Impact of a Nutrition Protocol on Vitamin D Supplementation in a Pediatric Intensive Care Unit:A Retrospective Cohort Study
doi:10.20944/preprints202508.1646.v1
Maria Pérez Marin *, Vivianne Chanez, Guillaume Maitre, Laurence Boillat, Frida Rizzati, Pauline Lauwers and Maria-Helena Perez
Pediatric Intensive Care Unit, Service of Paediatrics, Women-Mother-Children Department, Lausanne University and Lausanne University Hospital, Rue Du Bugnon 21, 1011 Lausanne, Switzerland.
Background: Vitamin D deficiency (VDD) is highly prevalent in pediatric critically ill patients and is a potentially modifiable risk factor during critical illness. There are no established national or international recommendations for vitamin D supplementation in Pediatric Intensive Care Unit (PICU) patients.
Objectives: This monocentric study aims to compare the practices regarding Vitamin D supplementation before and after the introduction of a nutrition protocol (NP).
Methods: We retrospectively analyzed vitamin D administration (time from PICU admission to initiation, amount of supplementation, accordance with existing guidelines) in children aged from 0 to 16 who were admitted to the PICU of Lausanne University Hospital for more than 48 hours the year before and after the introduction of a NP.
Results: Vitamin D supplementation increased after NP introduction (95 IU per day more, (p < 0.0001). More patients received vitamin D during their stay (95% after vs. 77% before, (p < 0.0001). The dose followed NP recommendations for children under 12, it was higher for older children. According to Swiss guidelines for the general pediatric population, vitamin D supplementation was accurate in children under one year old before and after NP implementation. However, it was less than recommended for patients over one year old.
Conclusions: The implementation of a NP significantly enhanced the scope of vitamin D supplementation. This study also highlights the practical limitations in meeting the recommended requirements with certain galenic formulations.
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If they had given 1,600 IU, they would have found far bigger benefits
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