Related Experiment Video
Updated: Feb 18, 2026
A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
Published on: December 9, 2015
Vitamin D deficiency in critically ill children: a systematic review and meta-analysis
James Dayre McNally1,2, Nassr Nama3, Katie O'Hearn4
1Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada. dmcnally@cheo.on.ca.
Insights
Vitamin D deficiency is common in critically ill children, affecting about 50%. This deficiency is linked to worse outcomes, including higher mortality rates in the pediatric intensive care unit.
Area of Science:
- Pediatric Critical Care Medicine
- Nutritional Biochemistry
- Epidemiology
Background:
- Vitamin D deficiency (VDD) is a prevalent condition.
- VDD may be a modifiable risk factor for severe illness and poor outcomes in critically ill patients.
- The frequency and impact of VDD in pediatric critical illness require systematic evaluation.
Purpose of the Study:
- To determine the prevalence of VDD in critically ill children.
- To compare vitamin D status in pediatric intensive care unit (PICU) patients with healthy controls.
- To assess the association between VDD and clinical outcomes, including mortality and illness severity.
Main Methods:
- A systematic review and meta-analysis of studies identified through MEDLINE, Embase, and CENTRAL databases.
- Searches were conducted without date or language restrictions.
- Pooled prevalence, mean differences in vitamin D levels, and odds ratios for mortality were calculated using random-effects models.
Main Results:
- Seventeen studies involving 2783 critically ill children were included.
- The pooled prevalence of VDD (defined as 25-hydroxyvitamin D [25(OH)D] < 50 nmol/L) was 54.8%.
- VDD was associated with increased mortality (OR 1.62), greater illness severity, and a higher need for PICU interventions.
Conclusions:
- Approximately half of critically ill children admitted to the PICU have VDD.
- VDD is associated with increased illness severity, multiple organ dysfunction, and mortality.
- Further clinical trials are needed to ascertain if vitamin D supplementation improves patient outcomes.
Background:
Vitamin D deficiency (VDD) has been hypothesized not only to be common but also to represent a potentially modifiable risk factor for greater illness severity and clinical outcome during critical illness. The objective of this systematic review was to determine the frequency of VDD in pediatric critical illness and its association with clinical outcomes.
Methods:
MEDLINE, Embase, and CENTRAL were searched through December 12, 2016, with no date or language restrictions. The primary objective was to estimate the prevalence of VDD in the pediatric intensive care unit (PICU) and compare vitamin D status with healthy control populations. Secondary objectives were to evaluate whether VDD is associated with mortality, increased illness severity, PICU interventions, and patient clinical course. Random effects meta-analysis was used to calculate pooled VDD event rate, compare levels with those of control subjects, and evaluate for associations between VDD and clinical outcome.
Results:
Among 2700 citations, 17 studies meeting study eligibility were identified. The studies reported a total of 2783 critically ill children and had a median sample size of 120 (range 12-511). The majority of studies used a 25-hydroxyvitamin D [25(OH)D] level less than 50 nmol/L to define VDD, and the pooled VDD prevalence was 54.8 (95% CI 45.4-63.9). Average 25(OH)D levels were significantly lower in PICU patients than in healthy control subjects (pooled difference -17.3 nmol/L, 95% CI -14.0 to -20.6). In a meta-analysis calculation, we found that VDD was associated with increased mortality (OR 1.62, 95% CI 1.11-2.36), illness severity, and need for PICU interventions.
Conclusions:
Approximately 50% of critically ill children have VDD at the time of PICU admission, defined as a blood total 25(OH)D concentration under 50 nmol/L. VDD was further determined to be associated with greater illness severity, multiple organ dysfunction, and mortality in the PICU setting. Clinical trials are required to determine if optimization of vitamin D status improves patient outcome.
Trial Registration:
PROSPERO, CRD42016026617 . Registered on 11 January 2016.
Related Concept Videos
01:23Role of Skin in Vitamin D Synthesis
The solar UV B rays (290-315 nm) are absorbed by the skin, and 7-dehydrocholesterol (provitamin D3) photolyzes it to previtamin D3, which undergoes a rapid transformation to vitamin...
01:29Drug Dosing: Infants and Children
01:25Role of Vitamins in Maintaining Bone Health
Vitamin A
Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
Vitamin B12
Vitamin B12 acts as a cofactor during the formation of osteoblast-related proteins, such as osteocalcin. Vitamin B12 plays a role...
01:30Vitamins
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
01:29Acute Kidney Injury III: Clinical Manifestations