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Vitamin D deficiency in surgical congenital heart disease: prevalence and relevance
James Dayre McNally1, Kusum Menon1
11 Division of Critical Care, Department of Pediatrics, Faculty of Medicine, University of Ottawa, Children's Hospital of Eastern Ontario, Ottawa, Canada ; 2 Research Institute, Children's Hospital of Eastern Ontario, Ottawa, Canada.
Insights
Vitamin D deficiency is linked to worse outcomes in critically ill children, especially those with congenital heart disease (CHD). Optimizing vitamin D levels may improve recovery and reduce complications after surgery.
Area of Science:
- Endocrinology
- Critical Care Medicine
- Pediatric Cardiology
Background:
- Vitamin D is a crucial hormone for organ system function.
- Vitamin D deficiency is increasingly recognized as a factor in critical illness outcomes.
- Pediatric patients with congenital heart disease (CHD) often exhibit post-operative vitamin D deficiency.
Purpose of the Study:
- To review the link between vitamin D deficiency and post-operative organ dysfunction in critically ill populations.
- To examine vitamin D supplementation strategies for preventing deficiency and toxicity in pediatric CHD patients.
- To identify research gaps and future directions for vitamin D supplementation in CHD.
Main Methods:
- Literature review of epidemiological and basic science research.
- Analysis of clinical studies on vitamin D status in pediatric CHD patients.
- Evaluation of current vitamin D supplementation approaches and their efficacy.
Main Results:
- Vitamin D deficiency is associated with increased organ dysfunction and prolonged ICU stays in critically ill patients.
- Children with CHD frequently present with post-operative vitamin D deficiency, correlating with cardiovascular dysfunction.
- Peri-operative vitamin D optimization shows potential for enhanced recovery and improved outcomes.
Conclusions:
- Vitamin D deficiency poses a significant risk in critically ill pediatric populations, particularly those with CHD.
- Strategic peri-operative vitamin D supplementation may mitigate post-operative complications and improve patient outcomes.
- Further research is needed to establish optimal supplementation protocols and address knowledge gaps.
Abstract:
Vitamin D is a pleiotropic hormone important for the proper functioning of multiple organ systems. An emerging body of adult and pediatric critical care literature strongly suggests that vitamin D deficiency contributes to secondary organ pathophysiology, prolongs ICU stay, and worsens outcome in critically ill populations. Recent clinical studies suggest that a significant number of children with congenital heart disease (CHD) have post-operative vitamin D deficiency which appears to be associated with greater cardiovascular dysfunction. Altogether the cumulative body of literature suggests that peri-operative optimization of vitamin D status has the potential to speed recovery and/or improve outcome. This review describes the epidemiological and basic science research linking vitamin D deficiency to post-operative organ dysfunction. Furthermore, the available supplementation approaches are reviewed in the context of prevention of post-operative vitamin D deficiency and avoidance of toxicity in the majority of CHD patients. Finally, knowledge gaps regarding vitamin D supplementation are identified and the next stages for research are outlined.
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