Poor clinical outcomes associated with vitamin D deficiency in critically ill children

Vitamin D deficiency in critically ill children may make them more vulnerable to severe illnesses, according to 2 studies that were published ahead of the September print issue of Pediatrics.

In the first study, researchers conducted a prospective cohort study of 6 tertiary-care pediatric intensive care units (PICUs) in Canada from 2005 to 2008.

In the study, led by J. Dayre McNally, MD, PhD, with the University of Ottawa, the researchers found that lower vitamin D levels were associated with hypocalcaemia, catecholamine utilization, and significant fluid bolus administration. In addition, vitamin D deficiency was independently associated with a longer PICU length of stay and increasing severity of illness, determined by the Pediatric Risk of Mortality score.

“Further research will determine whether targeted vitamin D supplementation or rapid restoration will improve outcomes,” the researchers wrote.

In the second study, Kate Madden, MD, with Harvard Medical School and Boston’s Children Hospital, and colleagues, tested 511 severely or critically ill children admitted to the hospital’s PICU.

Vitamin D levels were lower in the 238 children who had life-threatening infections and deficiencies, and lower levels were associated with a higher admission-day illness severity.

“We found a high rate of vitamin D deficiency in critically ill children. Given the roles of vitamin D in bone development and immunity, we recommend screening of those critically ill children with risk factors for vitamin D deficiency and implementation of effective repletion strategies,” the researchers wrote.