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Study links vitamin D to post-surgical recovery times

Logan Irvine was born eight weeks premature with tetralogy of fallot, a congenital heart disease.

Dave Chan/The Globe and Mail

Logan Irvine is a happy four-and-a-half-year-old boy. He loves watching Disney shows, cheering on his favourite team (the Ottawa Senators) and kicking balls around the yard.

But he gets tired faster than other kids his age. He needs to take breaks during physical activities, something his father, Graham Irvine, encourages. "We take every day where he's healthy and happy, we take it all as absolute gold," Irvine said.

Logan was born eight weeks premature with Tetralogy of Fallot, a congenital heart disease that is present when the baby is still in the womb. It's a combination of four defects in the heart that affect its structure and cause a lack of oxygen in the blood.

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When Logan was born, his condition required immediate surgery. His first two months of life were spent in the hospital.

When he was just six months old, Logan underwent his second heart surgery – a cardiac corrective surgery during which doctors installed the pulmonary artery and valve he was missing.

Two years ago, Logan had his third surgery; doctors replaced what thay had already put in. In a few years, those components will need replacing yet again.

Each time Logan has had surgery, he has spent anywhere from a few days to a couple months in recovery. That's tough on kids going through surgeries and on their families.

But a new study from the Children's Hospital of Eastern Ontario Research Institute in Ottawa suggests there may be a way to decrease that amount of recovery time, so children who require congenital heart disease surgery can get better, and get home, sooner.

The study, led by Dr. Dayre McNally, showed that patients who went into the procedure with normal or slightly below normal levels of vitamin D had 40 per cent less vitamin D in their system after surgery.

For the study, McNally took blood samples from 58 children before they went into cardiac surgery, at different points during surgery, and once they were recovering. He found the immediate drop in vitamin D levels happened when the children were hooked up to what is called the heart-lung machine, or the cardiopulmonary bypass machine, which allows surgeons to work on the heart.

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Because the children's vitamin D levels decreased, McNally says, they needed more recovery time post-surgery.

"We've known for 100 years that vitamin D is important for bone health," McNally said, "but more recently, there's rising or compelling evidence that vitamin D is important for other organs – the heart, the lungs, the immune system. All of these organ systems can become quite unwell after surgery."

"The relevance of this finding is that it presents an opportunity to help these organs stay healthier after surgery if we can make sure the kids aren't vitamin D-deficient post-operatively," he said.

McNally said they only have theories at this point as to why the cardiopulmonary bypass machine causes a decrease in vitamin D levels.

"In some ways, it's a concerning finding," McNally said. "In other ways it presents an opportunity. We have vitamin D, which is safe and simple and cheap, so we have this modifiable problem, fixable problem," he said.

The researchers have received funding from Heart and Stroke Foundation of Canada and are embarking on further studies this summer. They hope to optimize vitamin D levels in children before they go into surgery, to see if that helps maintain vitamin D levels after surgery and shorten the kids' recovery time.

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"The idea here is if we can optimize the vitamin D levels prior to going to surgery, and maintain levels in the normal range, that the heart will be healthier and the lungs will be healthier [post surgery]," McNally said.

Graham Irvine is excited by the news of the study.

"A parent doesn't want to see their child suffer for any more time than they have to. We took this as a positive," he said. "If this could in fact help promote his recovery that much faster, we'd be all for it."

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