Vitamin D deficiency and outcome of patients with sepsis in pediatric intensive care unit: a prospective observational study
Background: Vitamin D is important in immunomodulation, regulation of inflammation and cytokines, cell proliferation, cell differentiation, apoptosis, angiogenesis, muscle strength, and muscle contraction. Patients with sepsis have high mortality rate and high deficiency in vitamin D. (1) Vitamin D is increasingly recognized as an important mediator of immune function and may have a preventive role in the pathogenesis of sepsis. (2) Vitamin D also influence cardiovascular function. (3) We aimed to find the correlation of vitamin D level with severity of sepsis in patients admitted to pediatric intensive care unit (PICU).
Setting: Participants and laboratory were collected from patients with sepsis who admitted to the PICU at Dr. Sardjito General Hospital, Yogyakarta.
Patients and Participants: Participants pediatric sepsis patients admitted to the PICU from September 2015 to April 2016. Blood samples for 25-hydroxyvitamin D [25(OH)D] concentration were collected at the first 24 hours admission in PICU using ELISA method. Other data recorded include pediatric logistic organ dysfunction (PELOD) score at admission, PICU length of stay and mortality.
Measurement and results: A total of 297 patients were admitted to the PICU during the 8-month study period. Fourty-two patients had diagnosis of sepsis, severe sepsis or septic shock on PICU admission. Of all these studied patients, 25(OH)D deficiency was identified in 23 (54.8%) patients, insufficiency in 9 (21.4%) patients, and normal levels in 10 (23.8%) patients. PICU mortality was higher in patients with 25(OH)D deficiency, ie 7 (30.44%) patients, but it did not show any statistical significance compared to the group of patients with 25(OH)D insufficiency or normal level of 25(OH)D group of patients (p=0.78). The group with normal level of 25(OH)D had the highest PELOD score but on the other hand they have the lowest mortality rate.
Conclusions: There is a high prevalence of vitamin D deficiency in pediatric sepsis patients admitted to PICU, but not correlated with PELOD score on admission. PICU lenght of stay also not associated with mortality in PICU.