Vitamin D and critical illness outcomes.
Although low vitamin D levels have been shown to be a risk factor for adverse outcomes in critical care, it is not clear to date if supplementation can alter such outcomes in all ICU patients. The focus of vitamin D research now is on interventional trials to identify a critically ill patient subset who may benefit from high-dose vitamin D supplementation.



The VITdAL-ICU trial, a randomized, double-blind, placebo-controlled, single center trial of 475 heterogeneous critically ill patients, did not show improvement in hospital length of stay or overall mortality but did demonstrate in a secondary outcome that high-dose oral vitamin D3 improved mortality in patients with severe vitamin D deficiency.



Vitamin D supplementation may represent a personalized and targeted therapy for critical illness. Vitamin D regulates over 1000 genes in the human genome, and the mechanism of action is influenced by gene polymorphisms and epigenetics. The study of the metabolomics, transcriptomics and epigenetics of vitamin D status and supplementation holds promise generating insights into critical illness outcomes.
The Nathan E. Hellman Memorial Laboratory, Division of Renal Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Kenneth B
KB
Christopher
D016638:Critical Illness / Q000628:therapy*; D019587:Dietary Supplements; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D044623:Nutrition Therapy; D016896:Treatment Outcome; D014807:Vitamin D / Q000008:administration & dosage* / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000628:therapy*; D014815:Vitamins / Q000008:administration & dosage* / Q000627:therapeutic use
D014815:Vitamins; D014807:Vitamin D