Tags

Type your tag names separated by a space and hit enter

Clinical Trial of Vitamin D2 vs D3 Supplementation in Critically Ill Pediatric Burn Patients.
JPEN J Parenter Enteral Nutr. 2017 03; 41(3):412-421.JJ

Abstract

BACKGROUND

Hypovitaminosis D exists postburn. However, evidence-based guidelines for vitamin D repletion are unknown. This investigation examined differences between D2 and D3 supplementation on outcome in children with burn injuries.

METHODS

Fifty patients with total body surface area burn of 55.7% ± 2.6% and full-thickness injury of 40.8% ± 3.8% were enrolled, ranging in age from 0.7-18.4 years. All participants received multivitamin supplementation per standardized clinical protocol. In addition, 100 IU/kg D2, D3, or placebo was administered daily during hospitalization using a randomized, double-blinded study design. Assay of total 25-hydroxyvitamin D (D25), 1,25-dihydroxyvitamin D (D1,25), 25-hydroxyvitamin D2 (25-OH-D2), 25-hydroxyvitamin D3 (25-OH-D3), and parathyroid hormone (PTH) was performed at 4 preplanned time intervals (baseline, midpoint, discharge, and 1 year postburn). Differences in vitamin D status were compared over time and at each specific study interval.

RESULTS

There were no significant differences in serum vitamin D levels between groups, but >10% of patients had low D25 at discharge, and percent deficiency worsened by the 1-year follow up for the placebo (75%), D2 (56%), and D3 (25%) groups. There were no statistical differences in PTH or clinical outcomes between treatment groups, although vitamin D supplementation demonstrated nonsignificant but clinically relevant decreases in exogenous insulin requirements, sepsis, and scar formation.

CONCLUSIONS

The high incidence of low serum D25 levels 1 year following serious thermal injury indicates prolonged compromise. Continued treatment with vitamin D3 beyond the acute phase postburn is recommended to counteract the trajectory of abnormal serum levels and associated morbidity.

Authors+Show Affiliations

1 Department of Research, Shriners Hospitals for Children, Cincinnati, Ohio, USA. 2 Department of Nutrition, Shriners Hospitals for Children, Cincinnati, Ohio, USA. 3 Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.2 Department of Nutrition, Shriners Hospitals for Children, Cincinnati, Ohio, USA. 4 Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.4 Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.3 Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA. 5 Department of Surgery, Shriners Hospitals for Children, Cincinnati, Ohio, USA.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

26059899

Citation

Gottschlich, Michele M., et al. "Clinical Trial of Vitamin D2 Vs D3 Supplementation in Critically Ill Pediatric Burn Patients." JPEN. Journal of Parenteral and Enteral Nutrition, vol. 41, no. 3, 2017, pp. 412-421.
Gottschlich MM, Mayes T, Khoury J, et al. Clinical Trial of Vitamin D2 vs D3 Supplementation in Critically Ill Pediatric Burn Patients. JPEN J Parenter Enteral Nutr. 2017;41(3):412-421.
Gottschlich, M. M., Mayes, T., Khoury, J., & Kagan, R. J. (2017). Clinical Trial of Vitamin D2 vs D3 Supplementation in Critically Ill Pediatric Burn Patients. JPEN. Journal of Parenteral and Enteral Nutrition, 41(3), 412-421. https://doi.org/10.1177/0148607115587948
Gottschlich MM, et al. Clinical Trial of Vitamin D2 Vs D3 Supplementation in Critically Ill Pediatric Burn Patients. JPEN J Parenter Enteral Nutr. 2017;41(3):412-421. PubMed PMID: 26059899.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical Trial of Vitamin D2 vs D3 Supplementation in Critically Ill Pediatric Burn Patients. AU - Gottschlich,Michele M, AU - Mayes,Theresa, AU - Khoury,Jane, AU - Kagan,Richard J, Y1 - 2016/09/30/ PY - 2015/6/11/pubmed PY - 2017/12/29/medline PY - 2015/6/11/entrez KW - burn injury KW - pediatrics KW - vitamin D SP - 412 EP - 421 JF - JPEN. Journal of parenteral and enteral nutrition JO - JPEN J Parenter Enteral Nutr VL - 41 IS - 3 N2 - BACKGROUND: Hypovitaminosis D exists postburn. However, evidence-based guidelines for vitamin D repletion are unknown. This investigation examined differences between D2 and D3 supplementation on outcome in children with burn injuries. METHODS: Fifty patients with total body surface area burn of 55.7% ± 2.6% and full-thickness injury of 40.8% ± 3.8% were enrolled, ranging in age from 0.7-18.4 years. All participants received multivitamin supplementation per standardized clinical protocol. In addition, 100 IU/kg D2, D3, or placebo was administered daily during hospitalization using a randomized, double-blinded study design. Assay of total 25-hydroxyvitamin D (D25), 1,25-dihydroxyvitamin D (D1,25), 25-hydroxyvitamin D2 (25-OH-D2), 25-hydroxyvitamin D3 (25-OH-D3), and parathyroid hormone (PTH) was performed at 4 preplanned time intervals (baseline, midpoint, discharge, and 1 year postburn). Differences in vitamin D status were compared over time and at each specific study interval. RESULTS: There were no significant differences in serum vitamin D levels between groups, but >10% of patients had low D25 at discharge, and percent deficiency worsened by the 1-year follow up for the placebo (75%), D2 (56%), and D3 (25%) groups. There were no statistical differences in PTH or clinical outcomes between treatment groups, although vitamin D supplementation demonstrated nonsignificant but clinically relevant decreases in exogenous insulin requirements, sepsis, and scar formation. CONCLUSIONS: The high incidence of low serum D25 levels 1 year following serious thermal injury indicates prolonged compromise. Continued treatment with vitamin D3 beyond the acute phase postburn is recommended to counteract the trajectory of abnormal serum levels and associated morbidity. SN - 1941-2444 UR - https://www.unboundmedicine.com/medline/citation/26059899/Clinical_Trial_of_Vitamin_D2_vs_D3_Supplementation_in_Critically_Ill_Pediatric_Burn_Patients_ L2 - https://doi.org/10.1177/0148607115587948 DB - PRIME DP - Unbound Medicine ER -