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Vitamin D deficiency and clinical outcomes related to septic shock in children with critical illness: a systematic review

European Journal of Clinical Nutrition (2018) | Download Citation

Abstract

Purpose

Low vitamin D blood levels are related to many clinical outcomes in children with critically illness. However, the relationship of it and septic shock has not been systematically analyzed. The objective of this review was to evaluate the effect of vitamin D on septic shock and predict if vitamin D administration can improve prognosis of it.

Materials and methods

Online databases were searched up to June 1st, 2017 for studies on the relation of vitamin D deficiency (VDD) and clinical outcomes on septic shock in children with critical illness. The primary end point was the effect of VDD on occurrence of septic shock. The secondary endpoints were the association of VDD and clinical outcomes related to septic shock.

We summarized the strength of association between VDD and each factor on septic shock. Individual factors were defined as strong, moderate, weak, or inconclusive according to the numbers of the article supporting the relation between them.

Results

Eight studies published between 2012 and 2017, for a total of 1367 patients, were included in the final analysis. We extracted eight patient-level factors and among them one showed strong association of VDD and septic shock. Four factors demonstrated moderate or weak strength of evidence for it: nonresolution of shock, catecholamine refractory shock, fluid boluses, vasopressor use. But evidence for the association between VDD and severity of illness, stay of pediatric intensive care unit (PICU), are weak. Most of the articles showed no significant association between VDD and mortality.

Conclusions

Among critically ill children, VDD might be associated with the occurrence and resolution of septic shock. A larger multicenter trial could conclusively confirm these findings. Further research is also needed to identify vitamin D administration for better outcomes in pediatric patients.

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Funding

This work was supported by the Project of study abroad in Health system of Henan province in China. (2015082)

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  1. Department of Pediatrics, the People’s Hospital of Henan Province, Zhengzhou, 450003, Henan Province, China

    • Yu Wang
    • , Changsong Shi
    • , Zhongwen Yang
    • , Fengmin Chen
    •  & Li Gao

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Conflict of interest

The authors declare that they have no conflict of interest.

Corresponding author

Correspondence to Zhongwen Yang.

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DOI

https://doi.org/10.1038/s41430-018-0249-0