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VOLUME 21 , ISSUE 10 ( 2017 ) > List of Articles

RESEARCH ARTICLE

Serum vitamin D status and outcome in critically Ill children

Nazik Asilioglu, Halit Çiğdem, Sükrü Paksu

Keywords : illness severity, mortality, pediatric intensive care,25-hydroxyvitamin D

Citation Information : Asilioglu N, Çiğdem H, Paksu S. Serum vitamin D status and outcome in critically Ill children. Indian J Crit Care Med 2017; 21 (10):660-664.

DOI: 10.4103/ijccm.IJCCM_153_17

License: CC BY-ND 3.0

Published Online: 00-10-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: Vitamin D is a pleiotropic hormone essential for optimal health. Critical illness in children is a major cause of significant health-care utilization and mortality around the world. The association of Vitamin D deficiency (VDD) in critically ill adults has been well-studied, in comparison, the importance of Vitamin D in pediatric critical illness has been much less studied. Aim and Objectives: This study aimed to assess Vitamin D status and its determinants in patients admitted to a pediatric intensive care unit (PICU) in North of Turkey. We also investigated the association between Vitamin D status and clinical outcomes. Materials and Methods: All patients aged 1 month to 18 years admitted to the PICU of a tertiary care hospital who had levels of 25-hydroxy Vitamin D available within 24 h of admission were included in this retrospective study. VDD was defined as <20 ng/mL levels. Results: VDD was observed in 120 (58.5%) children. In multivariable linear regression model, only identified patient age and winter season as statistically associated with VDD. Vitamin D deficient patients were older and heavier and were more likely to receive catecholamine. There was no association between Vitamin D deficiency and other illness severity factors including mortality. Conclusions: Hypovitaminosis D occurrence was high in critically ill children and was associated with higher vasopressor requirement but not with other markers of illness severity including mortality.


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  1. de Haan K, Groeneveld AB, de Geus HR, Egal M, Struijs A. Vitamin D deficiency as a risk factor for infection, sepsis and mortality in the critically ill: Systematic review and meta-analysis. Crit Care 2014;18:660.
  2. Madden K, Feldman HA, Smith EM, Gordon CM, Keisling SM, Sullivan RM, et al. Vitamin D deficiency in critically ill children. Pediatrics 2012;130:421-8.
  3. McNally JD, Menon K, Chakraborty P, Fisher L, Williams KA, Al-Dirbashi OY, et al. The association of Vitamin D status with pediatric critical illness. Pediatrics 2012;130:429-36.
  4. Rippel C, South M, Butt WW, Shekerdemian LS. Vitamin D status in critically ill children. Intensive Care Med 2012;38:2055-62.
  5. Rey C, Sánchez-Arango D, López-Herce J, Martínez-Camblor P, García-Hernández I, Prieto B, et al. Vitamin D deficiency at pediatric intensive care admission. J Pediatr (Rio J) 2014;90:135-42.
  6. Prasad S, Raj D, Warsi S, Chowdhary S. Vitamin D deficiency and critical illness. Indian J Pediatr 2015;82:991-5.
  7. Sankar J, Lotha W, Ismail J, Anubhuti C, Meena RS, Sankar MJ, et al. Vitamin D deficiency and length of pediatric Intensive Care Unit stay: A prospective observational study. Ann Intensive Care 2016;6:3.
  8. Goldstein B, Giroir B, Randolph A, International Consensus Conference on Pediatric Sepsis. International pediatric sepsis consensus conference: Definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med 2005;6:2-8.
  9. And+ran N, Çelik N, Akça H, Doğan G. Vitamin D deficiency in children and adolescents. J Clin Res Pediatr Endocrinol 2012;4:25-9.
  10. Baeke F, Takiishi T, Korf H, Gysemans C, Mathieu C. Vitamin D: Modulator of the immune system. Curr Opin Pharmacol 2010;10:482-96.
  11. Gordon CM, Feldman HA, Sinclair L, Williams AL, Kleinman PK, Perez-Rossello J, et al. Prevalence of Vitamin D deficiency among healthy infants and toddlers. Arch Pediatr Adolesc Med 2008;162:505-12.
  12. Hewison M. Vitamin D and the immune system: New perspectives on an old theme. Endocrinol Metab Clin North Am 2010;39:365-79.
  13. Hewison M. Vitamin D and the intracrinology of innate immunity. Mol Cell Endocrinol 2010;321:103-11.
  14. Black PN, Scragg R. Relationship between serum 25-hydroxyvitamin d and pulmonary function in the third national health and nutrition examination survey. Chest 2005;128:3792-8.
  15. Onwuneme C, Carroll A, Doherty D, Bruell H, Segurado R, Kilbane M, et al. Inadequate Vitamin D levels are associated with culture positive sepsis and poor outcomes in paediatric intensive care. Acta Paediatr 2015;104:e433-8.
  16. Ayulo M Jr., Katyal CH, Agarwal CH, Sweberg T, Rastogi D, Markowitz M, et al. The prevalence of Vitamin D deficiency and its relationship with disease severity in an urban pediatric critical care unit. Endocr Regul 2014;48:69-76.
  17. Zosky GR, Berry LJ, Elliot JG, James AL, Gorman S, Hart PH, et al. Vitamin D deficiency causes deficits in lung function and alters lung structure. Am J Respir Crit Care Med 2011;183:1336-43.
  18. Dobnig H, Pilz S, Scharnagl H, Renner W, Seelhorst U, Wellnitz B, et al. Independent association of low serum 25-hydroxyvitamin d and 1,25-dihydroxyvitamin d levels with all-cause and cardiovascular mortality. Arch Intern Med 2008;168:1340-9.
  19. Makariou S, Liberopoulos EN, Elisaf M, Challa A. Novel roles of Vitamin D in disease: What is new in 2011? Eur J Intern Med 2011;22:355-62.
  20. Arnson Y, Gringauz I, Itzhaky D, Amital H. Vitamin D deficiency is associated with poor outcomes and increased mortality in severely ill patients. QJM 2012;105:633-9.
  21. Braun A, Chang D, Mahadevappa K, Gibbons FK, Liu Y, Giovannucci E, et al. Association of low serum 25-hydroxyvitamin D levels and mortality in the critically ill. Crit Care Med 2011;39:671-7.
  22. Braun AB, Gibbons FK, Litonjua AA, Giovannucci E, Christopher KB. Low serum 25-hydroxyvitamin D at critical care initiation is associated with increased mortality. Crit Care Med 2012;40:63-72.
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