A pediatric critical care perspective on vitamin D
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Published on: December 9, 2015
Riad Abou-Zahr1, Sarah B Kandil2
1Division of Pediatric Cardiology, Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut.
Insights
Vitamin D deficiency is linked to worse outcomes in critically ill children, especially those with heart conditions. Supplementation may benefit patients with congestive heart failure.
Area of Science:
- Pediatric critical care medicine
- Cardiology
- Endocrinology
Background:
- Vitamin D's role in immune function and cell proliferation is under investigation.
- Vitamin D deficiency is associated with increased illness severity in critical care.
- Pediatric cardiac patients exhibit higher rates of vitamin D deficiency.
Purpose of the Study:
- To review recent studies on vitamin D status in critically ill children.
- To examine the relationship between vitamin D levels and clinical outcomes in pediatric critical illness.
- To specifically assess the impact of vitamin D in critically ill children with cardiac disease.
Main Methods:
- Literature review of recent studies.
- Analysis of associations between vitamin D levels and illness severity metrics.
- Examination of outcomes in pediatric cardiac patients with varying vitamin D status.
Main Results:
- Vitamin D deficiency correlates with higher inotrope support, increased fluid resuscitation, and longer ICU stays.
- Postoperative cardiac patients show low vitamin D levels, potentially due to cardiopulmonary bypass.
- Children with congestive heart failure and vitamin D deficiency may benefit from supplementation.
Conclusions:
- Vitamin D status is a significant factor in pediatric critical illness outcomes.
- The pediatric cardiac population is at elevated risk for vitamin D deficiency.
- Further research into vitamin D's role and supplementation in critically ill children is warranted.
Abstract:
The mechanisms of action of vitamin D are the subject of intense investigation. Evidence now suggests vitamin D affects immune function and cell proliferation, prompting interest in its role in critical illness and cardiac disease. Multiple studies demonstrate strong associations between vitamin D deficiency and severity of illness including need for higher inotrope support, more fluid resuscitation, and longer intensive care unit stay. The pediatric cardiac population may be at even more risk and nearly twice as likely to be deficient compared to the noncardiac population. Low vitamin D levels have been found in postoperative cardiac patients, where investigators speculate cardiopulmonary bypass alters levels directly or indirectly. Patients with congestive heart failure who are deficient also seem to benefit from vitamin D supplementation. This review summarizes recent studies in children that investigate the relation between vitamin D status and clinical outcomes in the critically ill including those with cardiac disease.
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