The Association Between Low Levels of Vitamin D and Clinical Outcomes in Critically-Ill Children: A Systematic Review and Meta-Analysis

Khorasani, Niloofar Razavi; Moazzami, Bobak; Tajrishi, Farbod Zahedi; Mohammadpour, Zinat; Rouhi, Faeze; Alizadeh‐Navaei, Reza; Ghadimi, Reza

doi:10.1080/15513815.2019.1675832

Cited by 6 publications

(4 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It has been shown that in critically ill patients 25-(OH)D 3 even continue to decrease if no substitution is started [140]. In contrast to these findings in adults, a recent large meta-analysis in critically ill children was not able to link a 25-(OH)D 3 deficiency to a higher mortality [146]. The reason for a lower 25-(OH)D 3 in critically ill patients (both at admission and the subsequent decrease) is still not completely understood.…”

Section: The Impact Of Vitamin D Deficiency On the Immune System: In Vitro And In Vivo Datamentioning

confidence: 90%

Vitamin D’s Effect on Immune Function

et al. 2020

View full text Add to dashboard Cite

Ever since its discovery by Windhaus, the importance of the active metabolite of vitamin D (1,25-dihydroxyvitamin D3; 1,25-(OH)2D3) has been ever expanding. In this review, the attention is shifted towards the importance of the extra-skeletal effects of vitamin D, with special emphasis on the immune system. The first hint of the significant role of vitamin D on the immune system was made by the discovery of the presence of the vitamin D receptor on almost all cells of the immune system. In vitro, the overwhelming effect of supra-physiological doses of vitamin D on the individual components of the immune system is very clear. Despite these promising pre-clinical results, the translation of the in vitro observations to solid clinical effects has mostly failed. Nevertheless, the evidence of a link between vitamin D deficiency and adverse outcomes is overwhelming and clearly points towards avoidance of vitamin D deficiency especially in early life.

show abstract

Section: The Impact Of Vitamin D Deficiency On the Immune System: In Vitro And In Vivo Datamentioning

confidence: 90%

Vitamin D’s Effect on Immune Function

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In other words, hypovitaminosis D did not show higher prediction of risk scores for mortality. [ 31 , 32 ]…”

Section: Discussionmentioning

confidence: 99%

Vitamin D supplementation and improvement of pneumonic children at a tertiary pediatric hospital in Egypt

et al. 2021

View full text Add to dashboard Cite

Background: Despite the well-recognized effect of vitamin D in metabolism and homeostasis, there is now growing interest in its probable association with pneumonia. This study aims to supply vitamin D3 (Cholecalciferol) (100,000 IU) to pneumonic children to minimize the duration of illness and improve their outcome. Methods: A double-blinded, randomized, placebo-controlled trial was conducted in a Pediatric Cairo University affiliated hospital. An intervention arm (93 children) and a control arm (98 children), who had pneumonia with an insufficient or deficient level of vitamin D and whose parental permission was obtained, were enrolled in the trial. All children were treated with antibiotics according to WHO guidelines. Children were given a single injection of 1 mL of 100,000 IU of vitamin D3 or placebo. Clinical data were recorded every eight hours for all children. Outcomes were assessed 7 days after vitamin D injection. The primary outcome variable was the change in serum level of 25(OH)D, while the secondary outcomes were the medical state of the assigned cases (improvement or death) and duration between enrollment and hospital discharge for improved cases. Results: In the supplementation group, the percentage of patients who suffered either deficient (38.7%) or insufficient levels (61.3%) of 25 (OH)D at day one had significantly decreased in the seventh day to (11.8%) and (52.7%), respectively. Kaplan--Meier plots highlighted that the median time to recover of the placebo group was significantly longer than that of the supplementation group (Log Rank P value < .001). Conclusion: VDD was detected in pediatric critical care children. In pneumonic children with high VDD, it is illustrated that Vitamin D supplementation is accompanied by lowered mortality risk and pSOFA scores, reduced time to recover, and improved PaO 2 /FiO 2 . Trial registration: Trial Identifier number: NCT04244474. Registered on 27 January 2020- Retrospectively registered at ClinicalTrials.gov https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0009JXO&selectaction=Edit&uid=U0004UO8&ts=152&cx=9cceq6

show abstract

“…30 Deficiencies may increase the critically ill child's susceptibility to sepsis and ventilator support. 31 The redistribution of micronutrients between tissues and body fluids and the reduced synthesis of carrier proteins induced by the inflammatory response syndrome result in a significant depletion of many plasma micronutrient concentrations regardless of actual body stores (Se, Zn, vitamin A, vitamin B 6 , vitamin D, and vitamin C). 32,33 This has important implications for the interpretation of individual plasma concentrations.…”

Section: Rationalementioning

confidence: 99%

Parenteral Provision of Micronutrients to Pediatric Patients: An International Expert Consensus Paper

Hardy¹,

Wong²,

Morrissey

et al. 2020

J Parenter Enteral Nutr

View full text Add to dashboard Cite

Introduction Micronutrients (vitamins and trace elements) are essential to all nutrition. For children and neonates who are dependent upon nutrition support therapies for growth and development, the prescribed regimen must supply all essential components. This paper aims to facilitate interpretation of existing clinical guidelines into practical approaches for the provision of micronutrients in pediatric parenteral nutrition. Methods An international, interdisciplinary expert panel was convened to review recent evidence‐based guidelines and published literature to develop consensus‐based recommendations on practical micronutrient provision in pediatric parenteral nutrition. Results The guidelines and evidence have been interpreted as answers to 10 commonly asked questions around the practical principles for provision and monitoring of micronutrients in pediatric patients. Conclusion Micronutrients are an essential part of all parenteral nutrition and should be included in the pediatric nutrition therapy care plan.

show abstract

The Association Between Low Levels of Vitamin D and Clinical Outcomes in Critically-Ill Children: A Systematic Review and Meta-Analysis

Cited by 6 publications

References 43 publications

Vitamin D’s Effect on Immune Function

Vitamin D’s Effect on Immune Function

Vitamin D supplementation and improvement of pneumonic children at a tertiary pediatric hospital in Egypt

Parenteral Provision of Micronutrients to Pediatric Patients: An International Expert Consensus Paper

Contact Info

Product

Resources

About