The Effects of Vitamin D3 in Pediatric Patients Undergoing Congenital Heart Surgery

Abstract

Background: To investigate the effects of vitamin D3 on the surgical outcome of pediatric patients undergoing cardiac surgery for congenital heart conditions. Materials and Methods: Ninety pediatric cardiac surgery patients referred for preoperative evaluation were enrolled. Patients with insufficient vitamin D3 levels received intramuscular vitamin D3 (300,000 IU) three days before the surgery and those with final vitamin D3 level of ≥30 ng/dl were included and divided into 3 groups (Group A: abnormal Vit D levels, no Vit D treatment; Group B: abnormal Vit D levels, Vit D treatment up to normal serum Vit D levels before surgery; Group C: normal baseline Vit D levels, no supplemental Vit D treatment). Interleukin 1, 6, 10, tumor necrosis factor-alpha, vital signs, and arterial blood gas parameters were measured before the surgery and at 6 and 24 hours after cardiopulmonary bypass. Data on total hospital stay, reoperation rates, and inotropes scores were retrieved. Additionally, postoperative measures including hemodynamic factors, blood pressure, heart rate, cardiac output, electrocardiography changes, chest-tube drainage, and ventilation-related factors (i.e. respiratory rate, arterial blood gas, respiratory resistance, intubation time, …) were recorded. Results: We observed a significant increase in post cardiopulmonary bypass levels of IL-10 and IL-6 in all groups (p<0.002) regardless of vitamin D treatment status; however, no significant difference was seen in levels of IL-1 and TNF-alpha. Groups B had more patients with critical levels of VIS scores compared to groups A and C (p<0.002). Furthermore, no differences in hemodynamic and metabolic parameters were observed. Conclusion: No significant difference in the rates of postoperative parameters in patients with normal and those with deficient levels of vitamin D3 was observed