VITAMIN D STATUS OF PEDIATRIC INTENSIVE CARE UNIT PATIENTS WITH PNUMONIA

Introduction: Vitamin D plays an important role, not only for bone health, but also for the immune system. Both in vitro and clinical studies have demonstrated that vitamin D is important for the innate and adaptive immune response. Adequate nutritional support has been a mainstay in pediatric intensive care unit (PICU) management with research showing improved outcomes and fewer PICU stay. However, there have been few studies to investigate the prevalence of vitamin D deficiency in critically ill children.
Aim of the work: This study aims to examine vitamin D status in the children with pneumonia who will be admitted to pediatric intensive care unit and correlate it to the severity and occurrence of complications.
Patients and Methods: This study was conducted in Pediatric intensive care unit at Al-Hussein University Hospital on 60 children; divided into two groups: group I (study group) including 40 patients presented with pneumonia. These patients aged from one month to fifteen years and admitted to the PICU of El-Hussein University Hospital (This group had been furtherly sub-classified to group Ia and group Ib according to occurrence of complications) and group II (control group) including 20 apparently healthy children of matched age and sex with no evidence of pneumonia or history of lower respiratory tract infection. Serum vitamin D was estimated.
Results: Statistically, the vitamin D level was significantly lower in study group than in control group, vitamin D level was significantly very low in cases with complications (group Ia) than in cases without complications (group Ib).There was a significant negative correlation between vitamin D level and occurrence of complications as well as duration of hospitalization.
Conclusion: This study concluded that vitamin D level was significantly lower in severe pneumonia which admitted to pediatric intensive care unit. There were correlation between vitamin D level and occurrence of complications and severity of pneumonia in children, and these patients with lower vitamin D level had longer duration of hospital stay.
Recommendations: We recommend appropriate vitamin D supplementation and sun exposure to decrease the risk of respiratory tract infections, also recommend using vitamin D in addition to antibiotic as a treatment of pneumonia cases in children which has an important role in the production of anti-microbial peptides for innate immunity.