الفهرس 
Significance of CkMb to total cpk ratio in critically ill children
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Abstract
Introduction: Acute severe myocardial dysfunction remains a significant cause of mortality and morbidity in children requiring intensive care. In ICU patients, physiologic stresses can occur in the form of either increased myocardial oxygen demands or decreased myocardial oxygen delivery resulting in cardiac dysfunction, cardiac injury, or both. CKMB is one of the three creatinine-kinase isoenzymes expressed in the heart (=22% of the total CK content) and skeletal muscle (=1-3%). It is usually undetectable or in low levels in the blood except in the presence of both heart and skeletal diseases. Still no more studies have been evaluated the value of CKMB to total CPK in critically ill children to determine its effect in evaluation of myocardial injury. Aim of the study: To evaluate the sensitivity of Creatinine Kinase Myocardial Band to total Creatinine Phospho- Kinase in critically ill children and its evaluation as a marker for myocardial dysfunction in these patients. Patient and methods: our study was a comparative cross-sectional study which was performed on 102 critically ill children who were admitted to PICU of children’s hospital, Cairo University to evaluate the sensitivity of CKMB to total CK ratio in myocardial dysfunction in critically ill children. All the included children were subjected to full history taking, clinical examination, and investigations including CKMB to total CK ratio.Results: The present study revealed statistically significant difference between 2 groups (CKMB/CPK<0.51) and (CKMB/CPK >0.51) as regards cardiopulmonary causes (being mostly >0.51), neurometabolic causes (being mostly<.51), renal ((being mostly <0.51), and sepsis ((being mostly <0.51), with p-value <0.05. The present study revealed statistically significant difference between 2 groups (CKMB/CPK<0.42) and (CKMB/CPK >0.42) as regards outcome (died or survived) with p-value <0.001