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Low vitamin D status is linked with longer ICU stay among children

Posted on: January 20, 2016   by  Amber Tovey

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A recent study published in the journal Annals of Intensive Care discovered that vitamin D deficiency may be associated with a longer duration of intensive care unit (ICU) stay among children.

Researchers believe vitamin D is capable of reducing ICU patients’ risks for adverse events through its ability to modulate the immune response. Vitamin D receptors are expressed on immune cells, allowing vitamin D to increase the number of immune cells and to promote protective immunity.

Hospitalized patients face a greater risk for vitamin D deficiency due to a lack of physical activity and sun exposure. Research has clearly shown that vitamin D status relates to adverse health outcomes for critically ill patients, including infection, a prolonged length of stay and mortality. Though, this relationship has not been thoroughly studied in children.

Researchers from All India Institute of Medical Sciences recently hypothesized that vitamin D deficiency is highly prevalent in children admitted to ICUs and associated with clinically important outcomes in children admitted to ICUs. In order to test this, the researchers conducted a prospective observational study over a period of 8 months in 101 children admitted to the ICU.

The children were between ages 1 month and 17 years old. Those who were already on vitamin D supplementation were excluded from the study. The most common diagnoses upon admission to the ICU were pneumonia (19%) and septic shock (19%).

Here is what they found:

  • The prevalence of vitamin D deficiency (levels less than 20 ng/ml) was 74%.
  • The median vitamin D status of vitamin D deficient children was 5.8 ng/ml.
  • 61% were considered severely deficient (levels less than 15 ng/ml).
  • Children with vitamin D deficiency were found to be older (4 years vs. 1 year) and more likely to receive mechanical ventilation (57% vs. 39%). However, these associations were not statistically significant.
  • The median duration of ICU was significantly longer in vitamin D deficient children compared to those who were not (7 days vs. 3 days; p = 0.006).
  • After adjusting for factors that may skew results (confounding factors), such as diagnosis and illness severity, the relationship between ICU duration and vitamin D status remained significant (p = 0.024).

The researchers concluded,

“We observed that the length of ICU stay was longer in children with ‘vitamin D deficiency’ with a mean difference in ICU stay of 3.5 days (95 % CI: 0.50–6.53; p =  0.024) as compared to those ‘not deficient’.”

The researchers call for randomized controlled trials to assess the safety and efficacy of vitamin D supplementation in critically ill children.

Citation

Tovey, A. & Cannell, JJ. Low vitamin D levels is linked with longer ICU stay among children. The Vitamin D Council Blog/Newsletter, January 2016.

Source

Sankar, J. et al. Vitamin D deficiency and length of pediatric intensive care unit stay:  a prospective observational study. Annals of Intensive Care, 2016.

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