title: Vitamin D Status and Supplementation in the Critically Ill.
abstract: Vitamin D deficiency has recently been recognized as a widespread global disorder. Generally considered a direct extension of malnutrition, even subclinical hypovitaminosis D is now recognized in adequately nourished populations. Compared to the general population, the prevalence of hypovitaminosis D is greater in the critically ill population. In fact, several studies have shown poorer outcomes in critically ill patients discovered to be vitamin D deficient or insufficient. Controversy persists regarding vitamin D measurements, quantity of supplementation, and appropriate target level in various populations. Vitamin D has a vital role in calcium homeostasis and extra-skeletal health, such as immune function. Therefore, vitamin D supplementation may have a role for improving outcomes in critically ill patients. In this review, we will first discuss the metabolism and function of vitamin D under normal physiologic conditions. We will then explore the prevalence and prognostic value of vitamin D deficiency in critical illness. Finally, we will examine recent trials focusing on appropriate dosing, route of administration, and outcomes associated with vitamin D supplementation in the ICU.
authors.affiliation: Department of Surgery, University of Louisville School of Medicine, 550 South Jackson Street, Louisville, KY, 20222, USA.
authors.forename: T J
authors.initials: TJ
authors.lastname: McKinney
authors.affiliation: Department of Medicine, Division of Pulmonary & Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Jayshil J
authors.initials: JJ
authors.lastname: Patel
authors.affiliation: Department of Surgery, University of Louisville School of Medicine, 550 South Jackson Street, Louisville, KY, 20222, USA.
authors.forename: Matthew V
authors.initials: MV
authors.lastname: Benns
authors.affiliation: Department of Surgery, University of Louisville School of Medicine, 550 South Jackson Street, Louisville, KY, 20222, USA.
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Nash
authors.affiliation: Department of Surgery, University of Louisville School of Medicine, 550 South Jackson Street, Louisville, KY, 20222, USA. krmill10@louisville.edu.
authors.forename: Keith R
authors.initials: KR
authors.lastname: Miller
mesh_terms: D015415:Biomarkers / Q000097:blood; D003422:Critical Care / Q000379:methods; D016638:Critical Illness / Q000628:therapy; D019587:Dietary Supplements; D006801:Humans; D011379:Prognosis; D014807:Vitamin D / Q000097:blood / Q000502:physiology / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D014807:Vitamin D
keywords: Critical care; Hypovitaminosis D; Intensive care; Malnutrition; Vitamin D; Vitamin D deficiency