Association Between Preoperative 25-Hydroxyvitamin D Level and Hospital-Acquired Infections Following Roux-en-Y Gastric Bypass Surgery

Quraishi, Sadeq A.; Bittner, Edward A.; Blum, Livnat; Hutter, Mathew M.; Camargo, Carlos A.

doi:10.1001/jamasurg.2013.3176

Cited by 67 publications

(78 citation statements)

References 46 publications

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“…In this study, we found that 25-hydroxyvitamin D positively correlated with CRP, TNFα and IL-6. There are several cross-sectional studies in literature that showed strong relation between 25-hydroxy vitamin D deficiency and sepsis or mortality (Quraishi et al 2014;Moromizato et al 2014). In contrast, the present study is the first study that was made in same groups before and after treatment and found high level of 25-hydroxyvitamin D in pre-treatment group.…”

Section: Discussioncontrasting

confidence: 56%

High Serum 25-Hydroxyvitamin D Levels Are Associated with Pediatric Sepsis

Aydemir¹,

Çekmez²,

Kalkan

et al. 2014

Tohoku J. Exp. Med.

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Despite major advances in intensive care, sepsis continues to be a major cause of morbidity and mortality. Vitamin D is involved in various physiologic functions, including cellular responses during infection and inflammation. The aim of this study was to evaluate diagnostic value of 25-hydroxyvitamin D in childhood sepsis because it can be fatal if diagnosis delayed. The study included 40 children with sepsis and 20 children without sepsis (control group). We included only the patients with high probable sepsis, judged by clinical and laboratory findings, including positive blood culture. Blood samples were collected from patients with sepsis before treatment (pre-treatment group) and 48-72 hours later (post-treatment group). Treatment varied from ampicillin-sulbactam to cephalosporin. Blood samples were collected from control group once on admission. Serum 25-hydroxyvitamin D levels were significantly higher in sepsis (pre-treatment group) than control group (74 ± 8 ng/ml vs. 28 ± 12 ng/ml, p = 0.01) and the serum 25-hydroxyvitamin D levels were decreased to 44 ± 5 ng/ml (p = 0.01) after treatment. Moreover, we found significant positive correlation between 25-hydroxyvitamin D and each of well-know sepsis markers, C-reactive protein, tumor necrosis factor-α and interleukin-6. A cut-off point of 20 ng/mL for serum 25-hydroxyvitamin D showed 84% sensitivity and 76% specificity for sepsis diagnosis. This is the first study evaluating the diagnostic role of vitamin D in pediatric sepsis, thereby suggesting that serum 25-hydroxyvitamin D level can be used as a diagnostic marker for sepsis with high sensitivity and specificity.

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Section: Discussioncontrasting

confidence: 56%

High Serum 25-Hydroxyvitamin D Levels Are Associated with Pediatric Sepsis

Aydemir¹,

Çekmez²,

Kalkan

et al. 2014

Tohoku J. Exp. Med.

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“…Vitamin D is thought to be involved in muscle function, cardiovascular disease, inflammation, immunity, insulin sensitivity, and cancer development. 1,2 Turan and colleagues inform us that more than a third of purportedly healthy adults, more than half of all hospitalized patients, and more than 95% of critically ill patients have vitamin D deficiency. This begs the question of whether low 25OHD levels are the result of disease, rather than a cause of disease.…”

Section: Commentmentioning

confidence: 99%

The Association of Serum Vitamin D Concentration With Serious Complications After Noncardiac Surgery

Turan

Hesler

You

et al. 2015

Survey of Anesthesiology

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2.6%; P = 0.23]). The values decreased after the BCP in the control group, but in the AVP group, 10% decreases were noted with AVP alone and further decreased after the BCP (P < 0.0001). Hypotension occurred less often in the AVP patients than in the control group; 2 patients (13%) in the AVP group and 10 (67%) in the control group required ephedrine (P = 0.003). In the control group, the episodes occurred within 5 minutes of the BCP and lasted 2 to 15 minutes compared with 10 to 15 minutes and 1.5 to 2.5 minutes, respectively, in the AVP group. Among the 30 patients, SjvO 2 values decreased below 50% in 20 and below 40% in 11 patients. However, neither the incidence of SjvO 2 of less than 50% nor less than 40% differed between groups. The incidence of cerebral oxygen desaturation was 80% in the AVP group compared with 13% in the control patients (P = 0.0003).Arginine vasopressin was effective when given as a prophylactic bolus to prevent hypotension caused by the BCP in patients undergoing shoulder surgery. However, it was associated with a negative effect on regional cerebral oxygenation with upright positioning, which must be considered in clinical practice. Therefore, AVP should be used cautiously until future studies can determine more thoroughly and definitively its effects on cerebral oxygenation and hemodynamics. COMMENTArthroscopic shoulder surgery is often performed in the BCP because it offers several advantages including optimal anatomical orientation and surgical access, easy conversion to open surgery without repositioning, less risk of nerve traction injury, and possibly improved surgical outcome compared with the lateral decubitus position. The BCP, however, is frequently associated with systemic hypotension owing to pooling of blood in the lower extremities, which can result in cerebral hypoperfusion as evidenced by a low regional cerebral oxygen saturation. Regional anesthesia appears to protect cerebral perfusion by maintaining cerebral autoregulation better than general anaesthesia. Interestingly, the incidence of overt neurologic injury is low despite evidence of cerebral hypoperfusion.Short-acting vasopressors such as phenylephrine and ephedrine are routinely used in clinical practice to treat hypotension in the perioperative period. Arginine vasopressin is a long-acting potent vasopressor with a superior cerebral hemodynamic profile compared with phenylephrine and is useful in shock secondary to sepsis and cardiac surgery.In the current study, the authors evaluated the effect of AVP on hemodynamics and cerebral oxygenation during postural changes in the BCP. Thirty patients were randomized to receive AVP 0.07 U/kg or saline 20 minutes after induction of general anesthesia (GA) and before being placed in the BCP. Cerebral oxygenation was measured using continuous jugular venous saturation (SjvO 2 ) and regional tissue oxygen saturation (SctO 2 ) using near-infrared spectroscopy with the INVOS 5100B cerebral oximeter (Somanetics, Troy, Mich). Mean arterial pressure was reduced with induction ...

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“…There have been several studies which have linked hypovitaminosis D to adverse post-surgical outcomes following a wide range of procedures [14]. Iglar and Hogan reviewed 31 studies linking hypovitaminosis D to complications such as increased risk of graft failure in renal patients [15], wound breakdown and infection [16,17], and organ transplant rejection [18,19]. In cases specific to orthopaedic practice, suboptimal vitamin D levels have been linked to refracture following surgical fixation of 5th metatarsal fractures [20], and there is evidence to support giving vitamin D supplementation to elderly patients with fractures of the hip [21,22] and proximal humerus [23].…”

Section: Discussionmentioning

confidence: 99%