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Vitamin D supplementation in critically ill patients: a meta-analysis
Wen-He Zheng1, Jia-Heng Shi2, Da-Xing Yu2
1Department of Critical Care Medicine, The Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China.
Frontiers in Nutrition
|May 15, 2025
Summary
Vitamin D supplementation improves outcomes for critically ill patients, reducing mortality and mechanical ventilation duration. Further research is needed to confirm these benefits, especially for those on mechanical ventilation.
Area of Science:
- Critical Care Medicine
- Endocrinology
- Nutritional Science
Background:
- The role of vitamin D in critically ill patients is debated.
- Vitamin D is widely used, but its efficacy in severe illness requires clarification.
- This study addresses the controversy surrounding vitamin D's impact on critical care outcomes.
Purpose of the Study:
- To systematically review and meta-analyze randomized controlled trials (RCTs) on vitamin D's effects in critically ill adults.
- To evaluate vitamin D's impact on short-term mortality, serum 25-hydroxyvitamin D levels, mechanical ventilation duration, and length of stay.
Main Methods:
- Searched PubMed, Embase, and Cochrane Library for RCTs up to August 15, 2024.
- Included studies compared vitamin D supplementation versus control in critically ill adults.
- Assessed study quality using Cochrane risk of bias and GRADE; analyzed outcomes including mortality, serum vitamin D, mechanical ventilation (MV) duration, and length of stay (LOS) using meta-regression, subgroup, and trial sequential analyses (TSA).
Main Results:
- Nineteen RCTs involving 2,754 patients were analyzed.
- Vitamin D significantly increased serum 25-hydroxyvitamin D levels.
- It significantly reduced short-term mortality (RR=0.83), MV duration (MD=-2.96 days), and ICU LOS (MD=-2.66 days), but not hospital LOS.
- Meta-regression identified the proportion of patients on MV as a source of heterogeneity, with MV patients showing greater benefit.
- TSA indicated more data is needed to confirm the mortality findings.
Conclusions:
- Vitamin D supplementation effectively raises serum 25-hydroxyvitamin D levels in critically ill patients.
- Vitamin D demonstrates significant benefits, particularly for patients requiring mechanical ventilation, reducing mortality and resource utilization.
- While promising, further trials are recommended to definitively confirm the mortality benefit, especially in the context of mechanical ventilation.
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