Araştırma Makalesi
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Travma ile Başvuran Çocuklarda Kardiyak Değerlendirme

Yıl 2024, Cilt: 21 Sayı: 2, 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, Cilt: 21 Sayı: 2, 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 Cilt: 21 Sayı: 2

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