Alessandro Putzu1, Alessandro Belletti2, Tiziano Cassina3, Sara Clivio4, Giacomo Monti5, Alberto Zangrillo6, Giovanni Landoni7. 1. Department of Cardiovascular Anesthesia and Intensive Care, Fondazione Cardiocentro Ticino, Lugano, Switzerland. Electronic address: alessandroputzu@ymail.com. 2. Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy. Electronic address: belletti.ale@gmail.com. 3. Department of Cardiovascular Anesthesia and Intensive Care, Fondazione Cardiocentro Ticino, Lugano, Switzerland. Electronic address: tiziano.cassina@cardiocentro.org. 4. Department of Cardiovascular Anesthesia and Intensive Care, Fondazione Cardiocentro Ticino, Lugano, Switzerland. Electronic address: sara.clivio@cardiocentro.org. 5. Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy. Electronic address: monti.giacomo@hsr.it. 6. Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy. Electronic address: zangrillo.alberto@hsr.it. 7. Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy. Electronic address: landoni.giovanni@hsr.it.
Abstract
PURPOSE: Low vitamin D blood levels are associated with high mortality in critically ill patients. There is controversy about vitamin D supplementation in this population. The objective of this meta-analysis was to evaluate if vitamin D administration reduces mortality in critically ill patients. MATERIALS AND METHODS: Online databases were searched up to September 1st, 2016 for randomized placebo-controlled trials on the use of vitamin D in adult patients with critical illness. The primary end point was mortality among trials with low risk of bias. The secondary end points were length of hospital stay, length of intensive care unit stay, length of mechanical ventilation, and adverse events. RESULTS: Seven studies published between 2011 and 2016, for a total of 716 patients, were included in the analysis. Vitamin D administration was associated with significantly lower mortality compared with placebo (101/320 [32%] in the vitamin D group vs 123/307 [40%] in the placebo group; odds ratio, 0.70 [95% confidence interval, 0.50 to 0.98]; P=.04; I2=0%). No differences in adverse events and other secondary end points were found. CONCLUSIONS: In critically ill patients, vitamin D administration might be associated with a reduction in mortality without significant adverse events. A large multicenter randomized trial should conclusively confirm these findings.
PURPOSE: Low vitamin D blood levels are associated with high mortality in critically illpatients. There is controversy about vitamin D supplementation in this population. The objective of this meta-analysis was to evaluate if vitamin D administration reduces mortality in critically illpatients. MATERIALS AND METHODS: Online databases were searched up to September 1st, 2016 for randomized placebo-controlled trials on the use of vitamin D in adult patients with critical illness. The primary end point was mortality among trials with low risk of bias. The secondary end points were length of hospital stay, length of intensive care unit stay, length of mechanical ventilation, and adverse events. RESULTS: Seven studies published between 2011 and 2016, for a total of 716 patients, were included in the analysis. Vitamin D administration was associated with significantly lower mortality compared with placebo (101/320 [32%] in the vitamin D group vs 123/307 [40%] in the placebo group; odds ratio, 0.70 [95% confidence interval, 0.50 to 0.98]; P=.04; I2=0%). No differences in adverse events and other secondary end points were found. CONCLUSIONS: In critically illpatients, vitamin D administration might be associated with a reduction in mortality without significant adverse events. A large multicenter randomized trial should conclusively confirm these findings.
Authors: Jenny E Han; Jessica A Alvarez; Jennifer L Jones; Vin Tangpricha; Mona A Brown; Li Hao; Lou Ann S Brown; Greg S Martin; Thomas R Ziegler Journal: Nutrition Date: 2017-02-27 Impact factor: 4.008
Authors: Adit A Ginde; Roy G Brower; Jeffrey M Caterino; Lani Finck; Valerie M Banner-Goodspeed; Colin K Grissom; Douglas Hayden; Catherine L Hough; Robert C Hyzy; Akram Khan; Joseph E Levitt; Pauline K Park; Nancy Ringwood; Emanuel P Rivers; Wesley H Self; Nathan I Shapiro; B Taylor Thompson; Donald M Yealy; Daniel Talmor Journal: N Engl J Med Date: 2019-12-11 Impact factor: 91.245
Authors: Dayre McNally; Karin Amrein; Katharine O'Hearn; Dean Fergusson; Pavel Geier; Matt Henderson; Ali Khamessan; Margaret L Lawson; Lauralyn McIntyre; Stephanie Redpath; Hope A Weiler; Kusum Menon Journal: Pilot Feasibility Stud Date: 2017-12-08