Objectives. The aim of this study was to investigate the occurrence of myocardial injury in critically ill children through assessment of cardiac troponin T levels and whether levels are associated with disease severity and myocardial dysfunction measured by echocardiography. Methods. Over a 6-month period, this case control study included 50 patients admitted to Pediatric Intensive Care Unit of Zagazig University Children's Hospital. Twenty-five healthy children were included as a control group. Demographic and clinical data including the pediatric index of mortality II score were recorded. Echocardiographic examination was done and level of cardiac troponin T was measured using Elecsys Troponin T STAT Immunoassay. Results. Cardiac troponin T levels were significantly higher in critically ill in comparison to healthy children (median 22 (18–28) pg/mL versus 10 (10-10) pg/mL, P < 0.05). Cardiac troponin T levels correlated positively with duration of ventilation as well as with disease severity and correlated negatively with left ventricular fractional shortening. Moreover, cardiac troponin T levels were significantly higher in nonsurvivors when compared to survivors (median 34.5 (27.5–41.5) pg/mL versus 20 (18–24) pg/mL, P < 0.05). Conclusion. In critically ill children, cardiac troponin T levels were elevated and were associated with duration of ventilation and disease severity.

Background: Sepsis remains one of the leading causes of neonatal morbidity and mortality, particularly among premature infants. Blood culture is the ‘gold standard’ for the diagnosis of neonatal sepsis but is associated with several pitfalls. Aim of the work: We aim to evaluate the validity of measuring serum (S.Hep) and urinary hepcidin (U.Hep) concentrations as diagnostic biomarkers for late-onset sepsis (LOS) in preterm infants. Patients and Methods: The current case-control study included 73 cases of clinically and laboratory confirmed late-onset sepsis as the ‘case group’ and 50 nonseptic premature infants of comparable age and sex as the ‘control group’. S.Hep and U.Hep concentrations were evaluated at enrollment (acute sample) and after 1 week of treatment (convalescent sample). Results: Patients had a statistically significant higher concentration of both S.Hep and U.Hep as compared with nonseptic controls ( p = 0.0001). Similarly, a significant reduction of both S.Hep and U.Hep was detected after 1 week of treatment ( p = 0.001). A cut-off value of ⩾ 94.8 ng/ml of S.Hep and ⩾ 264 ng/mg of U.Hep/urinary creatinine showed high sensitivity, specificity, and positive predictive value in the diagnosis of neonatal LOS. Conclusions: Both S.Hep and U.Hep can function as promising accurate and rapid surrogate tests for the diagnosis of LOS. U.Hep measurement has the advantage of being noninvasive, with no hazards of phlebotomy, and is less variable throughout the day.

Background: Postoperative arrhythmias are an important cause of morbidity and mortality after cardiac surgery for congenital heart disease. In the early postoperative period, patients with congenital heart disease are especially vulnerable to rhythm disturbances. Objective: This study aimed to assess safety and efficacy of prophylactic amiodarone and magnesium sulphate in preventing cardiac arrhythmia especially junctional ectopic tachycardia (JET) in children with congenital heart disease (CHD) who undergo open heart surgery. Patients and Methods: This was a comparative clinical trial that was conducted on 48 cases at Cardiothoracic Department and Pediatric Cardiology Unit, Zagazig University Hospitals. The cases were divided into three groups according to received drug; Group (A): patients receiving placebo, Group (B): patients receiving magnesium sulfate and Group (C): patients receiving amiodarone. Results: There were highly statistically significant differences between groups as regard to Inotrope Score intraoperatively, heart rate and median arterial pressure postoperatively, postoperative Inotrope Score and drug complications where P<0.001. Conclusions: prophylactic of either amiodarone or magnesium sulfate are safe and relatively effective in preventing early postoperative arrhythmia in children after corrective heart surgery for CHD.

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