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Vitamin D deficiency in critically ill children with sepsis
Satheesh Ponnarmeni1, Suresh Kumar Angurana, Sunit Singhi
1Department of Paediatrics, Advanced Paediatric Center, Postgraduate Institute of Medical Education and Research (PGIMER) , Chandigarh, India.
Insights
Vitamin D deficiency is common in critically ill children with sepsis. However, this study found no link between vitamin D deficiency and increased illness severity or poorer outcomes in these children.
Area of Science:
- Pediatric Intensive Care
- Nutritional Science
- Infectious Diseases
Background:
- Limited data exists on vitamin D deficiency (VDD) prevalence in critically ill children with sepsis.
- Understanding VDD's impact on illness severity and outcomes is crucial.
Purpose of the Study:
- To determine the prevalence of vitamin D deficiency in critically ill children diagnosed with sepsis.
- To explore the association between VDD and the severity of illness and clinical outcomes in pediatric sepsis.
Main Methods:
- Prospective enrollment of 124 critically ill children (1-12 years) with sepsis in a pediatric intensive care unit.
- Collection of demographic data, risk factors for VDD, and clinical scores (PRISM III, SOFA).
- Measurement of plasma 25-hydroxy vitamin D [25(OH)D] levels and recording of clinical outcomes, compared with 338 healthy controls.
Main Results:
- The prevalence of VDD was significantly higher in critically ill children with sepsis (50.8%) compared to healthy controls (40.2%).
- VDD was not linked to demographic variables or identified risk factors.
- No statistically significant association was found between VDD and increased illness severity scores, septic shock, MODS, HCAI, mechanical ventilation, catecholamine use, PICU stay, or mortality.
Conclusions:
- A high prevalence of vitamin D deficiency exists in critically ill children with sepsis.
- Despite the high prevalence, VDD was not associated with increased illness severity or adverse clinical outcomes in this cohort.
Background:
Data on the prevalence of vitamin D deficiency (VDD) in critically ill children with sepsis and its association with illness severity and outcome are limited.
Aim:
To investigate the prevalence of VDD in critically ill children with sepsis.
Methods:
One hundred and twenty-four critically ill children with sepsis aged 1-12 years were prospectively enrolled in a paediatric intensive care unit (PICU) in North India over a 1-year period. Demographic data, clinical signs and risk factors for VDD, Paediatric Index of Mortality III (PRISM III) score, and sequential organ failure assessment (SOFA) score were recorded. Plasma 25-hydroxy vitamin D [25(OH)D] levels were measured by ELISA within 24 hours of admission. The occurrence of septic shock, multiple organ dysfunction syndrome (MODS) and healthcare-associated infection (HCAI), need for mechanical ventilation and catecholamines, length of PICU stay and mortality were also recorded. Cases were compared with 338 apparently healthy children for baseline variables and vitamin D status.
Results:
Prevalence of VDD [25(OH)D level < 50 nmol/L] was higher among critically ill children with sepsis compared to healthy controls (50.8% vs 40.2%, P = 0.04). VDD was not associated with any significant difference in baseline demographic variables or risk factors for VDD. Although there was a trend toward increased PRISM III score, septic shock, MODS, HCAI, need for mechanical ventilation and catecholamines, length of PICU stay, and mortality, the difference was not statistically significant.
Conclusion:
A high prevalence of VDD in critically ill children with sepsis was found but it was not associated with greater severity of illness or other clinical outcomes.
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