Preoperative Vitamin D Deficiency Is Associated With Higher Vasoactive-Inotropic Scores Following Pediatric Cardiac Surgery in Chinese Children
Front. Pediatr., 28 July 2021 | https://doi.org/10.3389/fped.2021.671289
Xiuxia Ye1,2, Shumei Dong1, Yujiao Deng1, Chuan Jiang3, Yanting Kong1, Lili Tang1, Yanlin Wang4*, Fei Bei1* and Haifa Hong3*
- 1) Univariate logistic regression model.
- 2) Multivariate logistic regression model in which age, sex, vitamin D class, season, and RACHS were controlled.
- 3) Multivariate logistic regression model in which age, sex, vitamin D status, season, RACHS score, CPB time, and concurrent preoperative diseases were controlled.
- CPB time andclamping time were closely related to each other and could not be put into the model at the same time.
Items in both categories Infant-Child and Trauma, Surgery are listed here:
- Fewer drugs needed after cardiac surgery if higher levels of vitamin D (Chinese children) – July 2021
- 3X less Septic Shock in children with sepsis getting 150,000 IU of Vitamin D - RCT June 2020
- PICU children with low vitamin D levels have worse health scores (PRISM-III) – Feb 2020
- Vitamin D levels dropped 42 percent immediately after pediatric cardiac surgery – Dec 2019
- Septic children have low Vitamin D (54 studies, ignored Vitamin D Receptor) – meta-analysis April 2019
- Candida infections in PICU reduced by Vitamin D in yogurt – RCT Feb 2019
- Children entering ICU with low vitamin D were 3.5 X more likely to have a poor ICU score– Oct 2018
- Critically ill children with low vitamin D: 2.5 X more likely to die or stay 2 days longer - meta-analysis Nov 2017
- Micronutrients (such as Vitamin D) for critically ill children – review Oct 2017
- Critically ill children – randomized clinical trial to give single doses of up to 400,000 IU of vitamin D – 2019
- Vitamin D deficiency in pediatric critical illness: Time to move on from observational studies – Nov 2016
- Low vitamin D in Pediatric ICU – 5 times more ill (morbidity) – Spanish Nov 2016
- Children in Intensive Care need Vitamin D loading dose of 10000 IU per kg (nearing a consensus) - Oct 2016
- Children stayed in ICU 3.5 days longer if low vitamin D – Dec 2015
- Rapid Normalization of Vitamin D in Critically Ill Children (10,000 IU per kg) – clinical trial
- Congenital Heart problems - vitamin D levels drop even lower after surgery, loading dose probably required - thesis 2015
- Infant in ICU much more likely to die if low vitamin D – Nov 2015
- 5 out of 6 children who died in pediatric critical care unit had low vitamin D – May 2014
- Hospitalization consumes vitamin D in children – March 2014
- Congenital heart surgery dropped vitamin D levels by 40 percent – July 2013
- Vitamin D deficient children stayed in ICU almost 2 days longer – Sept 2012
The relationship between vitamin D and cardiovascular health in children remains unclear. Vitamin D deficiency (VDD) is supposed to be a potential risk factor associated with poorer outcomes after congenital heart disease (CHD) surgery. The maximum vasoactive-inotropic use after cardiac surgery is considered to be a good predictor of adverse outcomes. We aimed to assess the correlation between preoperative VDD and the maximum vasoactive-inotropic score (VISmax) at 24 h postoperatively. Nine hundred children with CHD were enrolled in this study, and preoperative total serum 25-hydroxyvitamin D [25(OH)D] concentrations were measured by liquid chromatography-tandem mass spectrometry. Related demographic and clinical characteristics were collected. A total of 490 boys (54.4%) and 410 girls (45.6%) with a mean age of 1 year (range: 6 months-3 years) were enrolled. The median 25(OH)D level was 24.0 ng/mL, with 32.6% of patients having VDD [25(OH)D < 20 ng/mL].
The univariate analysis indicated that VDD [odds ratio (OR): 2.27; 95% confidence interval (CI): 1.48–3.50] is associated with a risk of increased VISmax at 24 h postoperation. Multivariate analysis revealed that VDD (OR: 1.85; 95% CI: 1.09–3.02), a Risk-adjusted Congenital Heart Surgery score of at least three points (OR: 1.55; 95% CI: 1.09–2.19), and cardiopulmonary bypass time (OR: 1.02; 95% CI: 1.01–1.02) were independently associated with an increased VISmax within 24 h after cardiac surgery.
VDD in pediatric patients before cardiac surgery is associated with the need for increased postoperative inotropic support at 24 h postoperation.