Vitamin D and the Critically Ill - meta-analysis

Vitamin D Supplementation in Critically Ill Patients: A Meta-Analysis of Randomized Controlled Trials

Cureus. 2022 Apr 30;14(4):e24625. doi: 10.7759/cureus.24625

Sahib Singh 1, Sauradeep Sarkar 1, Kushagra Gupta 2, Amit Rout 1

Randomized controlled trials (RCTs) have reported conflicting outcomes with the use of vitamin D in critically ill patients. With reporting of newer RCTs, we conducted this updated meta-analysis. Electronic databases were searched for RCTs comparing vitamin D with placebo in critically ill patients admitted to the intensive care unit (ICU). A random-effects meta-analysis was used to calculate the risk ratio (RR) and standardized mean difference (SMD) with a 95% confidence interval (CI). Eleven RCTs with a total of 2,187 patients (vitamin D: n = 1,120; placebo: n = 1,067) were included.

Vitamin D when compared to placebo was associated with the

• decreased duration of mechanical ventilation (SMD = -0.50; 95% CI = [-0.97, -0.03]; p = 0.04) and

• ICU stay (SMD = -0.60; 95% CI = [-1.03, -0.16]; p = 0.007)

without any difference in the

• mortality (RR = 0.85; 95% CI = [0.68, 1.04]; p = 0.12) and

• length of hospital stay (SMD = -0.21; 95% CI = (-0.51, 0.09); p = 0.18].

Subgroup analysis showed that

• parenteral vitamin D may reduce the risk of mortality (RR = 0.54; 95% CI = [0.35, 0.83], p = 0.005).

Vitamin D supplementation in critically ill patients

• decreases the duration of mechanical ventilation and

• ICU stay.

Further studies should identify specific groups of patients who will derive the most benefit from vitamin D supplementation.

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This meta-analysis ignores dose size, frequency, when it is given, etc.

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