Preoperative Vitamin D Deficiency Is Associated With Higher Vasoactive-Inotropic Scores
Following Pediatric Cardiac Surgery in Chinese Children
Front Pediatr. 2021 Jul 28;9:671289. doi: 10.3389/fped.2021.671289
Xiuxia Ye 1 2, Shumei Dong 1, Yujiao Deng 1, Chuan Jiang 3, Yanting Kong 1, Lili Tang 1, Yanlin Wang 4, Fei Bei 1, Haifa Hong 3
Vasoactive-Inotropic Scores are higher when more post-surgery drugs are needed:
dopamine, dobutamine, epinephrine, milrinone, vasopressin, and norepinephrine
- Improve your health BEFORE surgery (prehabilitation) helps your recovery - 2018
- :In many cases taking Vitamin D years before would have elminated the need for the surgery
- Chance of dying in hospital cut in half by just 10 ng higher level of Vitamin D – April 2016
- All ICU patients with good vitamin D level survived, none who died had a good level – April 2018
- Better Surgical outcomes if preceded by Vitamin D loading dose – Oct 2018
Items in both categories Infant-Child and Trauma-Surgery are listed here:
- Give ICU children a bolus dose of 10,000 IU of vitamin D per kg – RCT underway Sept 2024
- Sepsis is fought by Vitamin D in 9 ways – Feb 2023
- 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
- Sepsis is both prevented and treated by Vitamin D - many studies
Download the PDF from VitaminDWiki
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.