Impact of Serum Vitamin D Status on the Outcome of Ventilator-Associated Pneumonia in Neonates

Objectives: The aim of this work was to study the status of serum vitamin D level on the outcome of ventilator associated pneumonia (VAP) in neonates.

Methods: This prospective cohort study was carried out on 60 intubated neonates with gestational age > 32 weeks and ventilated for more than 48 h and included two groups, VAP group (n=30) and non-VAP group (n=30). Serum 25-hydroxy Vit D was tested at the start of mechanical ventilation, while blood culture and endotracheal culture were obtained after 2 days of mechanical ventilation and when VAP was suspected.

Results: The mean serum level of vitamin D in VAP group was statistically significantly lower than non-VAP group. Also, the total duration of mechanical ventilation, duration of O2 supplementation post extubation and duration of hospital stay were statistically significantly longer in VAP group. Although the mortality was higher in neonates developed VAP, it didn’t achieve a statistically significant difference. A cut off value of ≤17.35 ng/ml of serum 25-hydroxy vitamin D showed a sensitivity of 83.33%, specificity of 100% and area under curve (AUC) was 0.895 to predict neonatal VAP.

Conclusion: 25-hydroxy vitamin D deficiency is an important risk factor for VAP development in neonates, and low vitamin D levels is associated with significant longer duration of mechanical ventilation, post extubation O2 support and hospital stay in neonates with VAP.