Cardiac troponin I as a predictor of mortality for pediatric submersion injuries requiring out-of-hospital cardiopulmonary resuscitation.
BACKGROUND
It is difficult to predict ultimate survivors to hospital discharge in children who are successfully resuscitated after a cardiorespiratory arrest associated with a submersion injury. Serum measurements of organ injury or dysfunction may serve as a surrogate marker of the degree of hypoxic injury. We designed a prospective study whose purpose was to assess the predictive value for outcome of serum cardiac troponin I measurements after submersion injury and cardiorespiratory arrest.


METHODS
This is a prospective, observational study of children admitted to a postintensive care unit after experiencing an out-of-hospital cardiorespiratory arrest associated with a submersion event. Cardiac troponin I measurements were examined upon admission to the postoperative intensive care unit after successful emergency department resuscitation.


RESULTS
Nine patients were admitted, and 2 patients (22%) survived to hospital discharge. The area under the receiver operating characteristic curve is 0.786 (95% confidence interval, 0.481-1.0). This suggests that cardiac troponin I has a moderate degree of discriminatory power in selecting children who did not survive to hospital discharge.
Checchia
Paul A
PA
Department of Pediatrics, Division of Critical Care, Washington University School of Medicine, St Louis Children's Hospital, St Louis, MO 63110, USA. pchecchia@wustl.edu
Moynihan
James A
JA
Brown
Lance
L
D015415:Biomarkers / Q000097:blood; D002140:California / Q000453:epidemiology; D016887:Cardiopulmonary Resuscitation; D002648:Child; D002675:Child, Preschool; D004632:Emergency Medical Services; D005260:Female; D006323:Heart Arrest / Q000097:blood* / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D006801:Humans; D007223:Infant; D008297:Male; D015701:Near Drowning / Q000097:blood* / Q000150:complications / Q000628:therapy*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D016019:Survival Analysis; D019210:Troponin I / Q000097:blood*
D015415:Biomarkers; D019210:Troponin I