Effect of High-Dose Vitamin D₃on Hospital Length of Stay in Critically Ill Patients With Vitamin D Deficiency

Abstract

clinicaltrials.gov Identifier: NCT01130181.

Critically Ill Children Have Low Vitamin D Binding Protein, Influencing Bioavailability of Vitamin D

“…An intervention trial of calcitriol therapy in critically ill adults with sepsis did not have an impact on the primary outcome, antimicrobial peptide levels (29). A recent trial of high-dose vitamin D3 repletion in deficient critically ill adults did not show an impact on mortality or length of stay, except for subjects with the lowest 25(OH)D levels (,12 ng/ml) (30). The severely 25(OH)D-deficient group that was treated had lower mortality at 28 days after ICU admission, at hospital discharge, and at 6 months later (30).…”

Vitamin D deficiency in the critically ill

“…As in the total group no outcome effects were demonstrated that this may potentially imply that some patients also may have had some negative effects of the supplementation, although this cannot directly be concluded from the published data. For the total group, supplementation does not seem to be warranted, possibly only for those patients with severe deficiency (26).…”

“…Amrein and coworkers showed a survival benefit of supplementation in severely deficient patients (26).…”

Serum Vitamin D Level at ICU Admission and Mortality

“…In support of this, many studies report that vitamin D supplementation in critically ill patients is associated with decreased mortality (27,28). Conversely, in the VITdAL-ICU study, administration of high dose vitamin D compared with placebo did not reduce hospital length of stay, hospital mortality, or 6-month mortality (29). We found that the median APACHE II score and number of organ dysfunction were 28 and 2, respectively, in 38 non-survivor patients with low vitamin D level even though vitamin D had been administered to them, and they were 27.5 and 3 in 8 non-survivor patients with normal vitamin D level.…”