Author/Authors :
Jelveh-Moghaddam, Hossein Ali Anesthesiology Research Center - Shahid Beheshti University of Medical Sciences, Tehran , Fani, Kamal Anesthesiology Research Center - Shahid Beheshti University of Medical Sciences, Tehran , Hekmat, Manouchehr Department of Cardiovascular Surgery - Shahid Modarres Hospital - Shahid Beheshti University of Medical Sciences, Tehran , Azari, Amir A Anesthesiology Research Center - Shahid Beheshti University of Medical Sciences, Tehran
Abstract :
Background: To investigate the effects of vitamin D3 on the surgical outcome
of pediatric patients undergoing cardiac surgery for congenital heart
conditions.
Materials and Methods: Ninety pediatric cardiac surgery patients referred
for preoperative evaluation were enrolled. Patients with insufficient vitamin
D3 levels received intramuscular vitamin D3 (300,000 IU) three days before
the surgery and those with final vitamin D3 level of ≥30 ng/dl were included
and divided into 3 groups (Group A: abnormal Vit D levels, no Vit D
treatment; Group B: abnormal Vit D levels, Vit D treatment up to normal
serum Vit D levels before surgery; Group C: normal baseline Vit D levels, no
supplemental Vit D treatment). Interleukin 1, 6, 10, tumor necrosis factoralpha, vital signs, and arterial blood gas parameters were measured before the
surgery and at 6 and 24 hours after cardiopulmonary bypass. Data on total
hospital stay, reoperation rates, and inotropes scores were retrieved.
Additionally, postoperative measures including hemodynamic factors, blood
pressure, heart rate, cardiac output, electrocardiography changes, chest-tube
drainage, and ventilation-related factors (i.e. respiratory rate, arterial blood
gas, respiratory resistance, intubation time, …) were recorded.
Results: We observed a significant increase in post cardiopulmonary bypass
levels of IL-10 and IL-6 in all groups (p<0.002) regardless of vitamin D
treatment status; however, no significant difference was seen in levels of IL-
1 and TNF-alpha. Groups B had more patients with critical levels of VIS
scores compared to groups A and C (p<0.002). Furthermore, no differences
in hemodynamic and metabolic parameters were observed.
Conclusion: No significant difference in the rates of postoperative
parameters in patients with normal and those with deficient levels of vitamin
D3 was observed.
Keywords :
Vitamin D , Congenital heart disease (CHD) , Cardiac surgery , Cardiopulmonary bypass , Vitamin D3 supplementation