[Vitamin D deficiency and morbimortality in critically ill paediatric patients] Spanish
An Pediatr (Barc). 2016 Nov 25. pii: S1695-4033(16)30265-X. doi: 10.1016/j.anpedi.2016.09.005.
García-Soler P1, Morales-Martínez A2, Rosa-Camacho V2, Lillo-Muñoz JA2, Milano-Manso G2.
Pages in BOTH of the categories: Trauma/Surgery and Infants/Children
- 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
To determine the prevalence and risks factors of vitamin D deficiency, as well as its relationship with morbidity and mortality in a PICU.
MATERIAL AND METHODS:
An observational prospective study in a tertiary children's University Hospital PICU conducted in two phases: i: cohorts study, and ii: prevalence study. The study included 340 critically ill children with ages comprising 6 months to 16 years old.
Chronic kidney disease, known parathyroid disorders, and vitamin D supplementation. Total 25-hydroxyvitamin D [25(OH)D] was measured in the first 48 hours of admission to a PICU. Parathormone, calcium, phosphate, blood gases, blood count, C-reactive protein, and procalcitonin were also analysed. A record was also made of demographic features, characteristics of the episode, and complications during the PICU stay.
The overall prevalence rate of vitamin D deficiency was 43.8%, with a mean of 22.28 (95% CI 21.15-23.41) ng/ml.
Patients with vitamin D deficiency
- were older (61 vs 47 months, P=.039),
- had parents with a higher level of academic studies (36.5% vs 20%, P=.016),
- were admitted more often in winter and spring,
- had a higher PRISM-III (6.8 vs 5.1, P=.037),
- a longer PICU stay (3 vs 2 days, P=.001), and
- higher morbidity (61.1% vs 30.4%, P<001)
than the patients with sufficient levels of 25(OH)D.
Patients who died had lower levels of 25(OH)D (14±8.81ng/ml versus 22.53±10.53ng/ml, P=.012).
Adjusted OR for morbidity was 5.44 (95%CI; 2.5-11.6).
Vitamin D deficiency is frequent in critically ill children, and it is related to both morbidity and mortality, although it remains unclear whether it is a causal relationship or it is simply a marker of severity in different clinical situations.
PMID: 27894744 DOI: 10.1016/j.anpedi.2016.09.005