Children stayed in ICU 3.5 days longer if low vitamin D

Vitamin D deficiency and length of pediatric intensive care unit stay: a prospective observational study.

Ann Intensive Care. 2016 Dec;6(1):3. doi: 10.1186/s13613-015-0102-8. Epub 2016 Jan 8.

Sankar J1, Lotha W2, Ismail J3, Anubhuti C4,5, Meena RS6, Sankar MJ7.

1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. jhumaji@gmail.com.

2Department of Pediatrics, PGIMER, Dr RML Hospital, New Delhi, India. wonash_tsanglao@yahoo.co.in.

3Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. javedisi86@gmail.com.

4Department of Pediatrics, PGIMER, Dr RML Hospital, New Delhi, India. anubhuti1234@rediffmail.com.

5Department of Biochemistry, PGIMER, Dr RML Hospital, New Delhi, India. anubhuti1234@rediffmail.com.

6Department of Pediatrics, PGIMER, Dr RML Hospital, New Delhi, India. drrameshwaruk@gmail.com.

7Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. jeevasankar@gmail.com.

BACKGROUND:

Due to the limited data available in the pediatric population and lack of interventional studies to show that administration of vitamin D indeed improves clinical outcomes, opinion is still divided as to whether it is just an innocent bystander or a marker of severe disease. Our objective was therefore to estimate the prevalence of vitamin D deficiency in children admitted to intensive care unit (ICU) and to examine its association with duration of ICU stay and other key clinical outcomes.

METHODS:

We prospectively enrolled children aged 1 month-17 years admitted to the ICU over a period of 8 months (n = 101). The primary objectives were to estimate the prevalence of vitamin D deficiency (serum 25 (OH) <20 ng/mL) at 'admission' and to examine its association with length of ICU stay.

RESULTS:

The prevalence of vitamin D deficiency was 74 % (95 % CI: 65-88). The median (IQR) duration of ICU stay was significantly longer in 'vitamin D deficient' children (7 days; 2-12) than in those with 'no vitamin D deficiency' (3 days; 2-5; p = 0.006). On multivariable analysis, the association between length of ICU stay and vitamin D deficiency remained significant, even after adjusting for key baseline variables, diagnosis, illness severity (PIM-2), PELOD, and need for fluid boluses, ventilation, inotropes and mortality [adjusted mean difference (95 % CI): 3.5 days (0.50-6.53); p = 0.024].

CONCLUSIONS:

We observed a high prevalence of vitamin D deficiency in critically ill children in our study population. Vitamin D deficient children had a longer duration of ICU stay as compared to others.

PMID: 26745966

See also VitaminDWiki

• ICU survival increased with vitamin D single 540K IU loading dose - JAMA Sept 2014

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