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Efficacy of vitamin D supplementation for children with acute bronchiolitis: A randomized controlled trial
Elsayed Abdelkreem1,2, Yostena Safwat Labeeb1, Mostafa Ashry Mohamed1
1Department of Pediatrics, Faculty of Medicine, Sohag University, Nasser City 82524, Sohag, Egypt.
Insights
Vitamin D supplementation may benefit hospitalized children with bronchiolitis and deficiency. A high single dose improved outcomes in deficient children, suggesting a test-and-treat strategy for vitamin D (25(OH)D) levels.
Area of Science:
- Pediatrics
- Endocrinology
- Infectious Diseases
Background:
- Vitamin D deficiency is linked to bronchiolitis, but its role in treatment is unclear.
- Previous studies suggest an association, yet therapeutic benefits require further investigation.
Purpose of the Study:
- To evaluate the effectiveness of vitamin D supplementation in hospitalized children diagnosed with acute bronchiolitis.
- Assessing if vitamin D improves clinical outcomes and recovery time.
Main Methods:
- A randomized controlled trial involving 146 children (3-24 months) with bronchiolitis.
- Comparing a single 200,000 IU intramuscular dose versus a daily 400 IU oral dose of vitamin D3.
- Primary outcome: time to hospital discharge; Secondary outcomes: oxygen weaning, IV fluid cessation, discharge readiness, and serum 25(OH)D levels.
Main Results:
- No significant difference in discharge time for the overall cohort.
- However, in children with baseline vitamin D deficiency (serum 25(OH)D < 30 ng/mL), the high-dose group showed significantly faster discharge (120 vs. 170 hours).
- The deficient subgroup also experienced quicker oxygen weaning, IV fluid discontinuation, and discharge readiness with higher vitamin D levels.
Conclusions:
- Vitamin D supplementation can improve clinical outcomes for hospitalized children with bronchiolitis who are vitamin D deficient or insufficient.
- Results support a 'test-and-treat' approach for vitamin D levels in pediatric bronchiolitis cases.
Background:
Previous studies have suggested an association between vitamin D deficiency and bronchiolitis, but the therapeutic benefits of vitamin D supplementation remain uncertain.
Aim:
To investigate the efficacy of vitamin D supplementation for hospitalized children with acute bronchiolitis.
Methods:
This two-arm randomized controlled trial included 146 children aged 3-24 months who were hospitalized with bronchiolitis at an Egyptian tertiary care center. Participants were equally randomized to receive a single intramuscular dose of 200000 IU (study group) or a daily oral dose of 400 IU (comparison group) of vitamin D3. The primary outcome was the time to hospital discharge. Secondary outcomes included time to oxygen weaning, discontinuation of intravenous fluids, and discharge readiness as well as serum 25-hydroxyvitamin D [25(OH)D] levels on day 3 post-randomization. Both the study and comparison groups were compared in the whole cohort (primary analysis) and within the subgroup of participants with baseline serum 25(OH)D levels < 30 ng/mL (prespecified subgroup analysis).
Results:
In the overall analysis, the study and comparison groups showed no significant differences in median time to discharge (130 hours vs 140 hours, P = 0.149) or in secondary outcomes, except for a higher serum 25(OH)D level in the study group (51 ± 12.8 vs 32 ± 13.2 ng/mL, P < 0.001). However, among the subgroup of participants with baseline serum 25(OH)D levels < 30 ng/mL, the study group demonstrated significantly shorter median times to hospital discharge (120 hours vs 170 hours, P < 0.001), oxygen weaning (56 hours vs 79 hours, P = 0.012), discontinuation of intravenous fluids (55 hours vs 73 hours, P = 0.017), and discharge readiness (118 hours vs 165 hours, P = 0.001) as well as a greater increase in serum 25(OH)D levels (40 ± 6.6 ng/mL vs 20 ± 6.1 ng/mL, P < 0.001) than the comparison group.
Conclusion:
Vitamin D supplementation may improve clinical outcomes in hospitalized children with bronchiolitis who have vitamin D deficiency or insufficiency, supporting a test-and-treat approach.
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