Vitamin D deficiency common in critically ill children

By Helen Albert, Senior medwireNews Reporter

Children who are critically ill frequently have low serum levels of vitamin D, report researchers.

The team also found that vitamin D deficiency in these children was associated with more severe illness than in children with normal vitamin D levels.

"Although these findings are of concern, we are very encouraged because we've discovered something that is modifiable," explained lead investigator James McNally (Children's Hospital of Eastern Ontario, Canada) in a press statement.

"There are simple ways to prevent this problem, and it may be possible to rapidly restore vitamin D levels at the time of severe illness."

McNally and colleagues analyzed data collected from 326 critically ill children, aged 3.7 years on average, hospitalized in six Canadian pediatric intensive care units for various critical illnesses between 2005 and 2008.

They measured levels of serum 25 hydroxyvitamin D (vitamin D) and found that 69% of the children had vitamin D deficiency (<50 nmol/L), with a further 23% having insufficient levels of vitamin D (50-75 nmol/L).

Notably, lower levels of vitamin D were linked with low calcium levels, catecholamine utilization, and significant fluid bolus administration.

Patients who were vitamin D deficient had a significant 1.92 days longer intensive care unit stay than children with higher levels of the vitamin; and each additional point of the Pediatric Risk of Mortality score, used to measure illness severity, increased the chance of a child being vitamin D deficient by a significant 8%.

These findings add to those of previous studies showing that low levels of vitamin D can make people more susceptible to illnesses such as bone fractures, diabetes, and the common cold.

Writing in Pediatrics, the authors say: "Subsequent prospective interventional trials are required to establish whether rapid restoration of vitamin D body stores has an impact on critical illness disease course and outcome."

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