Most parents would travel to the ends of Earth in order to keep their children safe and well. What if something as simple as vitamin D status could play a part in protecting the wellbeing of your child? According to a recent systematic review and meta-analysis, it could be that simple.
Pediatric intensive care units (PICU) admit thousands of critically ill children every year within the United States. From pulmonary distress to electrolyte imbalance, to infection, children admitted to a PICU are usually in need of emergency medical procedures, invasive treatments or intensive monitoring of unstable medical conditions.
There are some major challenges in caring for critically ill children, especially because this group is already more susceptible to infection and may be affected by comorbid disease complications.
Many critical care patients, especially children, suffer from secondary health complications as a result of a compromised immune system and/or severe inflammatory response. Notably, there has been research supporting vitamin D plays an important role in regulating the immune system and supporting a healthy inflammatory response. Therefore, critical care physicians and researchers have hypothesized that vitamin D status may be an important component to the secondary health outcomes of intensive care unit (ICU) patients.
A recent systematic review and meta-analysis explored the prevalence of vitamin D deficiency in children admitted to a PICU as well as the outcomes associated with vitamin D status.
A total of 2,783 children were included in the analysis. Five of the studies primarily aimed to determine the vitamin D status of critically-ill children, while the remaining studies compared vitamin D status to illness severity, adrenal function, sepsis rate and treatment outcomes. Vitamin D status was measured in all studies at the time of admission into the PICU for all participants. Deficiency was defined as <20 ng/ml (50 nmol/l) in 15 the studies, and as <15 ng/ml (37.5 nmol/l) in the remaining two.
This is what the researchers found:
- Vitamin D deficiency was found in 54.8% of the participants.
- Children in the PICU had significantly lower vitamin D levels compared to healthy, matched controls (p < 0.001).
- Lower vitamin D status was associated with increased weight, older age, lower nutritional status, admission type (i.e. admission due to cardiac problems, pulmonary problems, etc.) and lack of supplementation.
- Vitamin D deficient children had a 1.62 times increased risk of mortality compared to those with higher levels (p = 0.02).
- Increased disease severity was seen in the vitamin D deficient children compared to the non-deficient children (p = 0.001).
- Vitamin D deficiency was also associated with use of cardiovascular drugs and use of mechanical ventilators (p < 0.001).
- Low vitamin D status increased the risk of infection by 2.21 times when compared to children with higher levels (p < 0.001).
The researchers concluded:
“In this systematic review, we identified vitamin D deficiency to be highly prevalent in the PICU and to be associated with illness severity and clinical outcome.”
It is important to consider potential modifiable factors, such as vitamin D status, for those who experience health issues. Due to the fact that vitamin D is a safe and inexpensive way to improve one’s overall health, the Vitamin D Council recommends that all individuals, from infancy to elderly, maintain a healthy vitamin D status (>40 ng/ml as the Endocrine Society recommended). Though sun exposure is the best way to increase your vitamin D levels, supplementation is safe and effective as well. For infants and children, supplementing with 1,000 IU per 25 lbs. body weight is effective in raising vitamin D levels to a healthy range (40-80 ng/ml).
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Peterson, R. & Cannell, JJ. Researchers discover vitamin D status is associated with health outcomes in critically-ill children. The Vitamin D Council Blog & Newsletter, 2017.