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Calcitriol trend following pediatric cardiac surgery and association with clinical outcome.
Acharya, Nina; Doherty, Dermot R; Barrowman, Nick; Maharajh, Gyaandeo; Girolamo, Tara; O'Hearn, Katie; McNally, J Dayre.
Afiliação
  • Acharya N; Department of Pediatrics, University of Ottawa, Ottawa, Canada.
  • Doherty DR; Division of Nutritional Science, Cornell University, Ithaca, NY, USA.
  • Barrowman N; Pediatric Intensive Care Unit, The Children's University Hospital, Dublin, Ireland.
  • Maharajh G; Clinical Research Unit, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.
  • Girolamo T; Division of Cardiovascular Surgery, University of Ottawa, Ottawa, Canada.
  • O'Hearn K; Division of Cardiovascular Surgery, University of Ottawa, Ottawa, Canada.
  • McNally JD; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.
Pediatr Res ; 84(2): 254-260, 2018 08.
Article em En | MEDLINE | ID: mdl-29899389
BACKGROUND: Consistent with accepted practice in stable ambulatory populations, the majority of ICU research has evaluated vitamin D status using a single blood 25-hydroxyvitamin D (25(OH)D) level. Only a limited number of ICU studies have measured the active hormone, 1,25-dihydroxyvitamin D (calcitriol) and none have used change in calcitriol levels to evaluate axis functioning. The objective of this study was to describe the impact of Congenital Heart Disease (CHD) surgery on calcitriol levels and evaluate the relationship between change in postoperative levels and clinical course. METHODS: Secondary analysis of a prospective cohort study of 56 children undergoing surgery for CHD. RESULTS: Mean calcitriol levels dropped from 122.3 ± 69.1 pmol/L preoperatively to 65.3 ± 36.5 pmol/L (p < 0.0001) at PICU admission. The majority (61%, n = 34) were unable to increase calcitriol levels in the 48 h immediately following surgery. Post operative trend in calcitriol was inversely related to cardiovascular dysfunction, fluid requirements, ventilatory support and PICU length of stay (p < 0.01). CONCLUSION: CHD patients had significant dysfunction of the vitamin D axis immediately postoperatively, demonstrated by both a significant intraoperative decline in calcitriol and inability to increase levels. Interventional research will be required to determine whether the use of calcitriol, in addition to cholecalciferol, reduces postoperative illness severity.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Calcitriol / Cuidados Críticos / Cardiopatias Congênitas / Procedimentos Cirúrgicos Cardíacos Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Pediatr Res Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Canadá

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Calcitriol / Cuidados Críticos / Cardiopatias Congênitas / Procedimentos Cirúrgicos Cardíacos Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Pediatr Res Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Canadá