[Vitamin D deficiency in children admitted to the paediatric intensive care unit]

Area of Science:

• Pediatric Critical Care Medicine
• Nutritional Biochemistry
• Clinical Endocrinology

Background:

• Vitamin D is crucial for bone health, cardiovascular function, and immune response.
• Vitamin D deficiency (VDD) is prevalent in critically ill adults, correlating with sepsis and disease severity.
• Understanding VDD in pediatric intensive care is vital for patient outcomes.

Purpose of the Study:

• To determine the prevalence of VDD in children admitted to a Paediatric Intensive Care Unit (PICU) in Concepcion, Chile.
• To investigate the association between VDD and significant clinical outcomes in this pediatric cohort.
• To provide data for potential therapeutic interventions in critically ill children.

Main Methods:

• A prospective observational cohort study involving 90 consecutive pediatric patients admitted to the PICU.
• Serum 25-hydroxyvitamin D (25-OH-D) levels were measured on PICU admission.
• Severity of illness was assessed using PRISM, PELOD, and vasoactive-inotropic score (VIS); VDD defined as 25-OH-D < 20 ng/ml.

Main Results:

• The prevalence of VDD among critically ill children was 43.3% (mean 25-OH-D level: 22.8 ng/ml).
• VDD was significantly associated with increased vasopressor use (RR 1.6), mechanical ventilation (RR 2.2), and septic shock (RR 1.9).
• A higher likelihood of requiring fluid bolus > 40 ml/kg in the first 24 hours was also observed (RR 1.5).

Conclusions:

• Vitamin D deficiency is highly prevalent upon admission to the PICU in critically ill children.
• VDD in this population is associated with adverse clinical outcomes, including severe illness indicators.
• Further research is warranted to explore the benefits of vitamin D supplementation in pediatric intensive care settings.