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100 www.pccmjournal.org January 2017 • Volume 18 • Number 1 plasma troponin I (TnI) level as a biomarker to predict mortality and requirement for vasoactive drugs in the PICU. We would like to provide some comments regarding this interesting study. Troponin I has been used in children with septic shock as a biomarker. However, Oliveira et al (2) in a prospective study concluded that serum levels of cardiac Tn (cTn) I within the first 24 hours of diagnosis of sepsis or septic shock in children were not better than creatine kinase MB isoenzyme or clinical evaluation to predict the outcome (death or discharge from hospital) of septic process. We should ask whether the TnI detection would be the same in a population with malnourished children. Would we find the same rise in TnI levels? And the relationship with the outcome would be the same? If this study demonstrates its reproducibility elsewhere, that could lead to the concept of making TnI a point-of-care test in PICUs settings, assisting clinicians to more accurate staging the severity of patients. Furthermore, cardiac biomarkers may also benefit centers without on-site echocardiography with evidence showing good correlation with echo-derived markers of myocardial function (3). In neonatology, troponin I might also play a role as a biomarker, not only in neonates with congenital heart defects. cTns are very sensitive markers for the detection of myocardial injury and have been studied in healthy newborns, after tocolysis, intrauterine growth restriction, respiratory distress syndrome, and asphyxia (3). We congratulate the authors for the article, highlighting that further studies are required to confirm these results. The authors have disclosed that they do not have any potential conflicts of interest.