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ICU mortality reduced by non-oral vitamin D – meta-analysis May 2021

The Effect of Vitamin D Supplementation on Clinical Outcomes for Critically Ill Patients: A Systemic Review and Meta-Analysis of Randomized Clinical Trials

Front Nutr. 2021 May 4;8:664940. doi: 10.3389/fnut.2021.664940
Hejuan Shen 1 2, Yijun Mei 1 2, Kai Zhang 3, Xiaoya Xu 1 2

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58% less mortality vs 8% for oral (Note: 8% was not statistically significant)

VitaminDWiki

ICU patients are often are unable to get nutrients orally
However, ICU patients need to get the benefit of Vitamin D as soon as possible
   restoring Vitamin D levels BEFORE the ICU would be ideal,
     Fewer days in hospital if 300,000 IU of vitamin D before brain surgery - RCT Feb 2021
    and sometimes will eliminate having to go to the ICU
Injection of vitamin D into muscle does avoid a poor gut,
  but at the expense of a somewhat slow response

Good options for vitamin D in the ICU appear to be:
1) Vitamin D water if a patient can sip
2) Vitamin D nanoemulsion if a person can swish it in mouth
3) Vitamin D nanoemulsion applied topically (face and/or arms)
     Note: nanoemulsion form is new and is starting to be used in ICU and elsewhere
      COVID-19 inflammation extinguished by Vitamin D nanoemulsion

Vitamin D levels might be raised very quickly summary by VitaminDWiki

Note: The founder of VitamDWiki planned to have nanoemulsion trials (swished in mouth, topical, and inhaled) in 2020, but COVID-19 happened

Poor guts need different forms of vitamin D has the following

Guesses of Vitamin D response if poor gut

Bio FormSpeedDuration
10Injection ($$$)
or Calcidiol or Calcitriol
D - Slow
C -Fast
Long
10 Sun/UVBSlowLong
10Topical
(skin patch/cream, vagina)
Slow
Fast nano
Normal
9Nanoemulsion -mucosal
perhaps activates VDR
FastNormal
9?Inhaled (future)FastNormal
8Bio-D-Mulsion ForteNormalNormal
6Water soluble (Bio-Tech)NormalNormal
4Sublingual/spray
(some goes into gut)
FastNormal
3Coconut oil basedSlowNormal
2Food (salmon etc.)SlowNormal
2Olive oil based (majority)SlowNormal

10= best bioavailable, 0 = worst, guesses have a range of +-2
Speed: Fast ~2-6 hours, Slow ~10-30 hours
Duration: Long ~3-6 months, Normal = ~2 months

Getting Vitamin D into your body has the following chart

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Items in both categories Trauma-surgery and Loading Dose:

Injection category listing has 60 items

Items in both categories Trauma-surgery and injection:

 Download the PDF from VitaminDWiki

Purpose: Vitamin D deficiency is a common scenario in critically ill patients and has been proven to be associated with poor outcomes. However, the effect of vitamin D supplementation for critically ill patients remains controversial. Thus, we conducted a meta-analysis to evaluate the effect of vitamin D supplementation among critically ill patients.

Methods: Electronic databases PubMed, Embase, Scopus, and the Cochrane Library were searched for eligible randomized controlled trials between 2000 and January 2021. The primary outcome was overall mortality, and the secondary ones were the length of intensive care unit stay, the length of hospital stay, as well as the duration of mechanical ventilation. Subgroup analyses were performed to explore the treatment effect by type of admission, route of administration, dose of supplemented vitamin D, and the degree of vitamin D deficiency.

Results: A total of 14 studies involving 2,324 patients were finally included. No effect on overall mortality was found between vitamin D supplementation and control group [odds ratio (OR), 0.73; 95% CI, 0.52-1.03; I 2 = 28%]. The vitamin D supplementation reduced the length of intensive care unit stay [mean difference (MD), -2.25; 95% CI, -4.07 to -0.44, I 2 = 71%] and duration of mechanical ventilation (MD, -3.47; 95% CI, -6.37 to -0.57, I 2 = 88%).
In the subgroup analyses, the vitamin D supplementation for surgical patients (OR, 0.67; 95% CI, 0.47-0.94; I 2 = 0%) or through parenteral way (OR, 0.42; 95% CI, 0.22-0.82, I 2 = 0%) was associated with reduced mortality.

Conclusion: In critically ill patients, the supplementation of vitamin D has no effect on overall mortality compared to placebo but may decrease the length of intensive care unit stay and mechanical ventilation. Further trials are necessary to confirm our findings.


Created by admin. Last Modification: Sunday May 23, 2021 16:07:58 GMT-0000 by admin. (Version 19)

Attached files

ID Name Comment Uploaded Size Downloads
15626 Parenteral.jpg admin 23 May, 2021 14:33 39.58 Kb 102
15625 Critically ill meta - perenteral better than oral_compressed.pdf PDF 2021 admin 23 May, 2021 14:32 588.76 Kb 46
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