The Concentrations And Associated Clinical Factors Of Vitamin A, D, And E In Critically ILL Children

OBJECTIVE: The study aimed to detect the concentrations of vitamin A, D, and E in critically ill children, and found the associated clinical factors of the development and prognostic of critical diseases.METHODS: A total 296 patients from April to October, 2015 in intensive care unit department were prospectively enrolled to examine the concentrations of vitamin A, D, and E, compared with those levels of 34 healthy children. Vitamin D was quantified by LC-MS/MS method, while Vitamin A and E were detected with UPLC approach. Clinical and laboratory elements [Blood gas analysis, serum lactic acid(LAC) and serum Ca(Ca++), platelet(PLT), white Blood Cells(WBC), hemoglobin(HB) lactate dehydrogenase(LDH), D-dimer(D-D), pediatric critical illness score(PCIS), PICU duration, hospitalization duration, parameters of mechanical ventilation, etc.].RESULTS: The median(Q25-Q75) of vitamin A and E levels were0.19 mg/l(0.12-0.24), 6.71 mg/l(4.80-8.08), respectively. and mean±sdvitamin D was 18.71±9.52 ng/ml in criticall ill children vs 0.35mg/l(0.28-0.41), 7.95 mg/l(7.00-9.00) and 27.66±6.01 ng/ml in healthy children(p < 0.05);The prevalence of vitamin A,D and E deficiency were61.82%,57.43% and 10.13% vs 8.82%,14.71% and 0(p < 0.05).Vitamin D levels was related with LAC levels negatively and PCIS levels positively,whereas vitamin A, E were no significant correlation in PCIS and LAC.Vitamin A[0.14 mg/l(0.09-0.22) vs 0.19 mg/l(0.13-0.25)],D(14.77±9.03 ng/ml vs. 19.50± 9.42 ng/ml) levels were less in 14 d death group.Vitamin E [6.00 mg/l(4.10-7.90) vs 6.40 mg/l(4.90-8.20)] was no significant difference between death group and survival group.Logstic regression analysis indicated that vitamin D(β: 0.056, OR: 0.056, 95% CI:0.907-0.986),PCIS and LAC were independent risk factors for critical internal disease,whereas vitamin A, E levels were no obvious effect on the prognosis.CONCLUSION: A high rate of vitamin A,D and E deficiency were found in critically ill children. And the deficiency of vitamin D was closely associated with higher mortality risk for critical internal diseases.