title: Vitamin D status in neonates undergoing cardiac operations: relationship to cardiopulmonary bypass and association with outcomes.
abstract: OBJECTIVE
  To determine the incidence of vitamin D deficiency in neonates with congenital heart disease and whether differences exist by race. In addition, we determined the effect of cardiopulmonary bypass on vitamin D levels and explored associations between 25-hydroxyvitamin D [25(OH)D] levels and postoperative outcomes.
  
  
  METHODS
  We performed a secondary analysis of a prospective randomized controlled trial in 70 neonates undergoing cardiac surgery. The neonates' 25(OH)D levels were measured in the operating room before skin incision (baseline), at the cessation of cardiopulmonary bypass, and at 24 hours postoperatively. Associations between these levels and clinical outcomes were explored. Vitamin D deficiency was defined as a 25(OH)D level <20 ng/mL.
  
  
  RESULTS
  Vitamin D deficiency was present in 84% (59/70); concentrations in African Americans (n = 20) were significantly lower than those of Caucasian/other race/ethnicity (n = 50) (10.2 ± 4.2 vs 16.0 ± 5.6 ng/mL, P < .0001). The 24-hour postoperative 25(OH)D levels were not different from baseline and correlated with a reduced postoperative inotropic requirement (r = -0.316, P = .008).
  
  
  CONCLUSIONS
  Vitamin D deficiency is prevalent in neonates with congenital cardiac defects, and lower postoperative 25(OH)D levels are associated with the need for increased inotropic support in neonates undergoing cardiac operations. These findings support that vitamin D deficiency may play a role in myocardial injury and postoperative recovery and warrants further investigation.
authors.affiliation: Division of Cardiology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC 29425, USA. grahamem@musc.edu
authors.forename: Eric M
authors.initials: EM
authors.lastname: Graham
authors.forename: Sarah N
authors.initials: SN
authors.lastname: Taylor
authors.forename: Sinai C
authors.initials: SC
authors.lastname: Zyblewski
authors.forename: Bethany
authors.initials: B
authors.lastname: Wolf
authors.forename: Scott M
authors.initials: SM
authors.lastname: Bradley
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Hollis
authors.forename: Francis X
authors.initials: FX
authors.lastname: McGowan
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Atz
mesh_terms: D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D005006:Ethnicity; D005260:Female; D006330:Heart Defects, Congenital / Q000208:ethnology / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009206:Myocardium / Q000473:pathology; D015995:Prevalence; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D016896:Treatment Outcome; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood* / Q000378:metabolism; D014808:Vitamin D Deficiency
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D