title: [Vitamin D deficiency in children admitted to the paediatric intensive care unit].
abstract: BACKGROUND
  Vitamin D is essential for bone health, as well as for cardiovascular and immune function. In critically ill adults vitamin D deficiency (VDD) is common, and is associated with sepsis and higher critical illness severity.
  
  
  OBJECTIVE
  To establish the prevalence of VDD and its association with clinically relevant outcomes in children admitted to a Paediatric Intensive Care Unit (PICU) in Concepcion, Chile.
  
  
  METHODS
  Prospective observational cohort study in 90 consecutive children admitted to the PICU in a university general hospital. Blood was collected on admission to PICU and analysed for 25-OH-D levels. Severity of illness and vasopressor use were assessed using PRISM, PELOD, and vasoactive-inotropic score (VIS) score. VDD was defined as a serum 25-OH-D level<20ng/ml. Relative risks (RR) were calculated to determine the association between VDD and relevant clinical outcomes.
  
  
  RESULTS
  Mean (SD) serum vitamin D (25-OH-D) level in the cohort was 22.8 (1.0)ng/ml. The prevalence of VDD was 43.3%. VDD was associated with vasopressors use (RR1.6; 95%CI: 1.2-2.3; P<.01), mechanical ventilation (RR2.2; 95%CI: 1.2-3.9, P<.01), septic shock (RR1.9; 95%CI: 1.3-2.9, P<.001), and fluid bolus>40ml/kg in the first 24h of admission (RR 1.5; 95%CI: 1.1-2.1, P<.05).
  
  
  CONCLUSIONS
  In this study, VDD at PICU admission was prevalent in critically ill children and was associated with adverse clinical outcomes. Further studies are needed to assess the potential benefit of optimizing vitamin D status in the PICU.
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Guillermo Grant Benavente, Concepción, Chile. Electronic address: rbustos@sanatorioaleman.cl.
authors.forename: Raúl
authors.initials: R
authors.lastname: Bustos B
authors.affiliation: Laboratorio de Biología del Ejercicio, Escuela de Kinesiología, Facultad de Ciencias de la Salud, Universidad San Sebastián, Concepción, Chile.
authors.forename: Iván
authors.initials: I
authors.lastname: Rodríguez-Nuñez
authors.affiliation: Servicio de Pediatría, Hospital Guillermo Grant, Concepción, Chile.
authors.forename: Rubén
authors.initials: R
authors.lastname: Peña Zavala
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Guillermo Grant Benavente, Concepción, Chile.
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Soto Germani
mesh_terms: D002675:Child, Preschool; D002677:Chile; D015331:Cohort Studies; D016638:Critical Illness; D005260:Female; D006801:Humans; D015278:Intensive Care Units, Pediatric; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index; D014662:Vasoconstrictor Agents / Q000008:administration & dosage* / Q000009:adverse effects; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000453:epidemiology* / Q000209:etiology
chemical_list: D014662:Vasoconstrictor Agents; D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: Children; Cuidado intensivo pediátrico; Niños; Paediatric intensive care; Sepsis; Vitamin D; Vitamina D