Araştırma Makalesi
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Travma ile Başvuran Çocuklarda Kardiyak Değerlendirme

Yıl 2024, , 321 - 325, 29.08.2024
https://doi.org/10.35440/hutfd.1511938

Öz

Amaç: Travma, özellikle gençleri etkileyen, önemli finansal ve manevi kayıplara yol açan kritik bir halk sağlığı sorunudur. Travma ile ilgili hastane yatışlarının yaklaşık üçte biri ve travma kaynaklı ölümlerin %20-25'ine ciddi göğüs yaralanmaları neden olmaktadır. Travma sonrası acil servise başvuran pediatrik hastalarda troponin düzeylerinin prognostik değerini belirlemeyi amaçladık
Materyal ve Metod: 1 Ocak 2015 ile 31 Ocak 2022 tarihleri arasında acil servise travma şikayetiyle başvuran hastalar değerlendirildi. 0 ile18 yaş arası çocuk hastaların kayıtları incelendi. Hastaların travma nedeni ve şiddeti, elektrokardiyografi ve ekokardiyografi sonuçları, laboratuvar verileri (biyokimyasal, hemogram, C-reaktif protein, pro-BNP, CK-MB, troponin vb.) değer-lendirildi. Bu araştırma gözlemsel ve retrospektiftir.
Bulgular: Yüksekten düşme en yaygın yaralanma nedeni olarak bulundu (%43). 55 (%56) hastada göğüs travması saptandı. Göğüs travması olan tüm hastalarda troponin yüksekliği mevcuttu. Göğüs travması olan hastalarda troponin seviyeleri anlamlı olarak yüksek bulundu (p=0.011).
Sonuç: Bulgularımız, özellikle travma ile başvuran pediatrik hastalarda kardiyak troponinlerin prognostik önemini vurguladı.

Kaynakça

  • 1. Battistella FD, Benfield JR. Blunt and penetrating injüries of the chest wall, pleura and lungs. In. Shield Tw. General thoracic surgery. 5nd Ed. Philadelphia: Williams and wil-kins, 2000; 815-863.
  • 2. Locicero I, Mattox KL. Epidemiology of chest trauma. Surg Clin North Am, 1989; 69:15-19.
  • 3. Tovar JA, Vazquez JJ. Management of chest trauma in children.Paediatr Respir Rev. 2013;14:86–91. .
  • 4. Bliss D, Silen M. Pediatric thoracic trauma. Crit Care Med. 2002; 30:S409–415.
  • 5. Tegethoff AM, Raney E, Mendelson J, Minckler MR. Paedi-atric chest Wall trauma causing delayed presentation of ventricular arrhythmia. BMJ Case Rep. 2017:bcr-2017-220498. .
  • 6. Dowd MD, Krug S. Pediatric blunt cardiac injury: epidemi-ology, clinical features, and diagnosis. Pediatric Emergency Medicine Collaborative Research Committee: Working Group on Blunt Cardiac Injury. J Trauma. 1996; 40:61–67. .
  • 7. Kalbitz M, Pressmar J, Stecher J, Weber B, Weiss M, Schwarz S, et al. The role of troponin in blunt cardiac injury after multiple trauma in humans. World J Surg. 2016; 41:162–169.
  • 8. Mahajan VS, Jarolim P. How to interpret elevated cardiac troponin levels. Circulation 2011; 124: 2350–2354.
  • 9. Cervellin G, Lippi G. Of MIs and men – a historical per spective on the diagnostics of acute myocardial infarc tion. Semin Thromb Hemost 2014; 40: 535–543.
  • 10. Bertinchant JP, Polge A, Mohty D, Nguyen-Ngoc-Lam R, Estorc J, Cohendy R, et al. Evaluation of incidence, clinical significance, and prognostic value of circulating cardiac troponin I and T elevation in hemodynamically stable pa-tients with suspected myoca.
  • 11. Bian F, Wu Y-E, Zhang C-L. Variation in the levels of IL-6 in pediatric patients with severe bacterial infectious diseases and correlation analysis between the levels of IL-6 and procalcitonin. Exp Ther Med. 2017; 13:3484–3488. .
  • 12. Tekinbaş C, Eroğlu A, Kürkçüoğlu IC, Türkyılmaz A, Yekeler E, Karanoğlu N. Chest Trauma: Analist of 592 cases. Ulus Travma Dergisi, 2003; (4):275-280.
  • 13. Scorpio RJ, Wesson DE, Smith CR, Hu X, Spence LJ. Blunt cardiac injuries in children: a postmortem study. J Trauma. 1996; 41:306–309.
  • 14. Wilson C, Sambandamoorthy G, Holloway P, Ramnarayan P, Inwald DP. Admission plasma troponin I is associated with mortality in pediatric intensive care. Pediatr Crit Care Med. 2016; 17:831–836.
  • 15. Potkin RT, Werner JA, Trobaugh GB. Evaluation of non-invaziv tests of cardiac damage in suspect cardiac contu-sion. Circulation, 1982; 66:627-631.
  • 16. Schick TD, Van der Zee H, Powers SR. Detection of cardiac disturbances following thoracic trauma with high-frequency analysis of the electrocardiogram. J Trauma, 1977;17:419–424.
  • 17. Rajan GP, Zellweger R. Cardiac troponin I as a predictor of arrhythmia and ventricular dysfunction in trauma patients with myocardial contusion. J Trauma. 2004; 57:808; discus-sion 808.
  • 18. Hiatt JR, Yeatman LA Jr, Child JS. The value of echocardiog-raphy in blunt chest trauma. J Trauma. 1988 ;28(7):914-922.

Cardiac Evaluation of Children Presenting with Trauma

Yıl 2024, , 321 - 325, 29.08.2024
https://doi.org/10.35440/hutfd.1511938

Öz

Background: Trauma is a critical public health issue, particularly impacting the young and caus-ing significant financial and moral losses. Approximately one-third of trauma-related hospitaliza-tions and 20-25% of trauma-related deaths are caused by serious chest injuries. We aimed to determine the prognostic value of changing pediatric global troponin levels in the emergency department after trauma.
Materials and Methods: Patients who applied to the emergency department with complaints of trauma between January 1, 2015 and January 31, 2022 were evaluated. Records of pediatric patients between the ages of 0 and 18 were reviewed. The cause and severity of the trauma, electrocardiography and echocardiography results, and laboratory data (biochemical, hemogram, C-reactive protein, pro-BNP, CK-MB, troponin, etc.) of the patients were evaluated. This study is an observational and retrospective.
Results: Falling from height was the most prevalent cause of injury, accounting for 43% of cases. Chest trauma was observed in 55 patients (56%). All patients with chest trauma exhibited ele-vated troponin levels. Troponin levels were found to be significantly higher in patients with chest trauma (p=0.011).
Conclusions: Our findings highlighted the prognostic importance of cardiac troponins, especially in pediatric patients presenting with trauma.

Kaynakça

  • 1. Battistella FD, Benfield JR. Blunt and penetrating injüries of the chest wall, pleura and lungs. In. Shield Tw. General thoracic surgery. 5nd Ed. Philadelphia: Williams and wil-kins, 2000; 815-863.
  • 2. Locicero I, Mattox KL. Epidemiology of chest trauma. Surg Clin North Am, 1989; 69:15-19.
  • 3. Tovar JA, Vazquez JJ. Management of chest trauma in children.Paediatr Respir Rev. 2013;14:86–91. .
  • 4. Bliss D, Silen M. Pediatric thoracic trauma. Crit Care Med. 2002; 30:S409–415.
  • 5. Tegethoff AM, Raney E, Mendelson J, Minckler MR. Paedi-atric chest Wall trauma causing delayed presentation of ventricular arrhythmia. BMJ Case Rep. 2017:bcr-2017-220498. .
  • 6. Dowd MD, Krug S. Pediatric blunt cardiac injury: epidemi-ology, clinical features, and diagnosis. Pediatric Emergency Medicine Collaborative Research Committee: Working Group on Blunt Cardiac Injury. J Trauma. 1996; 40:61–67. .
  • 7. Kalbitz M, Pressmar J, Stecher J, Weber B, Weiss M, Schwarz S, et al. The role of troponin in blunt cardiac injury after multiple trauma in humans. World J Surg. 2016; 41:162–169.
  • 8. Mahajan VS, Jarolim P. How to interpret elevated cardiac troponin levels. Circulation 2011; 124: 2350–2354.
  • 9. Cervellin G, Lippi G. Of MIs and men – a historical per spective on the diagnostics of acute myocardial infarc tion. Semin Thromb Hemost 2014; 40: 535–543.
  • 10. Bertinchant JP, Polge A, Mohty D, Nguyen-Ngoc-Lam R, Estorc J, Cohendy R, et al. Evaluation of incidence, clinical significance, and prognostic value of circulating cardiac troponin I and T elevation in hemodynamically stable pa-tients with suspected myoca.
  • 11. Bian F, Wu Y-E, Zhang C-L. Variation in the levels of IL-6 in pediatric patients with severe bacterial infectious diseases and correlation analysis between the levels of IL-6 and procalcitonin. Exp Ther Med. 2017; 13:3484–3488. .
  • 12. Tekinbaş C, Eroğlu A, Kürkçüoğlu IC, Türkyılmaz A, Yekeler E, Karanoğlu N. Chest Trauma: Analist of 592 cases. Ulus Travma Dergisi, 2003; (4):275-280.
  • 13. Scorpio RJ, Wesson DE, Smith CR, Hu X, Spence LJ. Blunt cardiac injuries in children: a postmortem study. J Trauma. 1996; 41:306–309.
  • 14. Wilson C, Sambandamoorthy G, Holloway P, Ramnarayan P, Inwald DP. Admission plasma troponin I is associated with mortality in pediatric intensive care. Pediatr Crit Care Med. 2016; 17:831–836.
  • 15. Potkin RT, Werner JA, Trobaugh GB. Evaluation of non-invaziv tests of cardiac damage in suspect cardiac contu-sion. Circulation, 1982; 66:627-631.
  • 16. Schick TD, Van der Zee H, Powers SR. Detection of cardiac disturbances following thoracic trauma with high-frequency analysis of the electrocardiogram. J Trauma, 1977;17:419–424.
  • 17. Rajan GP, Zellweger R. Cardiac troponin I as a predictor of arrhythmia and ventricular dysfunction in trauma patients with myocardial contusion. J Trauma. 2004; 57:808; discus-sion 808.
  • 18. Hiatt JR, Yeatman LA Jr, Child JS. The value of echocardiog-raphy in blunt chest trauma. J Trauma. 1988 ;28(7):914-922.
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Acil Tıp
Bölüm Araştırma Makalesi
Yazarlar

Mahmut Yaman 0000-0002-0783-1419

Mehmet Türe 0000-0001-8780-8122

Alper Akın 0000-0003-1587-9559

Duygu Uç 0000-0002-1162-0323

Mehmet Sürücü 0000-0001-5636-2009

Abdullah Şen 0000-0001-6705-4079

Cahfer Güloğlu 0000-0003-1100-3613

Erken Görünüm Tarihi 28 Ağustos 2024
Yayımlanma Tarihi 29 Ağustos 2024
Gönderilme Tarihi 7 Temmuz 2024
Kabul Tarihi 26 Ağustos 2024
Yayımlandığı Sayı Yıl 2024

Kaynak Göster

Vancouver Yaman M, Türe M, Akın A, Uç D, Sürücü M, Şen A, Güloğlu C. Cardiac Evaluation of Children Presenting with Trauma. Harran Üniversitesi Tıp Fakültesi Dergisi. 2024;21(2):321-5.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty