Vitamin D Deficiency Impacts PICU Outcomes in India

Published Online July 19, 2015
Indian Journal of Pediatrics

When researchers analyzed the conditions of critically ill patients at a pediatric hospital in South India, they found a common thread between severity of illness and the need for mechanical ventilation.

The children were deficient in vitamin D. It was the first study of its kind to examine the association between vitamin D status and how children fare in the PICU.

Low serum 25(OH) D level was also connected to the use of vasocompressors, which increase blood pressure and are typically used to treat hypertension in critically ill patients.

The study was led by senior author Mark Steinhoff, MD, director of Global Child Health, and included Adekunle Dawodu, MBBS, director of International Patient Care and Education.

Vitamin D deficiency affects 75 to 90 percent of Indian children. Factors include the lack of vitamin D-fortified foods and lower levels of skin exposure to the sun.

“They have chronic illness which may be associated with low vitamin D,” Dawodu says. “Vitamin D deficiency also may be associated with the severity of illness among critically ill children.”

The team examined 54 such children, nearly 40 percent of whom were infants. The three most common reasons for their hospitalization were shock (31 percent), central nervous system conditions (23 percent) and respiratory illnesses (21 percent).

Vitamin D was once only related to bone health and calcium homeostasis, but scientists have discovered that most tissues and cells have vitamin D receptors, and that vitamin D impacts cardiovascular function, innate immunity, and cell growth and proliferation.

The authors urged that additional studies should examine the association of vitamin D and mortality rates, and that “prospective evaluations of the effect of vitamin D supplementation among critically ill children warrant urgent study."