Vitamin D deficiency in critically ill children

Context: Vitamin D is needed for the proper function of different organs of the body. A few studies have assessed vitamin D status in critically ill children and reported the prevalence of vitamin D deficiency (VDD) in the range of 30–71%. Aim: The objectives of this study were to assess the prevalence of VDD in a pediatric ICU (PICU) patients and to determine whether there is any relationship between VDD and illness severity, mortality, or length of PICU stay. Design and settings: We carried out a cross-sectional study of serum 25(OH)-vitamin D levels, measured during the first day of admission to a 10-bedded medical PICU at the Children’s Cairo University. Materials and methods: We analyzed demographic data, pediatric risk of mortality III, and pediatric logistic organ dysfunction between normal and VDD groups in the PICU. Results: The prevalence of VDD was 44% and that of severe VDD was 34% in critically ill Egyptian children at the onset of critical illness. The median level of vitamin D in the whole group was 59 nmol/l and in deficient group it was 17 nmol/l. Infants had higher median vitamin D levels than those above 1 year of age, but with no statistical difference. VDD patients had higher pediatric logistic organ dysfunction (12 vs. 10; P=0.001) and lower platelet counts (240 vs. 331; P=0.021). Pediatric risk of mortality III, inotropes, sepsis, ventilation, duration of PICU stay, and mortality were not related to VDD. Conclusion: VDD is highly prevalent in critically ill children and is observed to be associated with organ dysfunction on admission.