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VOLUME 27 , ISSUE 7 ( July, 2023 ) > List of Articles


Clinical Profile, Intensive Care Needs and Outcome of Children with Dilated Cardiomyopathy Associated with Vitamin D Deficiency: A 5-year PICU Experience

Surjeet Kumar, Manjinder Singh Randhawa, Manoj Rohit Kumar, Naresh Sachdeva, Muralidharan Jayashree

Keywords : Inotropes, Intensive care units, Pediatric intensive care units, Vitamin D deficiency

Citation Information : Kumar S, Randhawa MS, Kumar MR, Sachdeva N, Jayashree M. Clinical Profile, Intensive Care Needs and Outcome of Children with Dilated Cardiomyopathy Associated with Vitamin D Deficiency: A 5-year PICU Experience. Indian J Crit Care Med 2023; 27 (7):510-514.

DOI: 10.5005/jp-journals-10071-24484

License: CC BY-NC 4.0

Published Online: 30-06-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Aim: To describe the clinical profile, treatment details, intensive care needs, and long-term outcome of children with dilated cardiomyopathy (DCM) associated with Vitamin D deficiency (VDD). Materials and methods: Case records of 14 children with DCM associated with VDD [25(OH)D3 levels <20 ng/mL] admitted to the pediatric intensive care unit (PICU) of a tertiary care teaching hospital between January 2017 and December 2021 were retrospectively analyzed for clinical features, echocardiographic findings, treatment details, intensive care needs, and outcomes. Results: The median (IQR) age was 6 (2–9) months and 71% (n=10) were males. The common modes of presentation included respiratory distress or failure (78.6%), congestive cardiac failure (71.4%), cardiogenic shock (37.5%), and seizures and encephalopathy (14.3% each). The median (IQR) serum calcium was 8.7 (7–9.5) mg%, ionized calcium 0.7 (0.7–1.1) mmol/L, alkaline phosphatase 343 (316–415) IU/L, phosphate 3.5 (2.6–4.5) mg%, PTH 115 (66–228) pg/mL, and 25(OH)D3 5 (3–7) ng/mL. The median (IQR) left ventricular ejection fraction (LVEF) at admission was 22 (17–25)%. The treatment included intravenous calcium infusion (35.7%), vitamin D supplementation in all (57.1% parenteral and 42.9% oral), mechanical ventilation (35.7%), and vasoactive drugs (57.1%). There was no mortality. The median (IQR) duration of PICU and hospital stay was 76 (31–98) hours and 6 (4.7–10) days, respectively. Out of 14 children, 10 (71.4%) were followed-up till median (IQR) of 10 (7–58) months. All were asymptomatic and had normal LEVF (except one had residual moderate mitral regurgitation). Conclusion: Vitamin D deficiency is a potentially treatable and reversible cause of DCM in children.

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