Outcomes of Vitamin D Supplementation in Adults Who are Deficient and Critically Ill: A Review of the Literature

Abstract

Vitamin D deficiency is known to be common in the general population and has been linked to all-cause mortality. The classically recognized role of vitamin D is its involvement in calcium and phosphorous homeostasis and bone health. Recent evidence suggests that vitamin D may also play a role in other nonskeletal processes, such as anti-proliferation, immunity, regulation of hormone section, and muscle strength. An extensive literature review of vitamin D and critical illness from 2000 to 2015 (PubMed and CINAL) produced multiple observational studies revealing a high prevalence of vitamin D deficiency in intensive care patients. Many of these studies have indicated that there is an association between vitamin D deficiency and clinical outcomes such as mortality, sepsis, duration of mechanical ventilation, and length of stay. This review article provides an overview of vitamin D physiology in adults, a summary of observational studies on vitamin D deficiency in critical illness, and an examination of the few clinical trials on vitamin D supplementation in intensive care patients.

Parenteral Provision of Micronutrients to Adult Patients: An Expert Consensus Paper

“…63 Vitamin D r Vitamin D levels are recognized to be commonly low in critically ill populations and a predictor of outcome. 114,118,122 r Vitamin D is ineffective in the acute setting. The 1,25 hydroxy form is needed when liver and renal functions are suboptimal.…”

Efficacy of high dose versus low dose vitamin D supplementation on serum levels of inflammatory factors and mortality rate in severe traumatic brain injury patients: study protocol for a randomized placebo-controlled trial

“…Antimicrobial proteins are expressed significantly in the respiratory epithelium and other organs and they could reduce risk of infections in integumentary barrier sites (5,6). Notably, infectious diseases such as pneumonia and sepsis are common in traumatic patients leading to more than 20 % rate of death in these patients, in addition there is a high prevalence of vitamin D deficiency in these patients, therefore vitamin D treatment is of high importance in traumatic brain injury (TBI) patients (7)(8)(9). Moreover, vitamin D deficiency is also related to serious complications such as coma, slow neurological recovery and critical illness polyneuropathy in TBI patients (TBI) (10,11).…”

“…Although, there has been a direct association between vitamin D deficiency and adverse clinical outcomes, the data regarding vitamin D supplementation from randomized clinical trials (RCT) are limited (12). It has not yet been shown that vitamin D supplementation can efficiently affect the endpoints of TBI patients (4,9). The type of vitamin D supplement, rout of intervention and speed of normalization may be associated in clinical outcomes (4,9,12).…”

“…It has not yet been shown that vitamin D supplementation can efficiently affect the endpoints of TBI patients (4,9). The type of vitamin D supplement, rout of intervention and speed of normalization may be associated in clinical outcomes (4,9,12). As compared to vitamin D injection, enteral vitamin D administration seems to be more effective and is considered safe (13,14).…”

Efficacy of high dose versus low dose vitamin D supplementation on serum levels of inflammatory factors and mortality rate in severe traumatic brain injury patients: study protocol for a randomized placebo-controlled trial

“…Although, there has been a direct association between vitamin D deficiency and adverse clinical outcomes, the data regarding vitamin D supplementation from randomized clinical trials are limited (12). It has not yet been shown that vitamin D supplementation can efficiently affect the endpoints of TBI patients (4,9). The type of vitamin D supplement, rout of intervention and speed of normalization may be associated in clinical outcomes (4,9,12).…”