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CTnI is a protein specific to cardiac muscle that indicates myocardial ischemia. This study was designed to determine the usefulness of CTnI as a prognostic indicator in the postoperative period in children undergoing cardiopulmonary bypass (CPB) during cardiac surgery. A predictive indicator of high risk cases would be valuable for developing specific therapeutic strategies. Methods: Patients undergoing CPB were enrolled in a non-random, consecutive fashion and informed consent obtained. Cardiac defects were categorized as ASD, 19; VSD, 21; HLHS, 9; complex, 34 and other, 17. Blood samples were collected prior to sternal incision (baseline) and 4, 8, 12 and 24 hours after going on CPB. CTnI levels were measured using an antibody detection system (Dade International) and the Stratus instrument (Baxter Scientific). Analysis: Means were compared using Mann Whitney U test. Continuous variables were analyzed by linear regression. ANOVA with post hoc analysis was used to determine differences within and between cardiac defect groups. Results: 100 patients (46 female) ranging in age from 2 days to 18 years old, mean 3.5±4.6 yr were studied. There were 10 deaths. CTnI and duration of CPB were significantly related at all time points. Baseline CTnI in the HLHS group and the 4 hr level in the complex group were significantly higher than in the other categories.Conclusion: While nonsurvivors tend to have higher CTnI levels at all sampling times, CTnI does not appear to be an indicator of mortality. Infants with HLHS have evidence of myocardial damage prior to their operative procedure. Children with complex defects experience significant myocardial ischemia and may benefit from improved intraoperative and postoperative management. Table
Montgomery, V., Strotman, J., Buchino, J. et al. Cardiac Troponin I (CTnI) as a Prognostic Indicator following Open Heart Surgery in Children 216.
Pediatr Res43
(Suppl 4), 39 (1998). https://doi.org/10.1203/00006450-199804001-00237
