Vitamin D deficiency in surgical congenital heart disease: prevalence and relevance
Vitamin D is a pleiotropic hormone important for the proper functioning of multiple organ systems. An emerging body of adult and pediatric critical care literature strongly suggests that vitamin D deficiency contributes to secondary organ pathophysiology, prolongs ICU stay, and worsens outcome in critically ill populations. Recent clinical studies suggest that a significant number of children with congenital heart disease (CHD) have post-operative vitamin D deficiency which appears to be associated with greater cardiovascular dysfunction. Altogether the cumulative body of literature suggests that peri-operative optimization of vitamin D status has the potential to speed recovery and/or improve outcome. This review describes the epidemiological and basic science research linking vitamin D deficiency to post-operative organ dysfunction. Furthermore, the available supplementation approaches are reviewed in the context of prevention of post-operative vitamin D deficiency and avoidance of toxicity in the majority of CHD patients. Finally, knowledge gaps regarding vitamin D supplementation are identified and the next stages for research are outlined.