cTnl was a more sensitive predictor of mortality in critically ill newborns (area under curve=0.96; 95% CI=0.90-1.02).
  
  
  CONCLUSIONS
  Significantly elevated cord cTnl may be a valuable predictor of mortality in critically ill newborns.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey. gulcanturker@superonline.com
authors.forename: Gülcan
authors.initials: G
authors.lastname: Türker
authors.forename: Nazan
authors.initials: N
authors.lastname: Sarper
authors.forename: Kadir
authors.initials: K
authors.lastname: Babaoğlu
authors.forename: Aye S
authors.initials: AS
authors.lastname: Gökalp
authors.forename: Can
authors.initials: C
authors.lastname: Duman
authors.forename: A Engin
authors.initials: AE
authors.lastname: Arisoy
mesh_terms: D001238:Asphyxia Neonatorum / Q000097:blood* / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D016638:Critical Illness; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D019210:Troponin I / Q000097:blood*
chemical_list: D015415:Biomarkers; D019210:Troponin I