Safety and Efficacy of Early Vitamin D Supplementation in Critically Ill Extremely Preterm Infants: An Ancillary Study of a Randomized Trial

Aristizabal, Natalia; Holder, Mary Pat; Durham, Leandra; Ashraf, Ambika P.; Taylor, Sarah N.; Salas, Ariel A.

doi:10.1016/j.jand.2022.06.012

Cited by 5 publications

(4 citation statements)

References 17 publications

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“…Antenatal vitamin D deficiency was also found to be associated with increased airway smooth muscle mass and airway collagen synthesis, as well as elevated bronchoalveolar lavage neutrophil counts and depressed lymphocyte counts in animal models [ 116 ]. A recent small, randomized control trial [ 117 ] reported that preterm infants who received early vitamin D supplementation had a lower risk of developing BPD; however, another recent trial [ 118 ] found that although there was a trend towards decreased BPD with vitamin D supplementation, it did not reach statistical significance. Further studies are required to explore the association between vitamin D supplementation and BPD.…”

Section: Pathogenesis Of Bronchopulmonary Dysplasiamentioning

confidence: 99%

Bronchopulmonary Dysplasia: Pathogenesis and Pathophysiology

Dankhara

Holla

Ramarao

et al. 2023

JCM

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Bronchopulmonary dysplasia (BPD), also known as chronic lung disease, is the most common respiratory morbidity in preterm infants. “Old” or “classic” BPD, as per the original description, is less common now. “New BPD”, which presents with distinct clinical and pathological features, is more frequently observed in the current era of advanced neonatal care, where extremely premature infants are surviving because of medical advancements. The pathogenesis of BPD is complex and multifactorial and involves both genetic and environmental factors. This review provides an overview of the pathology of BPD and discusses the influence of several prenatal and postnatal factors on its pathogenesis, such as maternal factors, genetic susceptibility, ventilator-associated lung injury, oxygen toxicity, sepsis, patent ductus arteriosus (PDA), and nutritional deficiencies. This in-depth review draws on existing literature to explore these factors and their potential contribution to the development of BPD.

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Section: Pathogenesis Of Bronchopulmonary Dysplasiamentioning

confidence: 99%

Bronchopulmonary Dysplasia: Pathogenesis and Pathophysiology

Dankhara

Holla

Ramarao

et al. 2023

JCM

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“…Another limitation is the retrospective nature of this study. Some variables such as ethnicity which are known to interfere with vitamin D metabolism [8] and BPD frequency [44] were not available, and the risk of bias was increased.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, low 25(OH)D at one month Nutrients 2023, 15, 4423 2 of 10 of age has also been associated with increased risk of bronchopulmonary dysplasia [6]. However, studies investigating high-dose supplementation (compared with low-dose) failed to demonstrate any significant effect on the frequency of BPD [7,8] but have found high 25(OH)D concentrations in the groups exposed to high doses [8][9][10]. The data on the consequence of vitamin D excess in this population (except for the risk of nephrocalcinosis and/or hypercalcemia) are sparse [11].…”

Section: Introductionmentioning

confidence: 99%

Is 25OH Vitamin D Excess before 36 Weeks Corrected Age an Independent Risk Factor for Bronchopulmonary Dysplasia or Death?

Laborie,

Bonjour,

Bacchetta

et al. 2023

Nutrients

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Low 25-Hydroxyvitamin D (25(OH)D) in preterm infants is a risk factor for bronchopulmonary dysplasia (BPD), but increased supplementation failed to demonstrate a beneficial effect on BPD. In neonatal animal models, deficiency and excessive vitamin D exposure have been associated with increased mortality and histological alterations in the lung evocative of BPD. Our hypothesis is that 25(OH)D levels ≥ 120 nmol/L are also a risk factor for BPD or death. This retrospective single-center cohort study included only infants born at <31 weeks gestational age without major malformations with at least a determination of 25(OH)D at <36 weeks corrected age and no determination <50 nmol/L. Routine 25(OH)D determination was performed at 1 month and monthly thereafter. A total of 175 infants were included. Infants with BPD or who died had a significantly lower term and weight, but a similar frequency of 25(OH)D ≥120 nmol/L (50.5% vs. 43.9%, p = 0.53). The logistic regression identified weight (OR 0.997, 95% CI [0.995–0.998]) and term (OR 0.737, 95% CI [0.551–0.975]) as significantly associated with BPD or death; the occurrence of excessive 25(OH)D was not significantly associated (OR 1.029, 95% CI [0.503–2.093]). The present study did not demonstrate any significant association between excessive 25(OH)D after one month of age and BPD or death.

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“…Normality of data was assessed via Shapiro Wilk. A power analysis based on an estimated baseline vitamin D level of 20 ng/ml (SD 10) and an estimated increase in vitamin D of 20 ng/ml show a necessary sample size of 8 patients to achieve 80% power [25–30]. Statistical analyses were completed using SPSS Version 28.0.0.0 (190).…”

Section: Methodsmentioning

confidence: 99%

Prospective pilot study evaluating a vitamin D3 loading dose in critically ill children with vitamin D deficiency

Covington,

Jasper‐Trotter,

Arnold

et al. 2023

Fundamemntal Clinical Pharma

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BackgroundVitamin D deficiency is a common finding in critically ill children. However, the optimal supplementation strategy in this patient population is unknown. The objective of this study was to evaluate the effects of high‐dose (10 000 IU/kg, max. 400 000 IU) vitamin D supplementation on 25‐hydroxyvitamin D3 (25[OH]D3) levels in pediatric intensive care unit (PICU) patients with baseline vitamin D deficiency.MethodsThis was a prospective, institutional review board‐approved pilot research study performed at the University of South Alabama Women's and Children's Hospital in Mobile, AL. The study sample consisted of patients less than 18 years old admitted to the PICU with baseline 25‐hydroxyvitamin D (25[OH]D) level less than 30 ng/ml. Included patients received a one‐time dose of vitamin D3 orally or via gastric tube (10 000 IU/kg, max. 400 000 IU).ResultsA total of 17 patients were screened with 11 included in the study. Blood analysis revealed a significant increase in 25(OH)D3 level from baseline to 12‐h post dose (21.6 [4.5] ng/ml vs. 46.7 [15.5] ng/ml, P < 0.001). At the 12‐h post‐dose time point, 10/11 patients (91%) had 25(OH)D3 levels that were greater than 30 ng/ml. No adverse effects were observed.ConclusionVitamin D3 supplementation at a dose of 10 000 IU/kg (max. 400 000 IU) significantly increased 25(OH)D3 levels in critically ill pediatric patients.

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Safety and Efficacy of Early Vitamin D Supplementation in Critically Ill Extremely Preterm Infants: An Ancillary Study of a Randomized Trial

Cited by 5 publications

References 17 publications

Bronchopulmonary Dysplasia: Pathogenesis and Pathophysiology

Bronchopulmonary Dysplasia: Pathogenesis and Pathophysiology

Is 25OH Vitamin D Excess before 36 Weeks Corrected Age an Independent Risk Factor for Bronchopulmonary Dysplasia or Death?

Prospective pilot study evaluating a vitamin D3 loading dose in critically ill children with vitamin D deficiency

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