This report was aimed to record the value of dynamic change of cardiac biomarkers in diagnosis of serious myocardial injury in electrical shock. One female patient was admitted to the emergency department, Cho Ray-Phn...This report was aimed to record the value of dynamic change of cardiac biomarkers in diagnosis of serious myocardial injury in electrical shock. One female patient was admitted to the emergency department, Cho Ray-Phnom Penh Hospital, Phnom Penh, Cambodia after electrical accident, in cardiopulmonary arrest status with no pulse, no breath. The cardiopulmonary resuscitation was done immediately as intra-tracheal ventilation, fluid replacement with NaCl 0.9%, urine alkalinization therapy with Natribicarbonate 4.2%, sympathomimetic agents as adrenaline and nor-adrenaline, and IV nutrition with glucose 30%. Cardiac biomarkers were repeated many times over 12 hours after admission. Troponin I increased 1000 times higher from 0.02 ng/mL on admission to 20.1 ng/mL within 12 hours. CK-MB increased from 55.4 to 227 U/L after 2 hours (normal value: <16 U/L). CPK (normal value: 90 - 140 U/L) changed quickly from 99 U/L on admission to a very high level as 9681 U/L after 12 hrs. The CK-MB/CPK index (defined as CK-MB × 100/CPK, unit as %) changed from 55.9% to 2.7%, respectively by time. In conclusion, the very quick dynamic change of cardiac biomarkers suggested the presence of serious myocardial injury among multiple organs injured in electric shock.展开更多
文摘This report was aimed to record the value of dynamic change of cardiac biomarkers in diagnosis of serious myocardial injury in electrical shock. One female patient was admitted to the emergency department, Cho Ray-Phnom Penh Hospital, Phnom Penh, Cambodia after electrical accident, in cardiopulmonary arrest status with no pulse, no breath. The cardiopulmonary resuscitation was done immediately as intra-tracheal ventilation, fluid replacement with NaCl 0.9%, urine alkalinization therapy with Natribicarbonate 4.2%, sympathomimetic agents as adrenaline and nor-adrenaline, and IV nutrition with glucose 30%. Cardiac biomarkers were repeated many times over 12 hours after admission. Troponin I increased 1000 times higher from 0.02 ng/mL on admission to 20.1 ng/mL within 12 hours. CK-MB increased from 55.4 to 227 U/L after 2 hours (normal value: <16 U/L). CPK (normal value: 90 - 140 U/L) changed quickly from 99 U/L on admission to a very high level as 9681 U/L after 12 hrs. The CK-MB/CPK index (defined as CK-MB × 100/CPK, unit as %) changed from 55.9% to 2.7%, respectively by time. In conclusion, the very quick dynamic change of cardiac biomarkers suggested the presence of serious myocardial injury among multiple organs injured in electric shock.
