Vitamin D status in critically ill children

Area of Science:

• Pediatric Critical Care Medicine
• Endocrinology
• Nutritional Science

Background:

• Hypovitaminosis D is a known risk factor for various health issues in adults, including cardiovascular disease and immune dysfunction.
• While common in critically ill adults, the prevalence and impact of hypovitaminosis D in critically ill children remain largely unknown.
• Understanding vitamin D status in pediatric intensive care is crucial for optimizing patient outcomes.

Purpose of the Study:

• To determine the prevalence of hypovitaminosis D in critically ill children.
• To investigate the association between hypovitaminosis D and key physiological/biochemical variables.
• To examine the relationship between hypovitaminosis D and pediatric intensive care unit (PICU) length of stay and hospital mortality.

Main Methods:

• A prospective study was conducted involving 316 critically ill children.
• Prevalence of hypovitaminosis D was defined as 25(OH)D(3) <50 nmol/L.
• Associations with physiological variables, PICU stay, and mortality were analyzed.

Main Results:

• The prevalence of hypovitaminosis D was 34.5% in the studied pediatric population.
• Hypovitaminosis D was significantly more common in postoperative cardiac patients (40.5%) compared to general medical ICU patients (22.6%).
• Patients with hypovitaminosis D had lower ionized calcium levels and higher inotrope scores (in cardiac patients), but no association was found with PICU stay or hospital mortality.

Conclusions:

• Hypovitaminosis D is prevalent in critically ill children.
• The condition is associated with increased need for inotropic support in postoperative pediatric cardiac patients.
• Hypovitaminosis D was not found to be associated with prolonged PICU admission or increased hospital mortality in this cohort.