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The relationship between vitamin D serum concentration and common inflammatory biomarkers in the early postoperative period in infants with congenital heart defects operated on with extracorporeal circulation: preliminary results

Julia Katarzyna Haponiuk-Skwarlińska12, Konrad Paczkowski1, Maciej Chojnicki1, Mariusz Steffens1, Anna Romanowicz-Sołtyszewska1, Marta Paśko-Majewska1, Monika Opacian-Bojanowska1, Paweł Macko1, Katarzyna Gierat-Haponiuk34, Ireneusz Haponiuk14
DOI: 10.5603/FC.a2022.0055
Affiliations
  1. Department of Pediatric Cardiac Surgery, St. Adalbertus Hospital Gdańsk-Zaspa, COPERNICUS Ltd, Gdańsk, Poland
  2. Faculty of Medicine, Medical University of Warsaw, Warszawa, Poland
  3. Department of Health and Biological Sciences, Gdansk Academy of Physical Education and Sport, Gdańsk, Poland
  4. Department of Rehabilitation, Medical University of Gdansk, Gdańsk, Poland

open access

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Published online: 2022-10-03

Abstract

Introduction. Children operated on congenital heart defects (CHD) with the use of extracorporeal circulation (ECC) experience various forms of systemic inflammatory response syndrome (SIRS) which can be measured by routine inflammatory biomarkers (C-reactive protein [CRP], procalcitonin). According to literature, vitamin D serum concentration in multiple potential ways may be related to the inflammatory response activation in the acute phase of SIRS in infants operated on CHD with the use of ECC. Material and methods. The study group consisted of 20 infants (mean age = 7.35 months; standard deviation = 2.76) with CHD underwent cardiac surgery with the use of ECC in one cardiac unit. Serum concentration of vitamin D (in 2 forms: 25(OH)D3 and 1.25(OH)2D3), as well as inflammatory biomarkers were measured three times: a day before surgery, on the 2nd day after the operation, and finally — in the 6th postoperative day. All participants received standard vitamin D supplementation (500 IU) orally within first week after birth as well as just after the return to oral feeding after cardiac surgery (1st postoperative day). The specimens were analysed in the local laboratory. The obtained data were analysed statistically. To asses vitamin D sufficiency the standard, recommended thresholds were used. Results. All patients had sufficient level of vitamin D before the surgery. Patients with any clinical sign of infection (including elevated inflammatory biomarkers) were excluded. On the 2nd postoperative day, when the peak level of CRP (median [m] = 131.59 mg/L) was observed, the 1.25(OH)2D3 fell to insufficiency (m = 66.10 ng/mL). In the 6th postoperative day CRP was observed in the nearly normal ranges, while vitamin D returned to preoperative sufficiency levels. Conclusions. The study’s preliminary results show that the dynamics of early postoperative inflammatory markers level increase correlates with early postoperative serum vitamin D concentration drop below the therapeutic level. Our results eligible further studies to determine new universal protocols of preoperative, and perioperative vitamin D administration to prevent from vitamin D deficiency in children operated on for CHD in infancy.

Abstract

Introduction. Children operated on congenital heart defects (CHD) with the use of extracorporeal circulation (ECC) experience various forms of systemic inflammatory response syndrome (SIRS) which can be measured by routine inflammatory biomarkers (C-reactive protein [CRP], procalcitonin). According to literature, vitamin D serum concentration in multiple potential ways may be related to the inflammatory response activation in the acute phase of SIRS in infants operated on CHD with the use of ECC. Material and methods. The study group consisted of 20 infants (mean age = 7.35 months; standard deviation = 2.76) with CHD underwent cardiac surgery with the use of ECC in one cardiac unit. Serum concentration of vitamin D (in 2 forms: 25(OH)D3 and 1.25(OH)2D3), as well as inflammatory biomarkers were measured three times: a day before surgery, on the 2nd day after the operation, and finally — in the 6th postoperative day. All participants received standard vitamin D supplementation (500 IU) orally within first week after birth as well as just after the return to oral feeding after cardiac surgery (1st postoperative day). The specimens were analysed in the local laboratory. The obtained data were analysed statistically. To asses vitamin D sufficiency the standard, recommended thresholds were used. Results. All patients had sufficient level of vitamin D before the surgery. Patients with any clinical sign of infection (including elevated inflammatory biomarkers) were excluded. On the 2nd postoperative day, when the peak level of CRP (median [m] = 131.59 mg/L) was observed, the 1.25(OH)2D3 fell to insufficiency (m = 66.10 ng/mL). In the 6th postoperative day CRP was observed in the nearly normal ranges, while vitamin D returned to preoperative sufficiency levels. Conclusions. The study’s preliminary results show that the dynamics of early postoperative inflammatory markers level increase correlates with early postoperative serum vitamin D concentration drop below the therapeutic level. Our results eligible further studies to determine new universal protocols of preoperative, and perioperative vitamin D administration to prevent from vitamin D deficiency in children operated on for CHD in infancy.

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Keywords

vitamin D, systemic inflammatory response syndrome, paediatrics, paediatric cardiac surgery, congenital heart defects

About this article
Title

The relationship between vitamin D serum concentration and common inflammatory biomarkers in the early postoperative period in infants with congenital heart defects operated on with extracorporeal circulation: preliminary results

Journal

Folia Cardiologica

Issue

Ahead of print

Article type

Original paper

Published online

2022-10-03

Page views

162

Article views/downloads

105

DOI

10.5603/FC.a2022.0055

Keywords

vitamin D
systemic inflammatory response syndrome
paediatrics
paediatric cardiac surgery
congenital heart defects

Authors

Julia Katarzyna Haponiuk-Skwarlińska
Konrad Paczkowski
Maciej Chojnicki
Mariusz Steffens
Anna Romanowicz-Sołtyszewska
Marta Paśko-Majewska
Monika Opacian-Bojanowska
Paweł Macko
Katarzyna Gierat-Haponiuk
Ireneusz Haponiuk

References (21)
  1. Liu Y, Chen S, Zühlke L, et al. Global birth prevalence of congenital heart defects 1970-2017: updated systematic review and meta-analysis of 260 studies. Int J Epidemiol. 2019; 48(2): 455–463.
    CrossRefPubMed
  2. Best KE, Rankin J. Long-term survival of individuals born with congenital heart disease: a systematic review and meta-analysis. J Am Heart Assoc. 2016; 5(6): e002846.
    CrossRefPubMed
  3. Ziyaeifard M, Alizadehasl A, Massoumi G. Modified ultrafiltration during cardiopulmonary bypass and postoperative course of pediatric cardiac surgery. Res Cardiovasc Med. 2014; 3(2): e17830.
    CrossRefPubMed
  4. Boehne M, Sasse M, Karch A, et al. Systemic inflammatory response syndrome after pediatric congenital heart surgery: Incidence, risk factors, and clinical outcome. J Card Surg. 2017; 32(2): 116–125.
    CrossRefPubMed
  5. McNally JD, O'Hearn K, Lawson ML, et al. Prevention of vitamin D deficiency in children following cardiac surgery: study protocol for a randomized controlled trial. Trials. 2015; 16: 402.
    CrossRefPubMed
  6. Pilz S, Zittermann A, Trummer C, et al. Vitamin D testing and treatment: a narrative review of current evidence. Endocr Connect. 2019; 8(2): R27–R43.
    CrossRefPubMed
  7. Rusińska A, Płudowski P, Walczak M, et al. Vitamin D supplementation guidelines for general population and groups at risk of vitamin D deficiency in Poland — recommendations of the Polish Society of Pediatric Endocrinology and Diabetes and the Expert Panel with Participation of National Specialist Consultants and Representatives of Scientific Societies — 2018 update. Front Endocrinol (Lausanne). 2018; 9: 246.
    CrossRefPubMed
  8. Ney J, Heyland DK, Amrein K, et al. The relevance of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D concentration for postoperative infections and postoperative organ dysfunctions in cardiac surgery patients: The eVIDenCe study. Clin Nutr. 2019; 38(6): 2756–2762.
    CrossRefPubMed
  9. Kruit A, Zanen P. The association between vitamin D and C-reactive protein levels in patients with inflammatory and non-inflammatory diseases. Clin Biochem. 2016; 49(7-8): 534–537.
    CrossRefPubMed
  10. Autier P, Mullie P, Macacu A, et al. Effect of vitamin D supplementation on non-skeletal disorders: a systematic review of meta-analyses and randomised trials. Lancet Diabetes Endocrinol. 2017; 5(12): 986–1004.
    CrossRefPubMed
  11. McNally JD, Menon K, Chakraborty P, et al. The association of vitamin D status with pediatric critical illness. Pediatrics. 2012; 130(3): 429–436.
    CrossRefPubMed
  12. Schleithoff SS, Zittermann A, Tenderich G, et al. Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr. 2006; 83(4): 754–759.
    CrossRefPubMed
  13. Dziedzic EA, Gąsior JS, Pawłowski M, et al. Vitamin D level is associated with severity of coronary artery atherosclerosis and incidence of acute coronary syndromes in non-diabetic cardiac patients. Arch Med Sci. 2019; 15(2): 359–368.
    CrossRefPubMed
  14. Izzo M, Carrizzo A, Izzo C, et al. Vitamin D: not just bone metabolism but a key player in cardiovascular diseases. Life (Basel). 2021; 11(5): 452.
    CrossRefPubMed
  15. Graham EM, Taylor SN, Zyblewski SC, et al. Vitamin D status in neonates undergoing cardiac operations: relationship to cardiopulmonary bypass and association with outcomes. J Pediatr. 2013; 162(4): 823–826.
    CrossRefPubMed
  16. Ye X, Dong S, Deng Y, et al. Preoperative vitamin D deficiency is associated with higher vasoactive-inotropic scores following pediatric cardiac surgery in Chinese children. Front Pediatr. 2021; 9: 671289.
    CrossRefPubMed
  17. Shedeed SA. Vitamin D supplementation in infants with chronic congestive heart failure. Pediatr Cardiol. 2012; 33(5): 713–719.
    CrossRefPubMed
  18. Chang HY, Hsu CH, Tsai JD, et al. Renal calcification in very low birth weight infants. Pediatr Neonatol. 2011; 52(3): 145–149.
    CrossRefPubMed
  19. Schlingmann KP, Kaufmann M, Weber S, et al. Mutations in CYP24A1 and idiopathic infantile hypercalcemia. N Engl J Med. 2011; 365(5): 410–421.
    CrossRefPubMed
  20. Abou Zahr R, Faustino EV, Carpenter T, et al. Vitamin D status after cardiopulmonary bypass in children with congenital heart disease. J Intensive Care Med. 2017; 32(8): 508–513.
    CrossRefPubMed
  21. Soares LC, Ribas D, Spring R, et al. [Clinical profile of systemic inflammatory response after pediatric cardiac surgery with cardiopulmonary bypass]. Arq Bras Cardiol. 2010; 94(1): 127–133.
    CrossRefPubMed

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