Abstract PD-049: PREVENTION OF POST-CARDIAC SURGERY VITAMIN D DEFICIENCY IN CHILDREN WITH CONGENITAL HEART DISEASE: RESULTS OF A PILOT DOSE EVALUATION RANDOMIZED CONTROLLED TRIAL
Bibliographic record
Abstract
Aims & Objectives: Associations between post-operative vitamin D status and illness severity suggest that optimization could improve outcome following pediatric congenital heart disease (CHD) surgery. Methods Two-arm, double blind RCT in children requiring cardiopulmonary bypass for CHD at a Canadian tertiary care center. Eligible patients were randomized to receive either usual care (UC, < 1 year = 400 IU/day, > 1 year=600 IU/day) or high dose (HD) vitamin D supplementation approximating the Institute of Medicine recommended Tolerable Upper Intake Level (< 1 year = 1600 IU/day, > 1 year = 2400 IU/day). The primary outcome was vitamin D status, assessed using blood 25-hydroxyvitamin D (25OHD). Results Forty-six children were randomized (24 HD, 22 UC). Five withdrew, leaving 41 children for analysis (21 HD, 20 UC). Compared to UC, the HD group had higher 25OHD concentrations immediately preoperatively (81.5 ± 36.5 vs. 55.5 ± 13.8 nmol/L, p=0.005) and at time of PICU admission (52.0 ± 23.3 vs. 34.8 ± 12.0 nmol/L, p =0.006). The post-operative rate for 25OHD <50 nmol/L was significantly lower in the HD arm (84% vs. 43%, p = 0.009). Multivariate regression demonstrated longer periods between enrollment and surgery to be associated with higher post-operative 25OHD concentrations (+0.73 nmol/L per week, p=0.02). No vitamin D related adverse events were observed. Conclusions Pre-operative daily high-dose supplementation safely improved post-operative vitamin D status compared to usual care. Findings suggest that an alternative loading dose supplementation strategy may be required to optimize post-operative vitamin D status in children with short intervals between presentation, diagnosis and surgery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".