Effect of Single High Dose Vitamin D Administration in Critically Ill Vitamin D-deficient Pediatric Patients: A Randomized Trial.

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 (p = 0.439), length of PICU stay (p = 0.57) need and duration of mechanical ventilation (p = 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 (p = 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.