The impact of vitamin D on fetal and neonatal lung maturation. A systematic review

2015 ◽  
Vol 308 (7) ◽  
pp. L587-L602 ◽  
Author(s):  
Sine Lykkedegn ◽  
Grith Lykke Sorensen ◽  
Signe Sparre Beck-Nielsen ◽  
Henrik Thybo Christesen
Keyword(s):  
Vitamin D ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Bronchopulmonary Dysplasia ◽  
Lung Development ◽  
Distress Syndrome ◽  
Hypovitaminosis D ◽  
Laboratory Studies ◽  
Lung Maturation ◽  
The Impact

Respiratory distress syndrome (RDS) and bronchopulmonary dysplasia (BPD) are major complications to preterm birth. Hypovitaminosis D is prevalent in pregnancy. We systematically reviewed the evidence of the impact of vitamin D on lung development, surfactant synthesis, RDS, and BPD searching PubMed, Embase, and Cochrane databases with the terms vitamin D AND (surfactant OR lung maturation OR lung development OR respiratory distress syndrome OR fetal lung OR prematurity OR bronchopulmonary dysplasia). Three human studies, ten animal studies, two laboratory studies, and one combined animal and laboratory study were included. Human evidence was sparse, allowing no conclusions. BPD was not associated with vitamin D receptor polymorphism in a fully adjusted analysis. Animal and laboratory studies showed substantial positive effects of vitamin D on the alveolar type II cell, fibroblast proliferation, surfactant synthesis, and alveolarization. These data support the hypothesis of hypovitaminosis D as a frequent, modifiable risk factor of RDS and BPD, which should be tested in randomized controlled trials on pregnant women, those with threatening preterm delivery, or in the preterm neonates. Future experimental and human studies should aim to identify optimal time windows, vitamin D doses, and cut-off levels for 25-hydroxyvitamin D in interventions against RDS, BPD, and later adverse respiratory outcomes.

scholarly journals Updates on the Status of Vitamin D as a Risk Factor for Respiratory Distress Syndrome

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Vesara Ardhe Gatera ◽  
Rizky Abdulah ◽  
Ida Musfiroh ◽  
Raden Tina Dewi Judistiani ◽  
Budi Setiabudiawan
Keyword(s):  
Vitamin D ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Animal Studies ◽  
Distress Syndrome ◽  
Vitamin D Supplementation ◽  
Preterm Neonates ◽  
Lung Maturation ◽  
Optimal Dosing ◽  
Dosing Strategies

To update the guidelines regarding vitamin D status in respiratory distress syndrome, we reviewed recent human and animal studies on the benefits of vitamin D in respiratory distress. We searched PubMed and ProQuest for studies on the use of vitamin D from 2009 to 2017. The common parameters in these studies included the use of lung tissue, phospholipids, blood, and plasma to assess the effects of vitamin D on respiratory syndrome. The metabolized form of vitamin D used in these studies was 1,25(OH)2D3 in animal studies and 25(OH)D in human studies. Vitamin D supplementation decreases the risk of respiratory distress syndrome, improves the quality of life, and is relatively effective and safe for preterm neonates as well as during lung maturation. However, although vitamin D supplementation may offer benefits for respiratory distress syndrome, the optimal dosing strategies for specific types of risk factors in the lungs must be clarified to confirm the therapeutic efficacy.

Chorioamnionitis and Early Lung Inflammation in Infants in Whom Bronchopulmonary Dysplasia Develops

PEDIATRICS ◽  
1996 ◽  
Vol 97 (2) ◽  
pp. 210-215 ◽  
Author(s):  
Kristi L. Watterberg ◽  
Laurence M. Demers ◽  
Susan M. Scott ◽  
Shirley Murphy
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Bronchopulmonary Dysplasia ◽  
Lung Inflammation ◽  
Distress Syndrome ◽  
Causative Factor ◽  
Supplemental Oxygen ◽  
Leukotriene B4 ◽  
Thromboxane B2 ◽  
Lung Maturation

Objective. The development of bronchopulmonary dysplasia (BPD) often has been attributed to injury from mechanical ventilation and supplemental oxygen. Early lung inflammation in infants with BPD has been thought to be secondary to these factors. The purpose of this study was to evaluate whether preexisting (prenatal) inflammation may be a primary causative factor in the development of BPD. Methods. Intubated newborns of less than 2000 g birth weight were prospectively enrolled. The presence or absence of chorioamnionitis was documented. Lung inflammation was evaluated on days 1, 2, and 4 of intubation by assaying concentrations of interleukin 1β(IL-1β), thromboxane B2, leukotriene B4, and prostaglandin E2 in tracheal lavages. Infants in whom BPD developed were compared with those in whom it did not using these measures. Results. Fifty-three infants were enrolled; 41 survived. Thirty-eight had respiratory distress syndrome; 15 were intubated for other diagnoses. Infants prenatally exposed to chorioamnionitis were less likely to present with respiratory distress syndrome; however, chorioamnionitis was significantly associated with both the presence of IL-1β from the first day of intubation and the development of BPD. Tracheal lavage concentrations of IL-1β were higher in infants in whom BPD developed. Thromboxane B2 concentrations were similar on day 1 but were higher on days 2 and 4 in infants in whom BPD developed. Conclusions. In this study, intubated infants weighing less than 2000 g at birth in whom BPD developed had increased exposure to inflammation prenatally (chorioamnionitis) and evidence of increased lung inflammation from the first postnatal day. We speculate that chorioamnionitis may accelerate lung maturation but that it also causes lung inflammation and subsequent lung injury in intubated infants, fostering the development of BPD.

Pre-Existing Psychiatric Illness Is Associated With an Increased Risk of Delirium in Patients With Acute Respiratory Distress Syndrome

2021 ◽  
pp. 088506662110190
Author(s):  
Saminder Singh Kalra ◽  
Johnny Jaber ◽  
Bashar N. Alzghoul ◽  
Ryan Hyde ◽  
Sarina Parikh ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Psychiatric Illness ◽  
Distress Syndrome ◽  
Multivariable Logistic Regression Analysis ◽  
Psychiatric Illnesses ◽  
Increased Risk ◽  
Icu Delirium ◽  
The Impact

Background: Patients with acute respiratory distress syndrome (ARDS) are highly susceptible to developing delirium for a multitude of reasons. Previous studies have linked pre-existing depression with an increased risk of postoperative delirium in patients undergoing cardiac and non-cardiac surgery. However, the evidence regarding the association between pre-existing psychiatric illnesses and delirium in ARDS patients is unknown. In this study, we aim to determine the relationship between pre-existing psychiatric illness and the risk of development of delirium amongst ARDS patients. Study Design and Methods: We performed a retrospective study of a mixed group of patients admitted to the intensive care unit (ICU) between January 2016 and December 2019 with a diagnosis of ARDS per the Berlin definition. The study group was divided into 2 cohorts: subjects with delirium and subjects without delirium. Comparison between the 2 groups was conducted to examine the impact of pre-existing psychiatric illnesses including major depressive disorder (MDD), generalized anxiety disorder (GAD), bipolar disorder, schizophrenia, or post-traumatic stress disorder. Multivariable logistic regression analysis was performed adjusting for benzodiazepine use, sedatives, analgesics, sequential organ failure assessment score, and corticosteroid use to determine the association between pre-existing psychiatric disorders and delirium. Results: 286 patients with ARDS were identified; 124 (43%) of whom were diagnosed with ICU delirium. In patients diagnosed with ICU delirium, 49.2% were found to have preexisting psychiatric illnesses, compared to 34.0% without any preexisting psychiatric illness (OR = 1.94, P = 0.01). In a subgroup analysis of individual psychiatric illnesses, GAD and MDD were associated with the development of delirium (OR = 1.88, P = 0.04 and OR = 1.76, P = 0.05 respectively). Interpretation: ARDS patients with preexisting psychiatric illnesses, particularly GAD and MDD are associated with an increased risk of developing ICU delirium. Clinicians should be aware of the effect of psychiatric co-morbidities on developing delirium in critically ill patients.

scholarly journals Vitamin D deficiency contributes directly to the acute respiratory distress syndrome (ARDS)

Thorax ◽  
2015 ◽  
Vol 70 (7) ◽  
pp. 617-624 ◽  
Author(s):  
R. C. A. Dancer ◽  
D. Parekh ◽  
S. Lax ◽  
V. D'Souza ◽  
S. Zheng ◽  
...  
Keyword(s):  
Vitamin D ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Vitamin D Deficiency ◽  
Distress Syndrome

scholarly journals The impact of betamethasone on fetal pulmonary, umbilical and middle cerebral artery Doppler velocimetry and its relationship with neonatal respiratory distress syndrome

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Homeira Vafaei ◽  
Fahimeh Kaveh Baghbahadorani ◽  
Nasrin Asadi ◽  
Maryam Kasraeian ◽  
Azam Faraji ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Distress Syndrome ◽  
Exposed Group ◽  
Doppler Velocity ◽  
Corticosteroid Administration ◽  
The Impact

Abstract Background Prenatal corticosteroid administration is known to be an effective strategy in improving fetal pulmonary maturity. This study aimed to evaluate the impact of maternal betamethasone administration on fetal pulmonary and other arteries Doppler velocity and the correlation between RDS development and Doppler indices results. Methods Fifty one singleton pregnancies between 26 and 34 gestational weeks with a diagnosis of preterm labor were included in the exposed group and received betamethasone. Fifty one uncomplicated pregnancies were included in the non-exposed group. Fetal pulmonary, umbilical and middle cerebral arteries Doppler parameters were evaluated before and 24 to 48 h after steroid administration in the exposed group and two times at same intervals in the non-exposed group. Maternal records were matched to neonatal charts if delivery happened, and demographic and outcome data were abstracted. Results When compared with the nonexposed group, fetuses treated with corticosteroids demonstrated significantly decreased umbilical artery Pulsatility index (PI) and significantly increased the middle cerebral artery PI, pulmonary artery Acceleration time (AT) and pulmonary artery AT/ET (Ejection time), while all other indices remained similar. We found significantly decreased pulmonary artery AT in the fetuses with respiratory distress syndrome (RDS) compared to those that did not. Conclusions The results of our study showed that maternal antenatal betamethasone administration caused significant changes in the fetus blood velocity waveforms and also affected the blood flow in the pulmonary artery which led to an increase in the pulmonary artery AT and AT/ET. Among those fetuses with RDS, we found a significant decrease in the pulmonary artery AT, but we did not observe any pulmonary artery AT/ET differences.

scholarly journals Effect of vitamin D deficiency in Korean patients with acute respiratory distress syndrome

2019 ◽  
Vol 34 (3) ◽  
pp. 685-685 ◽  
Author(s):  
Sojung Park ◽  
Min Gee Lee ◽  
Sang-Bum Hong ◽  
Chae-Man Lim ◽  
Younsuck Koh ◽  
...  
Keyword(s):  
Vitamin D ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Vitamin D Deficiency ◽  
Distress Syndrome ◽  
Korean Patients

scholarly journals Vitamin D deficiency and its effect on respiratory distress syndrome in premature infants: results from a prospective study in a tertiary care centre

2020 ◽  
Vol 20 (1) ◽  
pp. 437-443
Author(s):  
Pelin Dogan ◽  
Hilal Ozkan ◽  
Nilgun Koksal ◽  
Onur Bagci ◽  
Ipek Guney Varal
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Prospective Study ◽  
Premature Infants ◽  
Lung Development ◽  
Distress Syndrome ◽  
Tertiary Care ◽  
Hydroxyvitamin D ◽  
Positive Effects ◽  
25 Hydroxyvitamin D

Background: The positive effects of steroids on lung development are well known, and 1,25-dihydroxy vitamin D3 has been shown to exert positive effects on fetal lung development. Objective: We aimed to investigate the relationship between 25-hydroxyvitamin D [25(OH)D] levels and respiratory distress syn- drome (RDS) in premature infants. Methods: Infants aged ≤32 gestational weeks who were admitted to the neonatal intensive care unit (NICU) during 1 year were enrolled in this prospective study. 25(OH)D levels were obtained at the time of admission to NICU. Patients were divided into three groups according to their 25(OH)D levels: severe (group 1), moderate (group 2), and mild (group 3) 25(OH)D deficiencies. Results: The study comprised 72 patients; of them, RDS was observed in 49 and not observed in 23 patients. The mean 25(OH)D levels were significantly lower in RDS patients (p=0.04). Multivariate analysis showed that patients with higher 25(OH)D levels can be preventive for the development of RDS (odds ratio 0.89; 95% confidence interval 0.8–0.99; p=0.04). Conclusion: Our study revealed that 25(OH)D deficiency is an independent risk factor for RDS in premature infants. However, further studies are necessary to explore the association between 25(OH)D deficiency and RDS. Keywords: 25-hydroxyvitamin D; prematurity; respiratory distress syndrome. 

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