Circulating cardiac troponin I in trauma patients without cardiac contusion

Intensive Care Med. 1998 Jun;24(6):569-73. doi: 10.1007/s001340050617.


Objectives: To describe the evolution and the diagnostic value of cardiac troponin I (cTnI) and to relate its concentrations with the indicators of injury in trauma patients.

Design: Prospective, observational study of 17 young, previously healthy, mechanically-ventilated patients during the early post-traumatic period in the Surgical ICU of a University Hospital.

Methods: Serial measurements of serum cTnI, total creatine kinase activity (CKtot) and its isoenzyme MB (CK-MB) (on admission, 12 h later, then daily for 7 days), clinical data and repeated electrocardiographic (ECG) and transesophageal echocardiographic (TEE) recordings.

Results: Rhabdomyolysis was observed in all the patients with a significant relationship between CK-MB and CKtot. Despite the fact that no patient demonstrated ECG or TEE signs of myocardial contusion, elevated serum levels of cTnI were observed in six patients (35%) without obvious dilutional interference. As compared with the others, these patients exhibited a more frequent arterial hypotension (83% vs 18%, p = 0.035), required greater volume expansion on day 1 (22,000 vs 8,500 ml, p = 0.027) and usually demonstrated early (83% vs 9%, p = 0.005) and late (66% vs 9%, p = 0.028) multiple organ dysfunction syndrome.

Conclusions: Taking into account the high reported sensitivity and specificity of cTnI dosage, the present results suggest cTnI can play a role in the evaluation of indirect myocardial injury following traumatic shock.

MeSH terms

  • Adult
  • Biomarkers / blood
  • Creatine Kinase / blood
  • Critical Care / methods
  • Female
  • Heart Injuries / blood*
  • Heart Injuries / diagnosis*
  • Heart Injuries / enzymology
  • Hemodynamics / physiology
  • Humans
  • Isoenzymes
  • Male
  • Middle Aged
  • Multiple Organ Failure / blood
  • Multiple Organ Failure / physiopathology
  • Multiple Trauma / blood
  • Multiple Trauma / diagnosis
  • Multiple Trauma / physiopathology
  • Myocardium / chemistry*
  • Prognosis
  • Prospective Studies
  • Regression Analysis
  • Rhabdomyolysis / blood
  • Rhabdomyolysis / diagnosis
  • Time Factors
  • Trauma Severity Indices*
  • Troponin I / blood*


  • Biomarkers
  • Isoenzymes
  • Troponin I
  • Creatine Kinase