Effect of Single High Dose Vitamin D Administration in Critically Ill Vitamin D-deficient Pediatric Patients: A Randomized Trial
Indian J Crit Care Med 2025; 29 (2):170-176. DOI: 10.5005/jp-journals-10071-24895
Mrityunjay Sakkarwal, Pallavi Pallavi, Urmila Jhamb, Romit Saxena
Objective: Vitamin D deficiency (VDD) has been thought to be a common modifiable risk factor for severity and clinical outcome during critical illness. The primary objective was to evaluate the effect of single high-dose vitamin D supplementation on mortality in critically ill vitamin D-deficient children. The secondary objective was to study the change in vitamin D levels after the intervention.
Design and setting: This study was a randomized controlled trial conducted at the Department of Pediatrics of a Tertiary Care Hospital from May 2019 to March 2020. Subjects and intervention: Two hundred and fifty vitamin D-deficient children aged 1 month–12 years admitted in pediatric intensive care units (PICU) were randomized into 2 groups (group A received 10,000 U/kg cholecalciferol intramuscularly, group B received no intervention), with 125 in each group. Measurement: Baseline serum calcium, ionized calcium, serum phosphate, vitamin D and parathyroid hormone (PTH) levels were measured at the time of recruitment. Ionized calcium, and kidney function tests (KFT) were repeated at 24 and 72 hours, while vitamin D and PTH levels were repeated at 72 hours only.
Results: Both the groups were comparable for baseline characteristics. There was no statistically significant difference between mortality (p = 0.439), length of PICU stay (p = 0.57) need and duration of mechanical ventilation (p = 0.449) between 2 groups. The subgroup analysis between severe and less severe VDD had similar results. However, there was a significant increase in levels of vitamin D after intervention in group A at 72 hours (p = 0).
Conclusion: Administration of single high dose of vitamin D increases the vitamin D levels but does not convincingly improve the outcomes in vitamin D-deficient critically sick children admitted in PICU.
VitaminDWiki – Injection contains:
- Vitamin D injections last longer (3 month vs 2 month) than loading doses
- Getting Vitamin D into your blood and cells shows the many ways of getting Vitamin D
- Injections are currently made by medical professionals into muscle
- Home injection of Vitamin D appears to be possible in the future
- Injections are useful for people who might forget to take their periodic supplement (children, elderly, etc) and those who cannot swallow or have poor digestion
- While Vitamin D2 is historically the common form, Vitamin D3 is far better
- Should check (if there is time) for possible allergic reaction to Vitamin D or lack of Magnesium for both for loading dose and injection
- Note 600,000 IU Vitamin D loading dose via capsules is 1/20th the cost($2.40) of an injection, and does not require a prescription
- 100,000 IU single dose of vitamin D - 2010 has the following
- Vitamin D injection lasts longer and has bigger response than weekly oral – Jan 2017 has the following
- Non-oral Vitamin D should be a better form for MS, food allergy, PTSD, etc. – many studies might include injection
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