Sakkarwal Mrityunjay, Pallavi Pallavi, Jhamb Urmila, Saxena Romit
Department of Pediatrics, Maulana Azad Medical College, New Delhi, India.
Indian J Crit Care Med. 2025 Feb;29(2):170-176. doi: 10.5005/jp-journals-10071-24895. Epub 2025 Jan 31.
Vitamin D deficiency (VDD) has been thought to be a common modifiable risk factor for severity and clinical outcome during critical illness. The primary objective was to evaluate the effect of single high-dose vitamin D supplementation on mortality in critically ill vitamin D-deficient children. The secondary objective was to study the change in vitamin D levels after the intervention.
This study was a randomized controlled trial conducted at the Department of Pediatrics of a Tertiary Care Hospital from May 2019 to March 2020.
Two hundred and fifty vitamin D-deficient children aged 1 month-12 years admitted in pediatric intensive care units (PICU) were randomized into 2 groups (group A received 10,000 U/kg cholecalciferol intramuscularly, group B received no intervention), with 125 in each group.
Baseline serum calcium, ionized calcium, serum phosphate, vitamin D and parathyroid hormone (PTH) levels were measured at the time of recruitment. Ionized calcium, and kidney function tests (KFT) were repeated at 24 and 72 hours, while vitamin D and PTH levels were repeated at 72 hours only.
Both the groups were comparable for baseline characteristics. There was no statistically significant difference between mortality ( = 0.439), length of PICU stay ( = 0.57) need and duration of mechanical ventilation ( = 0.449) between 2 groups. The subgroup analysis between severe and less severe VDD had similar results. However, there was a significant increase in levels of vitamin D after intervention in group A at 72 hours ( = 0).
Administration of single high dose of vitamin D increases the vitamin D levels but does not convincingly improve the outcomes in vitamin D-deficient critically sick children admitted in PICU.
Sakkarwal M, Pallavi P, Jhamb U, Saxena R. Effect of Single High Dose Vitamin D Administration in Critically Ill Vitamin D-deficient Pediatric Patients: A Randomized Trial. Indian J Crit Care Med 2025;29(2):170-176.
维生素D缺乏（VDD）被认为是危重症期间严重程度和临床结局的常见可改变风险因素。主要目的是评估单次大剂量补充维生素D对维生素D缺乏的危重症儿童死亡率的影响。次要目的是研究干预后维生素D水平的变化。
本研究是一项随机对照试验，于2019年5月至2020年3月在一家三级护理医院的儿科进行。
250名年龄在1个月至12岁之间、入住儿科重症监护病房（PICU）的维生素D缺乏儿童被随机分为2组（A组肌肉注射10000 U/kg胆钙化醇，B组不进行干预），每组125名。
招募时测量基线血清钙、离子钙、血清磷、维生素D和甲状旁腺激素（PTH）水平。在24小时和72小时重复测量离子钙和肾功能测试（KFT），而仅在72小时重复测量维生素D和PTH水平。
两组的基线特征具有可比性。两组之间的死亡率（P = 0.439）、PICU住院时间（P = 0.57）需求和机械通气持续时间（P = 0.449）无统计学显著差异。重度和轻度VDD亚组分析结果相似。然而，A组干预后72小时维生素D水平显著升高（P = 0）。
单次大剂量给予维生素D可提高维生素D水平，但并未令人信服地改善入住PICU的维生素D缺乏危重症儿童的结局。
Sakkarwal M, Pallavi P, Jhamb U, Saxena R.单次大剂量维生素D给药对维生素D缺乏的危重症儿科患者的影响：一项随机试验。《印度危重症医学杂志》2025；29(2):170 - 176。
