Vitamin D Deficiency and Parathyroid Response in Critically-ill Children: Association with Illness Severity and...

Area of Science:

• Pediatric Intensive Care
• Endocrinology
• Nutritional Science

Background:

• Vitamin D deficiency is common in critically ill children.
• The impact of vitamin D deficiency on parathyroid response and clinical outcomes in this population is not well understood.

Purpose of the Study:

• To determine the prevalence of vitamin D deficiency in critically ill children.
• To investigate the association between vitamin D deficiency, parathyroid response, illness severity, and clinical outcomes.

Main Methods:

• Prospective observational study conducted in a tertiary care Medical Pediatric Intensive Care Unit in Northern India.
• 154 critically ill children were enrolled between August 2011 and January 2013.
• Children were categorized based on serum 25-hydroxy vitamin D levels and parathyroid hormone response; illness severity was assessed using the Pediatric Index of Mortality-2 (PIM-2) score.

Main Results:

• Vitamin D deficiency (83.1%) and hypocalcemia (59%) were highly prevalent at admission.
• No significant differences in illness severity, mortality, or length of stay were observed between vitamin D-deficient and non-deficient children.
• Among vitamin D-deficient children, those with a parathyroid response had a higher PIM-2 score compared to non-responders (P=0.01).

Conclusions:

• Critically ill children exhibit a high prevalence of vitamin D deficiency.
• The parathyroid gland response to hypocalcemia or vitamin D deficiency appears to be impaired during critical illness.
• Further research is needed to elucidate the clinical implications of impaired parathyroid response in critically ill children with vitamin D deficiency.