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Vitamin D deficiency in critically ill children

Kate Madden1, Henry A Feldman, Ellen M Smith

  • 1Division of Critical Care Medicine, Department of Anesthesia, Perioperative and Pain Medicine, Children's Hospital Boston, Boston, MA 02115, USA. kate.madden@childrens.harvard.edu

Pediatrics
|August 8, 2012
PubMed

Insights

Over 40% of critically ill children have vitamin D deficiency. Lower vitamin D levels correlate with increased illness severity, indicating a need for screening and repletion strategies in at-risk pediatric patients.

Area of Science:

  • Pediatric Critical Care Medicine
  • Nutritional Science
  • Immunology

Background:

  • Vitamin D plays a crucial role in cardiovascular and immune system functions.
  • Vitamin D deficiency is a growing concern in various populations, including children.
  • Understanding vitamin D status in critically ill children is essential for optimizing care.

Purpose of the Study:

  • To determine the prevalence of vitamin D deficiency in critically ill children.
  • To identify factors associated with vitamin D levels in this population.
  • To investigate the relationship between vitamin D status and illness severity.

Main Methods:

  • A prospective study involving 511 critically ill children admitted to the Pediatric Intensive Care Unit (PICU).
  • Blood samples were collected near PICU admission for 25-hydroxy vitamin D (25(OH)D) analysis using radioimmunoassay.
  • Multivariate analysis was employed to identify factors influencing vitamin D levels and deficiency.

Main Results:

  • The median 25(OH)D level was 22.5 ng/mL, with 40.1% of children exhibiting deficiency (<20 ng/mL).
  • Factors such as age and race were associated with deficiency, while summer season, vitamin D supplementation, and formula intake were protective.
  • Lower vitamin D levels were significantly associated with higher illness severity scores, particularly in cases of septic shock.

Conclusions:

  • A high prevalence of vitamin D deficiency exists among critically ill children.
  • Screening for vitamin D deficiency in critically ill children with risk factors is recommended.
  • Effective vitamin D repletion strategies should be implemented to address deficiency and support recovery.
Abstract

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