- Vitamin D supplementation in critically ill patients: a meta-analysis
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Vitamin D supplementation in critically ill patients: a meta-analysis
Front. Nutr., 29 April 2025 https://doi.org/10.3389/fnut.2025.1505616
Wen-He Zheng&#x;Wen-He Zheng1†Jia-Heng Shi&#x;Jia-Heng Shi2†Da-Xing YuDa-Xing Yu2Hui-Bin Huang
Hui-Bin Huang2*
- 1Department of Critical Care Medicine, The Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China
- 2Department of Critical Care Medicine, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
Background: Vitamin D is commonly used in clinical practice, while its clinical significance in critically ill patients remains controversial. Therefore, we aimed to perform a systemic review and meta-analysis to investigate the effect of vitamin D on this patient population.
Methods: We searched for randomized controlled trials (RCTs) in PubMed, Embase, and the Cochrane Library databases from inception until August 15, 2024. Studies evaluating critically ill adult patients who received vitamin D compared to controls were included. The primary outcome was short-term mortality. We used the Cochrane risk of bias tool and GRADE system to evaluate the study quality and evidence. Secondary outcomes were changes in serum 25-hydroxyvitamin D levels, mechanical ventilation (MV) duration, and length of stay (LOS) in the ICU or hospital. We also conducted meta-regression, subgroup analyses, and trial sequential analysis (TSA) to explore the potential heterogeneity among the included trials.
Results: Nineteen RCTs with 2,754 patients were eligible. Overall, vitamin D significantly increased serum 25-hydroxyvitamin D levels and significantly reduced the short-term mortality (risk ratio [RR] = 0.83; 95%CI, 0.70–0.98; p = 0.03, I2 = 13%), duration of MV (MD = −2.96 days; 95% CI, −5.39 to −0.52; I2 = 77%; p = 0.02) and ICU LOS (MD = −2.66 days; 95% CI, −4.04 to −1.29, I2 = 70%; p = 0.0001) but not hospital LOS (MD = −0.48 days; 95% CI, −2.37 to 1.40; I2 = 31%; p = 0.61). The meta-regression analysis revealed that the proportion of MV (MV%) accounted for the source of heterogeneity, and the subgroup analyses based on MV% suggested that the MV group was more likely to benefit from vitamin D applications than the partly MV group in all the predefined outcomes (all p values<0.05). TSA for short-term mortality suggested that more data is required to confirm our main conclusion.
Conclusion: Vitamin D supplementation increased serum 25-hydroxyvitamin D levels and significantly benefited critically ill patients, especially those with MV.
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VitaminDWiki - ICU patients typically benefit from 300-500,000 IU of Vitamin D - many studies
VitaminDWiki - ICU - need Vitamin D ASAP - interview and transcript, Matthews Aug 2024
VitaminDWiki - 4.8 X more likely to die within 28 days of ICU if low Vitamin D - Jan 2024
VitaminDWiki - ICU cost reduced by at least 27,000 dollars if get high dose vitamin D in first week - April 2017
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300,000 IU of Vitamin D - many studies