The Effect of Vitamin E Supplementation on Hospital Stay Duration in Non-cyanotic Heart Disease Children With Lower Respiratory Tract Infections

The Effect of Vitamin E Supplementation on Hospital Stay Duration in Non-cyanotic Heart Disease Children With Lower Respiratory Tract Infections - Randomized Controlled Trial

Congenital heart disease can lead to serious health issues, particularly an increased risk of infections, specifically respiratory infections. Lower respiratory tract infections are the fifth leading cause of death globally. Also considered a significant cause of morbidity and mortality among children with congenital heart disease.

In Egypt, it is estimated that 10% of deaths in children under the age of 5 years are probably caused by lower respiratory tract infections and other acute respiratory infections. common non-cyanotic CHD like Ventricular septal defect predispose to bronchopneumonia.

Hemodynamically significant congenital heart disease with pulmonary congestion increases the risk of lower respiratory tract infections and hospitalizations. This relies on several modifiable risk factors, including low socioeconomic status, poor diet, overcrowding, prematurity, male gender, and exposure to secondhand smoke.

Micronutrients play a crucial role in strengthening the immune system. Many Studies have shown that when children are supplemented with various micronutrients, they experience fewer episodes of acute respiratory infections, and the duration and severity of these infections are reduced.

Vitamin E is essential for immune system function and may lower disease risk by enhancing immune responses. It protects neurons and respiratory mucosa from oxidative damage and has been linked to a reduced incidence of asthma and inflammation, potentially safeguarding young children from atopy and wheezing.

There are no available studies in our locality about the effect of vitamin E supplementation on the length of hospital stay for non-cyanotic cardiac patients with lower respiratory tract infections.

Study Overview

• Status: Not yet recruiting
• Conditions: Respiratory Disease
• Intervention / Treatment: Drug: Vitamin E

Detailed Description

Congenital heart disease can lead to serious health issues, particularly an increased risk of infections, specifically respiratory infections. Lower respiratory tract infections are the fifth leading cause of death globally. Also considered a significant cause of morbidity and mortality among children with congenital heart disease.

In Egypt, it is estimated that 10% of deaths in children under the age of 5 years are probably caused by lower respiratory tract infections and other acute respiratory infections. common non-cyanotic CHD like Ventricular septal defect predispose to bronchopneumonia.

Hemodynamically significant congenital heart disease with pulmonary congestion increases the risk of lower respiratory tract infections and hospitalizations. This relies on several modifiable risk factors, including low socioeconomic status, poor diet, overcrowding, prematurity, male gender, and exposure to secondhand smoke.

Micronutrients play a crucial role in strengthening the immune system. Many Studies have shown that when children are supplemented with various micronutrients, they experience fewer episodes of acute respiratory infections, and the duration and severity of these infections are reduced.

Vitamin E is essential for immune system function and may lower disease risk by enhancing immune responses. It protects neurons and respiratory mucosa from oxidative damage and has been linked to a reduced incidence of asthma and inflammation, potentially safeguarding young children from atopy and wheezing.

There are no available studies in our locality about the effect of vitamin E supplementation on the length of hospital stay for non-cyanotic cardiac patients with lower respiratory tract infections.

• Study Type: Interventional
• Enrollment (Estimated): 260
• Phase: Phase 4

Contacts and Locations

• Study Contact: Name: safaa ahmed, master; Phone Number: 01016896337; Email: s.ahmed2795@gmail.com
• Study Contact Backup: Name: safaa ahmed, master; Phone Number: 01016896337; Email: safaaAM@aun.edu.eg

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Pediatric patients are diagnosed with non-cyanotic heart disease associated with severe lower respiratory tract infection. ⁃ The patients are aged 2 months to 5 years of both sexes.

Exclusion Criteria:

• Pediatric patients that have other congenital anomalies other than CHD.

  • Those with chronic respiratory diseases such as asthma, bronchiectasis, etc.).
  • Immunocompromised patients, such as those who receive steroids or chemotherapy, etc.
  • Pediatric patient that received vitamin E in the previous month.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: intervention; The intervention group will receive vitamin E in an appropriate dose during the hospital stay with the treatment protocol for chest infection	Drug: Vitamin E; dose of vitamin E in an appropriate dose for age during hospital stay for intervention group
No Intervention: control group; The control group will receive the treatment protocol for chest infection only or with placebo instead of vitamin E.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
the length of hospital stay	The effect of vitamin E supplementation on the length of hospital stay in non-cyanotic cardiac pediatric patients with lower respiratory tract infections.	During the intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
risk factors	To assess the impact of identified risk factors (e.g., prematurity, malnutrition, severity of pneumonia, and different age groups) on hospital length of stay. - To determine the incidence of complications (e.g., need for ICU, mechanical ventilation, congestive heart failure) concerning identified risk factors.	During the intervention

Collaborators and Investigators

• Sponsor: Assiut University

Publications and helpful links

General Publications

• [1] M. M. Djer and D. B. S. , Emilda Osmardin, Badriul Hegar, "Increased Risk of Recurrent Acute Respiratory Infections in Children with Congenital Heart Disease: A Prospective Cohort Study," Indones. Biomed. J., vol. 12, no. 4, p. p.288-389, 2020, doi: 10.18585/inabj.v12i4.1262. [2] E. Kılıçoğlu and Z. Ü. Tutar, "Evaluation of Children with Congenital Heart Disease Hospitalized with the Diagnosis of Lower Respiratory Tract Infection," J. Pediatr. Res., vol. 5, no. July 2017, pp. 32-36, 2018. [3] Z. Chen, "Circulating micronutrient levels and respiratory infection susceptibility and severity : a bidirectional Mendelian randomization analysis," no. August, 2024, doi: 10.3389/fnut.2024.1373179. [4] A. M. M. Hamed, Y. T. Kassem, H. K. Fayed, and A. M. Solaiman, "Serum zinc levels in hospitalized children with pneumonia: a hospital-based case-control study," Egypt. J. Bronchol., vol. 13, no. 5, pp. 730-737, 2019, doi: 10.4103/ejb.ejb_30_19. [5] N. K. Jat, D. K. Bhagwani, N. Bhutani, U. Sharma, R. Sharma, and R. Gupta, "Assessment of the prevalence of congenital heart disease in children with pneumonia in tertiary care hospital : A cross-sectional study," Ann. Med. Surg., vol. 73, no. November 2021, p. 103111, 2022, doi: 10.1016/j.amsu.2021.103111. [6] O. Investigation, "The Role of the Micronutrients; Vitamin A, Vitamin B12, Iron, Zinc, Copper Levels of Children with Lower Respiratory Tract Infections," pp. 105-109, 2005, doi: 10.5152/ced.2014.1319. [7] M. X. Wang, J. Koh, and J. Pang, "Association between micronutrient deficiency and acute respiratory infections in healthy adults : a systematic review of observational studies," pp. 1-12, 2019. [8] P. C. Calder and P. Yaqoob, "Nutrient Regulation of the Immune Response," Present Knowl. Nutr. Tenth Ed., no. January, pp. 688-708, 2012, doi: 10.1002/9781119946045.ch44. [9] S. Wu and A. Wang, "Serum level and clinical significance of vitamin E in pregnant women with allergic rhinitis," J. Chinese Med. Assoc., vol. 85, no. 5, pp. 597-602, 2022, doi: 10.1097/JCMA.0000000000000723. [10] S. I. Fahmy, L. M. Nofal, S. F. Shehata, H. M. El, and H. K. Ibrahim, "Updating indicators for scaling the socioeconomic level of families for health research," pp. 1-7, 2015, doi: 10.1097/01.EPX.0000461924.05829.93. [11] J. Thokngaen and W. Karoonboonyanan, "Pediatric respiratory severity score evaluates disease severity of respiratory tract infection in children," Chulalongkorn Med. J., vol. 63, no. 1, pp. 41-46, 2019, doi: 10.14456/clmj.1476.6. [12] T. Bohn et al., "Scientific opinion on the tolerable upper intake level for vitamin E," vol. 22, pp. 1-104, 2024, doi: 10.2903/j.efsa.2024.8953.

Study record dates

Study Major Dates

• Study Start (Estimated): June 1, 2025
• Primary Completion (Estimated): June 1, 2026
• Study Completion (Estimated): June 1, 2026

Study Registration Dates

• First Submitted: March 12, 2025
• First Submitted That Met QC Criteria: April 11, 2025
• First Posted (Actual): April 15, 2025

Study Record Updates

• Last Update Posted (Actual): April 15, 2025
• Last Update Submitted That Met QC Criteria: April 11, 2025
• Last Verified: April 1, 2025

More Information

Terms related to this study

• Keywords: RTI-VIT E- CHD
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Infections; Heart Diseases; Respiratory Tract Infections; Respiratory Tract Diseases; Respiration Disorders; Physiological Effects of Drugs; Molecular Mechanisms of Pharmacological Action; Micronutrients; Antioxidants; Protective Agents; Vitamins; Vitamin E
• Other Study ID Numbers: safaa1451995protocol

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No