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Category: Volume 08 Issue 01 January 2020
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Title: A Study on Vitamin D Level in Critically Ill Children Admitted in PICU at A Tertiary Care Hospital

Authors: Anupama Deka, Sumit Das, Somrita Chakravarty

 DOI: https://dx.doi.org/10.18535/jmscr/v8i1.138

Abstract

Introduction: Vitamin D is critical in bone metabolism and calcium homeostasis,as well as an important regulator in metabolic processes, cardiovascular and immune systems. It is crucial for humans to have sufficient vitamin D levels to maintain bone health and improve response to infection. Vitamin D deficiency (VDD) represent a potentially modifiable risk factor for greater illness severity and clinical outcome during critical illness.

The objective of this study is to assess Vitamin D status in critically ill children admitted in PICU and to determine the frequency of VDD amongst them and its association with disease severity and important clinical outcomes.

Methods: It was a prospective observational study conducted over a period of 6 months in the PICU of tertiary care hospital on 100 critically ill children aged 1 month –12 years. Serum Vitamin D levels were estimated within 24 hours of admission to PICU. Severity of illness was assessed using Pediatric Index of Mortality III (PRISM III) score. The need for catecholamines and mechanical ventillation, length of PICU stay and mortality were also recorded.

Results: The prevalence of VDD among critically ill children was 49%.Vitamin D level was significantly lower in VDD group as compared to ‘no deficiency’ group (16.3±2.5 vs 38±5.9, p value 0.01). There was also a trend toward increased disease severity, higher need of catecholamines and mechanical ventillation in VDD group. The length of PICU stay (pvalue0.004) and mortality rate (pvalue0.006) was also significantly higher in VDD group.

Conclusion: VDD is common in critically ill children and associated with greater illness severity, longer PICU stay and higher mortality.

Keywords: Critically ill children, Mortality, PICU, PRISM III, Vitamin D, Vitamin D deficiency

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Corresponding Author

Somrita Chakravarty

Department of Pediatrics, Silchar Medical College and Hospital, Silchar, Assam, India