A Randomized Controlled Trial to Compare the Efficacy of Single Mega Dose Vitamin D Therapy with Standard Daily Dose Vitamin D Therapy in Vitamin D Deficient Critically Ill Children

Abstract

Introduction: The prevalence of vitamin D deficiency has been reported to be very high (up to 50%) in critically
ill children admitted in Paediatric ICU, and vitamin D deficiency has been associated with increased mortality,
increased length of Paediatric ICU and hospital stay. But the impact of supplementation of vitamin D in these
children on the clinical outcome is not very clear.
Study Objectives: Primary Objective: To compare the efficacy of single mega dose vitamin D therapy with
standard daily dose vitamin D therapy in vitamin D deficient critically ill children.
Secondary Objective: To assess the prevalence of vitamin D deficiency in critically ill children in a tertiary care
centre.
Methodology: A study population of 50 children meeting inclusion criteria were enrolled in our study. All the
subjects admitted to our Paediatric ICU were subjected to a detailed history and examination. Vitamin D levels
were sent at admission and children with vitamin D deficiency (< 20ng/dl) were taken as study subjects and
randomized into two groups. One group received single mega dose vitamin D therapy, and the second group
received standard daily dose vitamin D therapy. These children were followed up until their Paediatric ICU stay
or death. The impact of supplementation was compared among both the groups in terms of length of Paediatric
ICU stay and mortality.
Results: The mean length of Paediatric ICU stay among children receiving a single mega dose vitamin D therapy
was 5.04 days compared to 3.56 days among children receiving standard-dose vitamin D therapy (p-value 0.337),suggesting no significant difference in the length of Paediatric ICU stay among the study subjects of both groups.
There was no mortality among these study subjects. The prevalence of vitamin D deficiency in the study group
was 55.6%.
Conclusion: Supplementation of a single mega dose of vitamin D compared to the standard dose of vitamin D has
no advantage on the clinical outcome of Vitamin D deficient critically ill children in terms of length of Paediatric
ICU stay and mortality.