Myocardial cell injury is common in children with septic shock.
OBJECTIVE
To determine the prevalence of myocardial cell injury in children with septic shock by estimating the levels of biochemical markers of myocardial injury, troponin I (TnI) and creatine kinase MB (CK-MB).


METHODS
Children aged 3 months to 16 years were admitted to paediatric intensive care unit (PICU) with septic shock. Children with sepsis without shock and children with hypovolaemic shock were enrolled as controls.


RESULTS
Serum TnI and CK-MB levels were measured at admission and serially at 24 h, 48 h and 96 h in children with septic shock, while baseline measurement of the same markers was taken from the controls. In total, 88% (15/18) of children with septic shock had elevated TnI levels compared with 25% (5/20) with sepsis and 6.7% (1/15) with hypovolaemic shock (p < 0.001). Serial TnI levels at admission, 24 h, 48 h and 96 h were higher in the nonsurvivors. There was a positive correlation between the baseline TnI levels and the predicted mortality using the paediatric index of mortality (PIM2) scores at admission (r = 0.51, p = 0.03).


CONCLUSIONS
A majority of children with septic shock have evidence of myocardial cell injury. The estimation of serum TnI levels may help in better prognostication of children with septic shock.
Lodha
Rakesh
R
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. rakesh_lodha@hotmail.com
Arun
Sasi
S
Vivekanandhan
Subbiah
S
Kohli
Utkarsh
U
Kabra
Sushil K
SK
D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D052279:Creatine Kinase, MB Form / Q000097:blood; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D032383:Myocytes, Cardiac / Q000473:pathology*; D011446:Prospective Studies; D012772:Shock, Septic / Q000097:blood* / Q000401:mortality / Q000473:pathology; D019210:Troponin I / Q000097:blood*
D015415:Biomarkers; D019210:Troponin I; D052279:Creatine Kinase, MB Form