Assessment of Vitamin D status among Septic Children Admitted to PICU and its effect on the Clinical Outcome

Abstract

Vitamin D deficiency is thought to negatively impact the cardiovascular, respiratory and immune systems directly through cellular vitamin D receptors. Aim: To determine the incidence of vitamin D deficiency among septic critically ill children admitted to pediatric intensive care unit (PICU), Children's Hospital, Ain Shams University and the influence of vitamin D status on clinical outcome. Patients and method: Prospective observational study on 52 critically ill children who were diagnosed with sepsis and admitted to pediatric ICU, Children's Hospital, Ain Shams University in the time period from July 2017 till January 2019. The patients aged 1 month - 18 years and they were subjected to detailed clinical history and examination. The patients were divided according to vitamin D status which was obtained as close as possible to diagnosis of sepsis using ELIZA. Studied groups were compared regarding demographic data, risk factors of vitamin D deficiency, severity of illness at admission and clinical outcome during PICU stay. Results: The frequency of vitamin D deficiency (67.3 %) among septic children admitted to PICU while 11.5 % of patients were vitamin D insufficient. The mean of serum vitamin D (25OHD) among patients was (18.6 ± 20.6 ng/ml). Vitamin D deficiency was highly significant associated with low serum calcium level and high serum CRP level. There was a poor clinical outcome among vitamin D deficient patients but with no significant difference compared to vitamin D sufficient patients regarding need for mechanical ventilation, use of catecholamines, progression to septic shock, length of PICU stay and mortality. Conclusion: Vitamin D deficiency should be considered as a risk factor for pediatric sepsis. However, it does not affect the clinical outcome.