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Serial measurements of troponin and echocardiography in patients with moderate-to-severe acute respiratory distress syndrome.

Abstract：

PURPOSE:To assess the clinical significance of serial troponin I levels (measured in the first 72 hours from admission) in 42 consecutive patients with moderate-to-severe acute respiratory distress syndrome (ARDS). Echocardiography and electrocardiogram testings were serially performed in the time window. MATERIALS AND METHODS:Troponin I was measured every 12 hours in the first 72 hours from intensive care unit (ICU) admission. Echocardiography and electrocardiogram testings were serially performed in the same time window to clinically interpret Tn I levels. RESULTS:Patients with admission positive Tn I (38.1%) showed higher values of systolic pulmonary hypertension (P = .013) associated with significantly lower values of tricuspid annular plane excursion (P = .011). Twenty-five patients (25/42, 59.5%) exhibited positive peak Tn I and at second echocardiographic assessment exhibited significant lower tricuspid annular plane excursion values (P = .005). At stepwise regression analysis the following variables were an independent predictor for in-ICU mortality: Pco2 (OR 1.08, 95% CI 1.011-1.161, P = .023), systolic pulmonary arterial hypertension (OR 0.83, 95% CI 0.701-0.977, P = .002), log peak Tn I (OR 3.56, 95% CI 1.045-12.132, P = .042). CONCLUSIONS:In moderate-to-severe ARDS, serial troponin I assessment together with echocardiography evaluation helped to identify a subgroup at higher risk for in-ICU death. Moreover, troponin release can be related to right ventricular dysfunction, thus highlighting the clinical role of echocardiography in ARDS patients.

journal_name

J Crit Care

journal_title

Journal of critical care

authors

Lazzeri C,Bonizzoli M,Cozzolino M,Verdi C,Cianchi G,Batacchi S,Franci A,Gensini GF,Peris A

doi

10.1016/j.jcrc.2016.01.004

subject

Has Abstract

pub_date

2016-06-01 00:00:00

pages

132-6

eissn

0883-9441

issn

1557-8615

pii

S0883-9441(16)00005-8

journal_volume

33

pub_type

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