Serum vitamin D status in pediatric critical care

Abstract

Aim: Vitamin D deficiency (VDD) is a huge public health problem affecting people of all ages, races, and genders. Studies performed in pediatric intensive care units (PICUs) found a prevalence of VDD between 30% and 70%, and it was shown that VDD was related to a more severe disease course and a longer PICU stay. The aim of our study was to investigate the prevalence of VDD at PICU admission and its relationship between disease type, severity, and prognosis. Material and Method: The medical records of pediatric patients aged 1 month-17 years who were admitted to PICU between March 2017 and March 2018 were retrospectively reviewed. The patients' pediatric mortality risk score (PRISM), 25-hydroxyvitamin D(25(OH)vitD) level at admission, serum calcium (Ca), phosphorus (P), magnesium (Mg), and alkaline phosphatase (ALP) levels were recorded. Blood 25(OH)VitD level ≤20 ng/mL was defined as VDD. Patients with low 25(OH)VitD levels (≤20 ng/mL) were grouped as 'Group-1', those without (>20 ng/mL) were grouped as 'Group-2'. Results: Among the patients, 55 (56.7%) had VDD. The mean 25(OH)D level was 12.7 ng/ml in Group 1 and 27.8 ng/ml in Group 2. Patients in Group 1 had a greater age, body weight, and height, but BMI (body mass index) was not significantly different between both groups. The two groups also did not differ significantly with respect to race, gender, admission season, underlying disease, PRISM score, sepsis rate, vasoactive agent need, mechanical ventilation support, number of days on mechanical ventilation, number of days of PICU stay, and mortality rate. Discussion: As the prevalence of VDD is high among pediatric critical care patients, it is important to perform screening and administer effective replacement therapy to these patients. We believe that assessment of the relationship between vitamin D and disease duration, severity, and prognosis, and determining optimal vitamin D dose, administration route, and safety profile through prospective controlled studies could affect morbidity and mortality rates.