Cardiac troponin i and acute lung injury after subarachnoid hemorrhage

Andrew M. Naidech, Sarice L. Bassin, Rajeev K. Garg, Michael L. Ault, Bernard Bendok, H. Hunt Batjer, Charles M. Watts, Thomas P. Bleck

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Introduction: There are few predictors of acute lung injury (ALI) or the acute respiratory distress syndrome (ARDS) after subarachnoid hemorrhage (SAH). We hypothesized that cardiac troponin I, which is associated with cardiovascular morbidity, would also predict ALI. Methods: We prospectively enrolled 171 consecutive patients with SAH. Troponin was routinely measured on admission and the next day and subsequently if abnormal. We prospectively recorded the maximum troponin, in-hospital events, and clinical endpoints. ALI and ARDS were defined by standard criteria. Results: Acute lung injury was found in 10 patients (6%), ARDS in an additional 14 (8%), and pulmonary edema without lung injury in 9 (5%). Maximum troponin was different in patients without lung injury or pulmonary edema (0.03 [0.02-0.12] mcg/l), ALI (0.17 [0.04-1.4]), or ARDS (0.31 [0.9-1.8], P < 0.001). In ROC analysis, a cutoff of 0.04 mcg/l had 91% sensitivity and 42% specificity for ALI or ARDS (AUC = 0.75, P < 0.001). Troponin was associated with ALI or ARDS after accounting for neurologic grade in multivariate models without further contribution from pneumonia, packed red cell transfusion, gender, tobacco use, coronary artery disease, vasospasm, depressed ejection fraction on echocardiography, or CT grade. Lung injury was associated with worse functional outcome at 14 days, but not at 28 days or 3 months. Conclusion: Troponin I is associated with the development of ALI after SAH.

Original languageEnglish (US)
Pages (from-to)177-182
Number of pages6
JournalNeurocritical Care
Volume11
Issue number2
DOIs
StatePublished - Oct 2009
Externally publishedYes

Fingerprint

Troponin
Acute Lung Injury
Subarachnoid Hemorrhage
Adult Respiratory Distress Syndrome
Lung Injury
Troponin I
Pulmonary Edema
Coronary Vasospasm
Tobacco Use
ROC Curve
Nervous System
Area Under Curve
Echocardiography
Coronary Artery Disease
Pneumonia
Morbidity
Sensitivity and Specificity

Keywords

  • Acute lung injury
  • Subarachnoid hemorrhage
  • Troponin

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

Cite this

Naidech, A. M., Bassin, S. L., Garg, R. K., Ault, M. L., Bendok, B., Batjer, H. H., ... Bleck, T. P. (2009). Cardiac troponin i and acute lung injury after subarachnoid hemorrhage. Neurocritical Care, 11(2), 177-182. https://doi.org/10.1007/s12028-009-9223-y

Cardiac troponin i and acute lung injury after subarachnoid hemorrhage. / Naidech, Andrew M.; Bassin, Sarice L.; Garg, Rajeev K.; Ault, Michael L.; Bendok, Bernard; Batjer, H. Hunt; Watts, Charles M.; Bleck, Thomas P.

In: Neurocritical Care, Vol. 11, No. 2, 10.2009, p. 177-182.

Research output: Contribution to journalArticle

Naidech, AM, Bassin, SL, Garg, RK, Ault, ML, Bendok, B, Batjer, HH, Watts, CM & Bleck, TP 2009, 'Cardiac troponin i and acute lung injury after subarachnoid hemorrhage', Neurocritical Care, vol. 11, no. 2, pp. 177-182. https://doi.org/10.1007/s12028-009-9223-y
Naidech, Andrew M. ; Bassin, Sarice L. ; Garg, Rajeev K. ; Ault, Michael L. ; Bendok, Bernard ; Batjer, H. Hunt ; Watts, Charles M. ; Bleck, Thomas P. / Cardiac troponin i and acute lung injury after subarachnoid hemorrhage. In: Neurocritical Care. 2009 ; Vol. 11, No. 2. pp. 177-182.
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