Correlation Between Hemodynamic Parameters Measured by Ultrasonic Cardiac Output Monitor and Serum Troponin I Levels in Pediatric Septic Shock Patients: A Prospective Observational Study

Q: What are the key findings of this study?

USCOM-derived hemodynamic parameters, including early changes in stroke volume index (r = -0.409), were significantly correlated with serum troponin I levels during the first 24 hours of pediatric septic shock.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Pediatric septic shock (n=32). Intervention: USCOM-derived hemodynamic parameters. Primary outcome: Correlation between early changes in stroke volume index (1-6 hours) and serum cardiac troponin I (cTnI) at 6 hours (r = -0.409, p=0.020).

Q: What does this research mean for the field?

In pediatric septic shock, USCOM-derived hemodynamic parameters and the extent of inotropic support significantly correlate with serum cardiac troponin I levels during the first 24 hours. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Indra Sandinirwan; Dzulfikar Djalil Lukmanul Hakim; Sri Endah Rahayuningsih; Saptadi Yuliarto; Stanza Uga Peryoga

doi:10.2147/oaem.s606300

August 1, 2026Open Access Emergency MedicineOpen Access

Correlation Between Hemodynamic Parameters Measured by Ultrasonic Cardiac Output Monitor and Serum Troponin I Levels in Pediatric Septic Shock Patients: A Prospective Observational Study

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Key result

Early stroke volume index drops link to higher troponin I in pediatric septic shock.

r = -0.409
P=0.020
n=32

Figures

Why the study?

Pediatric septic shock is frequently associated with myocardial dysfunction and high mortality, but the correlation between USCOM-derived hemodynamic parameters and serum troponin I levels is not well understood.

Key Points

To examine the correlation between hemodynamic parameters measured via Ultrasonic Cardiac Output Monitor (USCOM) and serum cardiac troponin I levels, and evaluate the effect of inotropic therapy in children with septic shock.
Prospective observational study of N=32 pediatric patients with septic shock admitted to Hasan Sadikin Hospital between May and September 2025.
Hemodynamic indices (cardiac index, stroke volume index, Smith-Madigan Inotropy Index, and systemic vascular resistance index) were tracked non-invasively by USCOM at 1, 3, 6, 12, and 24 hours.
Serum cardiac troponin I was measured at 6 and 24 hours with high-sensitivity assays, followed by Spearman correlation and multivariable linear regression.
Median serum cardiac troponin I rose significantly from 71 pg/mL at 6 hours to 201 pg/mL at 24 hours (p < 0.01), with elevated levels in 72% and 83% of patients, respectively.
Early SVI change from 1 to 6 hours correlated inversely with 6-hour troponin (r = -0.409; p = 0.020), while 24-hour troponin correlated positively with 1-hour SMII (r = 0.409; p = 0.025) and 24-hour SVI (r = 0.387; p = 0.035).
Multivariable regression identified the total number of inotropic agents as the strongest independent predictor of troponin levels at both 6 hours (B = 1586.7, p = 0.006) and 24 hours (B = 2768.6, p = 0.002).

Study Design

Type

Observational (n=32)

Multicenter

No

Structured PICO

P

Population

32 pediatric patients with septic shock, aged 1 month to 18 years, monitored over 24 hours to explore the correlation between hemodynamics and myocardial injury.

E

Exposure

Non-invasive hemodynamic monitoring with Ultrasonic Cardiac Output Monitor (USCOM) and serial serum cardiac troponin I (cTnI) measurement

O

Outcome

Correlation between USCOM-derived hemodynamic parameters and cTnI levels at 6 and 24 hourssurrogate

Main Result

Effect estimate: r = -0.409

p-value: p=0.020

In pediatric septic shock, the severity of inotropic support independently predicts myocardial injury (elevated cTnI), and dynamic hemodynamic changes measured via USCOM correlate with troponin release, suggesting potential utility of multimodal bedside monitoring.

Limitations

Single-center design and modest sample size limit generalizability.
Absence of formal power calculation introduces the possibility of type I error.
Multivariable analyses may be subject to overfitting due to limited sample size.
Important confounding variables, such as fluid balance and vasoactive dosing, were not systematically included.
Observational design precludes causal inference.
Single-center design
Modest sample size
Absence of formal power calculation introducing possibility of type I error
Potential for overfitting in multivariable analyses
Important confounding variables (fluid balance, vasoactive dosing, echocardiographic findings) not systematically included
Observational design precludes causal inference

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Implication

USCOM parameters may reflect myocardial injury in pediatric septic shock; hypothesis-generating and requires prospective validation before clinical use.

Abstract

Purpose: Pediatric septic shock is frequently associated with myocardial dysfunction and high mortality. Cardiac troponin I (cTnI) is a biomarker of myocardial injury, while the Ultrasonic Cardiac Output Monitor (USCOM) enables non-invasive hemodynamic assessment. This study aimed to explore the correlation between USCOM-derived hemodynamic parameters and serum cTnI levels in pediatric septic shock, and to examine the association of inotropic therapy with troponin levels. Patients and Methods: A prospective observational study was conducted in 32 pediatric patients with septic shock admitted to Hasan Sadikin Hospital, Bandung, between May and September 2025. Serial USCOM measurements were performed at 1, 3, 6, 12, and 24 hours to assess cardiac index (CI), stroke volume index (SVI), Smith-Madigan Inotropy Index (SMII), and systemic vascular resistance index (SVRI). Serum cTnI levels were measured at 6 and 24 hours using a high-sensitivity assay. Correlations were analyzed using Spearman's test, and multivariable regression was applied to explore independent associations. Results: Median cTnI levels increased significantly from 71 pg/mL at 6 hours to 201 pg/mL at 24 hours (p < 0.01). Early changes in SVI (1-6 hours) were negatively correlated with cTnI at 6 hours (r = -0.409; p = 0.020). SMII at 1 hour was positively correlated with cTnI at 24 hours (r = 0.409; p = 0.025), while SVI at 24 hours showed a positive correlation with cTnI at 24 hours (r = 0.387; p = 0.035). The number of inotropic agents was independently associated with higher cTnI levels at both 6 and 24 hours. Conclusion: Serum cTnI levels increased during the first 24 hours of pediatric septic shock and were associated with dynamic hemodynamic changes. These findings suggest a potential role for integrating serial troponin measurement with non-invasive hemodynamic monitoring. Further studies with larger cohorts are needed to validate these observations.

Discussion

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Cite This Study

Sandinirwan et al. (2026) conducted an observational in Pediatric septic shock (n=32). USCOM-derived hemodynamic parameters was evaluated on Correlation between early changes in stroke volume index (1-6 hours) and serum cardiac troponin I (cTnI) at 6 hours (r = -0.409, p=0.020). USCOM-derived hemodynamic parameters, including early changes in stroke volume index (r = -0.409), were significantly correlated with serum troponin I levels during the first 24 hours of pediatric septic shock.

synapsesocial.com/papers/6ad0fcb515427f6a840402a3 https://doi.org/10.2147/oaem.s606300

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Correlation Between Hemodynamic Parameters Measured by Ultrasonic Cardiac Output Monitor and Serum Troponin I Levels in Pediatric Septic Shock Patients: A Prospective Observational Study

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Correlation Between Hemodynamic Parameters Measured by Ultrasonic Cardiac Output Monitor and Serum Troponin I Levels in Pediatric Septic Shock Patients: A Prospective Observational Study

Figures

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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