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2017, Number 4

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Rev Mex Pediatr 2017; 84 (4)

Troponin I in the diagnosis of acute respiratory distress syndrome

Avilés-Martínez KI, Mercado-Uribe MC, Villa-Manzano IA, López-Enríquez A, Santos Hernández-Flores M

Language: Spanish
References: 14
Page: 149-153
PDF size: 259.80 Kb.


ABSTRACT

Acute respiratory distress syndrome (ARDS) is a heterogeneous, multidimensional, and potentially lethal disease. Biological markers such as troponin I (TI) may be useful for diagnosis and prognosis. Objective: To determine the usefulness of TI as a marker for early identification of ARDS and as a prognostic factor of death. Material and methods: Diagnostic test study. We included children from one month to 14 years of age with shock; those who presented ARDS on admission, history of toxic intake, and renal disease were excluded. TI was determined in blood at the time of shock diagnosis. Follow-up was given for seven days in search of ARDS development. Results: Sixty-five children with shock were enrolled; 32 developed ARDS, of which 16 (50%) showed an increase in TI, range of 0.06-4.6 ng/dL. TI as a diagnostic test showed sensitivity 50% (CI 95% 0.33-0.67), specificity 85% (CI 95% 0.73-0.97), positive predictive value 76% (CI 95% 0.58-0.94), negative predictive value 0.64 (CI 95% 0.49-0.78), positive likelihood ratio 3.3 (CI 95% 1.4-7.9), negative likelihood ratio 0.59 (CI 95% 0.40-0.87). Children who had an increase in TI had a higher severity of ARDS; in this group, nine (43%) children died (p = 0.98). Conclusions: TI seems to be a marker for early identification of ARDS in children with shock; it requires further research to verify its true usefulness.


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