1,000 IU of vitamin D daily did not help ICU much (no surprise)

Created February 2019

Vitamin D Supplementation in Mechanically Ventilated Patients in the Medical Intensive Care Unit

Journal of Parenteral and Enteral Nutrition https://doi.org/10.1002/jpen.1520

Timothy R. Leclair MD Neil Zakai MD, MSc Janice Y. Bunn PhD Michael Gianni BA Daren K. Heyland MD, MSc Sara S. Ardren PA Renee D. Stapleton MD, PhD

Note: The paltry 1,000 IU dosing informatiion is deep inside of the PDF "...supplementation during critical illness at our institution is commonly suggested by our dietitians, with usual doses of 1000 international units (IU) daily" Many of the successful ICU studies use 30X larger daily or loading doses which are 300X larger The items which are in both Intervention and Trauma/Surgery are listed here {category} Pages in BOTH of the categories: Trauma/Surgery and Loading Dose {category}

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Background

The utility of vitamin D (VITD) supplementation during critical illness and whether it may alter outcomes, including mortality and ventilator‐free days, is unclear. We performed a retrospective cohort study in a generalizable population to investigate this question.

Methods

We included all mechanically ventilated adults admitted to the medical intensive care unit (ICU) service at a tertiary center from 2009 to 2012 who were in the ICU for at least 72 hours. Patients were grouped as having received or not received VITD at any time during the first 7 days of their ICU stay, and we adjusted for the following covariates with multivariable analyses: simplified acute physiology score, age, gender, admission diagnosis, race/ethnicity, admission season, admission day of the week, and VITD supplementation prior to admission.

Results

Among the 610 included patients, 281 received VITD, and 329 did not. There were no differences in outcomes between these groups. However, we did find significantly more ventilator‐free days (21.0±2.6 [adjusted mean days±standard error] vs 17.6±2.4, P=0.04) and ICU‐free days (18.5±2.5 vs 16.3±2.3, P=0.03) in patients who were taking VITD prior to admission (n=91) vs those who were not (n=519). No patients who were taking VITD before admission died vs 34.5% of those who were not (estimated odds ratio=4.9×10−7, 95% CI=3.1×10−7 to 7.5×10−7, P<0.0001).

Conclusion

These results suggest that VITD supplementation during critical illness may not provide benefit and that further research investigating potential supplementation in ambulatory patients at high risk of ICU admission (eg, severe underlying chronic disease) is warranted.

Tags: Trauma and surgery