Vitamin D status in critically ill children.
BACKGROUND
Hypovitaminosis D is an independent risk factor for cardiovascular disease, muscle weakness, impaired metabolism, immune dysfunction, and compromised lung function. Hypovitaminosis D is common in critically ill adults and has been associated with adverse outcomes. The prevalence of hypovitaminosis D and its significance in critically ill children are unclear.


METHODS
We performed a prospective study to determine the prevalence of hypovitaminosis D in 316 critically ill children, and examined its association with physiological and biochemical variables, length of pediatric intensive care unit (PICU) stay, and hospital mortality.


RESULTS
The prevalence of hypovitaminosis D [25(OH)D(3) <50 nmol/L] was 34.5 %. Hypovitaminosis D was more common in postoperative cardiac patients than in general medical ICU patients (40.5 versus 22.6 %, p = 0.002), and the cardiac patients had a higher inotrope score [2.5 (1.9-3.3) versus 1.4 (1.1-1.9), p = 0.006]. Additionally, ionized calcium within the first 24 h was lower in patients with 25(OH)D(3) <50 nmol/L [1.07 (0.99-1.14) mmol/L] compared with patients with normal vitamin D(3) [1.17 (1.14-1.19) mmol/L, p = 0.02]. Hypovitaminosis D was not associated with longer PICU stay or increased hospital mortality.


CONCLUSIONS
Hypovitaminosis D is common in critically ill children, and is associated with higher inotropes in the postoperative cardiac population, but not with PICU length of stay or hospital survival.
Department of Paediatric Intensive Care, The Royal Children's Hospital, Melbourne, Parkville, Australia.
Constance
C
Rippel
Michael
M
South
Warwick W
WW
Butt
Lara S
LS
Shekerdemian
D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012621:Seasons; D014739:Victoria / Q000453:epidemiology; D014808:Vitamin D Deficiency / Q000453:epidemiology*