title: Association Between Vitamin D Status and Weaning From Prolonged Mechanical Ventilation in Survivors of Critical Illness.
abstract: BACKGROUND
  In this study, we examined the association between 25-hydroxyvitamin D (25(OH)D) concentration and successful weaning from mechanical ventilation in a cohort of ICU survivors requiring prolonged mechanical ventilation.
  
  
  METHODS
  This was a retrospective cohort study of ICU survivors admitted to a long-term acute care hospital. Demographic data were extracted from medical records, including 25(OH)D concentrations drawn on admission. Subjects were divided into 2 groups based on their 25(OH)D concentrations (deficient, < 20 ng/mL; not deficient, ≥ 20 ng/mL), and associations between 25(OH)D concentration and successful weaning were calculated.
  
  
  RESULTS
  A total of 183 subjects were studied. A high prevalence of 25(OH)D deficiency was found (61%, 111/183). No association was found between 25(OH)D concentration and weaning from mechanical ventilation. Increased comorbidity burden (Charlson comorbidity index) was associated with decreased odds of weaning (odds ratio of 0.50, 95% CI 0.25-0.99, P = .05).
  
  
  CONCLUSIONS
  Vitamin D deficiency is common in ICU survivors requiring prolonged mechanical ventilation. Surprisingly, there was no significant relationship between 25(OH)D concentration and successful weaning. This finding may be due to the low 25(OH)D concentrations seen in our subjects. Given what is known about vitamin D and lung function and given the low vitamin D concentrations seen in patients requiring long-term ventilatory support, interventional studies assessing the effects of 25(OH)D supplementation in these patients are needed.
authors.affiliation: Division of Pulmonary and Critical Care Medicine University of Maryland Claude D Pepper Older Americans Independence Center avercele@medicine.umaryland.edu.
authors.forename: Avelino C
authors.initials: AC
authors.lastname: Verceles
authors.affiliation: Department of Medicine.
authors.forename: Bethany
authors.initials: B
authors.lastname: Weiler
authors.affiliation: Clinical Associates, Life Bridge Health, Towson, Maryland.
authors.forename: Dafna
authors.initials: D
authors.lastname: Koldobskiy
authors.affiliation: University of Maryland Claude D Pepper Older Americans Independence Center Division of Geriatric Medicine, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Goldberg
authors.affiliation: Division of Pulmonary and Critical Care Medicine Department of Epidemiology and Public Health.
authors.forename: Giora
authors.initials: G
authors.lastname: Netzer
authors.affiliation: University of Maryland Claude D Pepper Older Americans Independence Center Division of Geriatric Medicine, University of Maryland School of Medicine, Baltimore, Maryland. Baltimore Veterans Affairs Geriatric Research, Education, and Clinical Center, Baltimore, Maryland.
authors.forename: John D
authors.initials: JD
authors.lastname: Sorkin
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D016638:Critical Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012189:Retrospective Studies; D017741:Survivors; D015300:Ventilator Weaning; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000453:epidemiology*
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: critical illness; prolonged mechanical ventilation; respiratory failure; ventilator weaning; vitamin D