Vitamin D and critical illness

clips from a post September 30, 2011 by Dr John Cannell

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Lee P. Vitamin D metabolism and deficiency in critical illness. - see below

• “Collectively these results provide unequivocal evidence that vitamin D insufficiency and deficiency are highly prevalent among critically ill patients.”

• “These results demonstrate current replacement regimes are grossly inadequate.”

He ends by citing studies showing death in the ICU and the CCU is 2-3 times higher for the vitamin D deficient.

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Vitamin D metabolism and deficiency in critical illness.

Best Pract Res Clin Endocrinol Metab. 2011 Oct;25(5):769-81.

Lee P.

Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, Queensland, Australia; School of Medicine, University of Queensland, Australia; Centres for Health Research, Princess Alexandra Hospital, Brisbane, Queensland, Australia.

Vitamin D deficiency is highly prevalent and has been associated with a diverse range of chronic medical conditions in the general population.

In contrast, the prevalence, pathogenesis and significance of vitamin D deficiency have received little attention in acute medicine.

Vitamin D deficiency is seldom considered and rarely corrected adequately, if at all, in critically ill patients.

Recent recognition of the extra-skeletal, pleiotropic actions of vitamin D in

• immunity,

• epithelial function and

• metabolic regulation

may underlie the previously under-recognized contribution of vitamin D deficiency to typical co-morbidities in critically ill patients, including

• sepsis,

• systemic inflammatory response syndrome and

• metabolic dysfunction.

Improved understanding of vitamin D metabolism and regulation in critical illness may allow therapeutic exploitation of vitamin D to improve outcome in critically ill patients.

PMID: 21925077

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See also VitaminDWiki

• All items in After surgery or trauma 55 items as of Feb 2012

• 540,000 IU active vitamin D before ICU raised vitamin D level average at least 25 ng – March 2011

• ICU time is 2X more likely to be longer than 2 days if vitamin D less than 20 ng – Mar 2011

• Health Care Providers save $ by providing vitamin D before and/or after surgery or trauma - reduces the time in bed, etc.

• Virtually all veterans in ICU had vitamin D less than 32 ng – Jan 2011