Ventilator-associated pneumonia death rate cut in half by Vitamin D injection (300,000 IU) – RCT

Created December 2017

Effect of Vitamin D Supplementation on Procalcitonin as Prognostic Biomarker in Patients with Ventilator Associated Pneumonia Complicated with Vitamin D Deficiency.

Iran J Pharm Res. 2017 Summer;16(3):1254-1263.

Miroliaee AE1, Salamzadeh J1, Shokouhi S2, Fatemi A3, Ardehali SH4, Hajiesmaeili MR5, Sahraei Z1.

Suspect even better results if: 1. Injection was given sooner 1. Larger injection was used * (not much increased n Vitamin D level - suggest 600,000 IU) 1. A second injection was made a few weeks later 1. See also VitaminDWiki * 10 fewer days of ICU Mechanical Ventilation 300,000 IU injection of vitamin D – RCT March 2019 * Much higher hospital costs (ICU and pneumonia) if low vitamin D – Dec 2015 * 18 fewer hospital days if given 500,000 IU of vitamin D while ventilated in ICU – RCT June 2016 * ICU survival increased with vitamin D single 540K IU loading dose - JAMA Sept 2014 * Chance of dying in hospital cut in half by just 10 ng higher level of Vitamin D – April 2016 * * Injection category listing has items along with related searches * Trauma and Surgery category listing has items along with related searches**

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Ventilator-associated pneumonia (VAP) is a common and serious problem that develops after more than 48 h of mechanical ventilation. Improving the activity of immune system with vitamin D, and its consequent impact on prognostic biomarkers of VAP was studied in the current study. A randomized double blind placebo controlled clinical trial was designed.

A total of 46 patients with VAP, who were suffering from vitamin D deficiency, were randomly allocated into the study groups of placebo (n=22) and treatment (n=24) The treatment group received 300,000 units of intramuscular vitamin D . Serum levels of procalcitonin and vitamin D along with SOFA and CPIS scores were determined at baseline and on day 7 after intervention. The mortality rate of patients was also monitored for the succeeding 28 days after the injection. The administration of vitamin D significantly enhanced its levels (P<0.0001) in the treated patients (12.28 ± 8.26) in comparison to placebo group (1.15 ± 1.50). The levels of PCT were significantly decreased (p=0.001) in the treatment group (- 0.02 ± 0.59 ng/mL) compared to that of placebo group (0.68 ± 1.03 ng/mL). However, changes in (SOFA) and CPIS scores were not significantly different between study groups (p=0.63 and p=0.32, respectively).

Interestingly, the mortality rate of patients in the treatment group (5/24) was significantly lower (p=0.04) than that of the placebo group (11/22). (21% vs 50%)

In conclusion, our results indicate that vitamin D supplementation can significantly reduce the procalcitonin in (VAP) patients, and must be considered as a preventive and/or therapeutic strategy.

PMID: 29201115

Tags: Injection Intervention Intervention - non daily Mortality Trauma and surgery