Vitamin D deficiency and length of pediatric intensive care unit stay: a prospective observational study.
Ann Intensive Care. 2016 Dec;6(1):3. doi: 10.1186/s13613-015-0102-8. Epub 2016 Jan 8.
Sankar J1, Lotha W2, Ismail J3, Anubhuti C4,5, Meena RS6, Sankar MJ7.
1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. jhumaji at gmail.com.
2Department of Pediatrics, PGIMER, Dr RML Hospital, New Delhi, India. wonash_tsanglao at yahoo.co.in.
3Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. javedisi86 at gmail.com.
4Department of Pediatrics, PGIMER, Dr RML Hospital, New Delhi, India. anubhuti1234 at rediffmail.com.
5Department of Biochemistry, PGIMER, Dr RML Hospital, New Delhi, India. anubhuti1234 at rediffmail.com.
6Department of Pediatrics, PGIMER, Dr RML Hospital, New Delhi, India. drrameshwaruk at gmail.com.
7Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. jeevasankar at gmail.com.
BACKGROUND:
Due to the limited data available in the pediatric population and lack of interventional studies to show that administration of vitamin D indeed improves clinical outcomes, opinion is still divided as to whether it is just an innocent bystander or a marker of severe disease. Our objective was therefore to estimate the prevalence of vitamin D deficiency in children admitted to intensive care unit (ICU) and to examine its association with duration of ICU stay and other key clinical outcomes.
METHODS:
We prospectively enrolled children aged 1 month-17 years admitted to the ICU over a period of 8 months (n = 101). The primary objectives were to estimate the prevalence of vitamin D deficiency (serum 25 (OH) <20 ng/mL) at 'admission' and to examine its association with length of ICU stay.
RESULTS:
The prevalence of vitamin D deficiency was 74 % (95 % CI: 65-88). The median (IQR) duration of ICU stay was significantly longer in 'vitamin D deficient' children (7 days; 2-12) than in those with 'no vitamin D deficiency' (3 days; 2-5; p = 0.006). On multivariable analysis, the association between length of ICU stay and vitamin D deficiency remained significant, even after adjusting for key baseline variables, diagnosis, illness severity (PIM-2), PELOD, and need for fluid boluses, ventilation, inotropes and mortality [adjusted mean difference (95 % CI): 3.5 days (0.50-6.53); p = 0.024].
CONCLUSIONS:
We observed a high prevalence of vitamin D deficiency in critically ill children in our study population. Vitamin D deficient children had a longer duration of ICU stay as compared to others.
PMID: 26745966
See also VitaminDWiki
Pages listed in BOTH of the categories: Trauma/Surgery and Infants/Children
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- 3X less Septic Shock in children with sepsis getting 150,000 IU of Vitamin D - RCT June 2020
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- Septic children have low Vitamin D (54 studies, ignored Vitamin D Receptor) – meta-analysis April 2019
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- Children entering ICU with low vitamin D were 3.5 X more likely to have a poor ICU score– Oct 2018
- Critically ill children with low vitamin D: 2.5 X more likely to die or stay 2 days longer - meta-analysis Nov 2017
- Micronutrients (such as Vitamin D) for critically ill children – review Oct 2017
- Critically ill children – randomized clinical trial to give single doses of up to 400,000 IU of vitamin D – 2019
- Vitamin D deficiency in pediatric critical illness: Time to move on from observational studies – Nov 2016
- Low vitamin D in Pediatric ICU – 5 times more ill (morbidity) – Spanish Nov 2016
- Children in Intensive Care need Vitamin D loading dose of 10000 IU per kg (nearing a consensus) - Oct 2016
- Children stayed in ICU 3.5 days longer if low vitamin D – Dec 2015
- Rapid Normalization of Vitamin D in Critically Ill Children (10,000 IU per kg) – clinical trial
- Congenital Heart problems - vitamin D levels drop even lower after surgery, loading dose probably required - thesis 2015
- Infant in ICU much more likely to die if low vitamin D – Nov 2015
- 5 out of 6 children who died in pediatric critical care unit had low vitamin D – May 2014
- Hospitalization consumes vitamin D in children – March 2014
- Congenital heart surgery dropped vitamin D levels by 40 percent – July 2013
- Vitamin D deficient children stayed in ICU almost 2 days longer – Sept 2012
- Sepsis is both prevented and treated by Vitamin D - many studies
items in BOTH of categories: Trauma/Surgery and Youths
- Critically ill children – randomized clinical trial to give single doses of up to 400,000 IU of vitamin D – 2019
- Children stayed in ICU 3.5 days longer if low vitamin D – Dec 2015
- Rapid Normalization of Vitamin D in Critically Ill Children (10,000 IU per kg) – clinical trial
- Vitamin D deficient children stayed in ICU almost 2 days longer – Sept 2012
- Septic shock and low vitamin D in children – Oct 2011
- Hardly any children had enough vitamin D before bone surgery – April 2011