.jpg "Alireza Fathi, MD, MBA photo")
Alireza Fathi, MD, MBA
Pediatric Critical Care
MemorialCare Miller Childrens Hospital and Womens Hospital Long Beach
Palos Verdes Estates, California
Disclosure information not submitted.
Corcoran Downey, RD
Registered Dietitian
Memorial Care - Miller Children's & Women's Hospital of Long Beach, United States
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Aida Rabiee Gohar, MS
MS - Data Analyst
University of West Viginia, United States
Disclosure information not submitted.
Title: Vitamin C Deficiency In Critically Ill Children
Introduction: Diseases encountered in critical care, such as sepsis, ARDS and MODS, can result in oxidative stress leading to increase free radical formation. Increase in free radical formation increases demand for Vitamin C, an antioxidant and a free radical scavenger. Human body cannot synthesis nor store Vitamin C levels. As many critical ill patients may be kept NPO, there is inadequate Vitamin C supply to meet the higher Vitamin C demand. Vitamin C deficiency has been shown in critically ill adult patients but has not been studied in critically ill children. The goal of our study is to evaluate Vitamin C levels in critically ill children admitted to Pediatric Intensive Care Unit (PICU).
Methods: This is a single centered cohort prospective study. Children 0-21 years of age admitted to PICU were enrolled in the study. Vitamin C level was measured daily for up to 7 days if patient remained in PICU (PICU group). Children 0-21 years of age, receiving deep sedation for elective procedure in outpatient procedure room served as the control group.
Results: Total of 60 patients (average age 10.2 years) in PICU were enrolled in the PICU group and had vitamin C level drawn. Total of 21 patients (average age 12.3 years) in outpatient procedure room were enrolled in the control group and had Vitamin C level drawn prior to start of elective procedure. Mean Vitamin C level on day 1 in children admitted to PICU (PICU group) was significantly lower than mean Vitamin C level in children undergoing outpatient procedures (Control group) (35.9 µmol/L [CI 95% 29.4 - 42.5 µmol/L] vs. 62.8 µmol/L [CI 95% 55.3 - 70.3 µmol/L]; p < 0.001. Vitamin C depletion was more common in PICU group (48% vs. 9%); p< 0.001. Patients with vitamin C depletion had higher length of PICU stay (8..6 vs.4.1 days; p< 0.001). Mean Vitamin C level continued to decline for patients during their PICU course (day 1: 35.9 µmol/L [CI 95% 29.4 - 42.5 µmol/L] vs. day 7: 23 µmol/L [CI 95% 13.2 - 32.8 µmol/L]); p < 0.01
Conclusions: Vitamin C depletion is common in critical ill children. Furthermore, in critically ill children, vitamin C levels continue to decline during hospitalization in PICU. Children with vitamin C depletion have higher length of PICU stay.