title: Clinical Trial of Vitamin D2vs D3Supplementation in Critically Ill Pediatric Burn Patients.
abstract: Hypovitaminosis D exists postburn. However, evidence-based guidelines for vitamin D repletion are unknown. This investigation examined differences between D2and D3supplementation on outcome in children with burn injuries.
  
  
  
  Fifty patients with total body surface area burn of 55.7% ± 2.6% and full-thickness injury of 40.8% ± 3.8% were enrolled, ranging in age from 0.7-18.4 years. All participants received multivitamin supplementation per standardized clinical protocol. In addition, 100 IU/kg D2, D3, or placebo was administered daily during hospitalization using a randomized, double-blinded study design. Assay of total 25-hydroxyvitamin D (D25), 1,25-dihydroxyvitamin D (D1,25), 25-hydroxyvitamin D2(25-OH-D2), 25-hydroxyvitamin D3(25-OH-D3), and parathyroid hormone (PTH) was performed at 4 preplanned time intervals (baseline, midpoint, discharge, and 1 year postburn). Differences in vitamin D status were compared over time and at each specific study interval.
  
  
  
  There were no significant differences in serum vitamin D levels between groups, but >10% of patients had low D25 at discharge, and percent deficiency worsened by the 1-year follow up for the placebo (75%), D2(56%), and D3(25%) groups. There were no statistical differences in PTH or clinical outcomes between treatment groups, although vitamin D supplementation demonstrated nonsignificant but clinically relevant decreases in exogenous insulin requirements, sepsis, and scar formation.
  
  
  
  The high incidence of low serum D25 levels 1 year following serious thermal injury indicates prolonged compromise. Continued treatment with vitamin D3beyond the acute phase postburn is recommended to counteract the trajectory of abnormal serum levels and associated morbidity.
authors.affiliation: 1 Department of Research, Shriners Hospitals for Children, Cincinnati, Ohio, USA.|2 Department of Nutrition, Shriners Hospitals for Children, Cincinnati, Ohio, USA.|3 Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
authors.forename: Michele M
authors.initials: MM
authors.lastname: Gottschlich
authors.affiliation: 2 Department of Nutrition, Shriners Hospitals for Children, Cincinnati, Ohio, USA.|4 Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Theresa
authors.initials: T
authors.lastname: Mayes
authors.affiliation: 4 Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Jane
authors.initials: J
authors.lastname: Khoury
authors.affiliation: 3 Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.|5 Department of Surgery, Shriners Hospitals for Children, Cincinnati, Ohio, USA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Kagan
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D002056:Burns / Q000097:blood / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D002762:Cholecalciferol / Q000008:administration & dosage* / Q000097:blood; D016638:Critical Illness / Q000628:therapy*; D019587:Dietary Supplements; D004311:Double-Blind Method; D004872:Ergocalciferols / Q000008:administration & dosage* / Q000097:blood; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D011446:Prospective Studies; D016896:Treatment Outcome; D014808:Vitamin D Deficiency / Q000097:blood / Q000188:drug therapy; D014815:Vitamins / Q000008:administration & dosage / Q000097:blood
chemical_list: D015415:Biomarkers; D004872:Ergocalciferols; D010281:Parathyroid Hormone; D014815:Vitamins; D002762:Cholecalciferol
keywords: burn injury; pediatrics; vitamin D