Authors: Kala Ebenezer Victoria Job Belavendra Antonisamy Adekunle Dawodu M N Manivachagan Mark Steinhoff
Publish Date: 2015/07/19
Volume: 83, Issue: 2, Pages: 120-125
Abstract
Fiftyfour consecutive children with medical and surgical diagnoses were included with parental consent Severity of illness was assessed using PIM2 score Sequential Organ Failure Assessment Cardiovascular Score CVSOFA was used to describe vasopressor use Serum for 25OH D levels was obtained as close as possible to the ICU admission Vitamin D deficiency was defined as serum 25OH D level 20 ng/ml 50 nmol/L Primary outcome measures were serum 25OH D level and inhospital all cause mortality Secondary outcomes were illness severity vasopressor requirement use of mechanical ventilation and duration of ICU stayOf the 54 children two were excluded due to insufficient serum for vitamin D analysis Median age was 175 mo IQR = 45–78 385 were infants Higher age was associated with low vitamin D levels r s = −034 p 001 Median serum 25OH D level was 251 ng/ml IQR = 162–342 Shock 308 CNS conditions 231 and respiratory illnesses 212 were the three most common reasons for admission to the PICU Vitamin D deficiency was seen in 403 of the critically ill children Higher PIM score or SOFA score were associated with low vitamin levels r s = −029 p 004 and r s = −029 p 005 respectively Children who were mechanically ventilated had a significantly lower median serum 25OH D level than those who were not on ventilation 195 ng/ml IQR = 146–277 vs 321 ng/mlIQR = 165–509 p 001 Serum 25OH D level was also positively associated with serum calcium levels r s = 032 p 003 The proportion of children who died or were discharged terminally at parental request was 238 among those with serum 25OH D level 20 ng/ml as compared to 161 among those with serum 25OH D level 20 ng/ml p 049Vitamin D deficiency is common among pediatric patients admitted to PICU in South India Low serum 25OH D level was associated with higher severity of illness need for mechanical ventilation more vasopressor use and lower serum calcium levels No association between vitamin D status and mortality was demonstratedKE Designed the project supervised patient care was responsible for data collection data management and drafted the manuscript VJ Performed the vitamin D assay BA Completed the statistical analysis MN Involved in patient care and assisted in data collection AD and MS Provided intellectual support for the conception of the study and critically reviewed the manuscript KE will act as guarantor for this paper
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