1.8 X more heart medicines needed by children after heart surgery if low Vitamin D

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*

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  • 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: {category} --- * Taking Vitamin D just before and after surgery helps (open-heart in this case) – RCT Feb 2021 * Improve your health BEFORE surgery (prehabilitation) helps your recovery - 2018 * Pre-operative Vitamin D often helps (thyroidectomy in this case) – June 2021

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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.