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@gmail.com.
2Department of Pediatrics, PGIMER, Dr RML Hospital, New Delhi, India. wonash_tsanglao@yahoo.co.in.
3Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. javedisi86@gmail.com.
4Department of Pediatrics, PGIMER, Dr RML Hospital, New Delhi, India. anubhuti1234@rediffmail.com.
5Department of Biochemistry, PGIMER, Dr RML Hospital, New Delhi, India. anubhuti1234@rediffmail.com.
6Department of Pediatrics, PGIMER, Dr RML Hospital, New Delhi, India. drrameshwaruk@gmail.com.
7Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. jeevasankar@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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- 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