الفهرس 
Introduction & Aim of the workOnly 14 pages are availabe for public view
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Abstract
Acute malnutrition is a global public health problem, that remains a major cause of child mortality worldwide. It is a major cause of morbidity and mortality in low-income countries due to multifactorial causes for example vitamins deficiency as vitamin D which has important functions besides bone and calcium homeostasis.
In this work, we tried to evaluate the effect of acute malnutrition and vitamin D deficiency on morbidity and mortality in pediatric intensive care unit.
In our prospective case-control study, 210 patients were admitted to the Pediatric Intensive Care Unit, Minia University Children Hospital ,they were selected during the period of June 2019 to November 2019. The investigations were done in the Clinical Pathology Department, Minia University Hospital.
Patients were classified into groups:
1-group (Ι): malnourished child
Which is further subdivided to: Group( Ι a): moderate malnourished child.
group (Ι b): severe malnourished child.
2-group (Π): normal weight for age child.
All patients were subjected to full history taking, thorough clinical examination, and laboratory investigations including CBC, liver function, renal function, serum electrolyte, random blood sugar,CRP, blood culture and serum vitamin D level.
Our results showed that;
Among the 210 cases, 101 patients (48.1%) were malnourished, 109 patients (51.9%) were normal weight for age. The infant age group was more predominant in both malnourished group and normal weight group . most of malnourished patient were from rural area.
Children who were delayed weaned after 6 months and who depend on artificial feeding were more predominant in severe malnourished group.
Concerning assessment of intubation incidence and PICU length of stay our results showed statistically significant correlation between malnutrition and length of PICU stay where most of severe malnourished group stayed more than 10 days in PICU , average of moderate malnutrition group duration was 7-10 days in PICU while in normal weight children stayed less than 7 days (p value 0.0001).
The outcome of severely malnourished patients was expressed by mortality of 79.1% in comparison with 43.1% for normal weight child (P<0.0001).
Regarding laboratory investigation, significant increase in serum urea level, hypokalemia and hypocalcaemia were more in severe malnourished patients compared to those of normal weight group.
Regarding serum level of vitamin D; as the prevalence of hypovitaminosis D on PICU admission was highly significant among all studied group. Lowest level was in severe malnourished patients, lower in moderate malnourished patients than normal weight patient.
It was obvious that vitamin D level was significantly low in patients from rural area and delayed weaned patients.
We observed significant negative correlation between both incidence of ventilation & longer duration of PICU stay and low serum vitamin D level.