Role of Pre-operative Vitamin D Supplementation to Reduce Post-Thyroidectomy Hypocalcemia; Cohort Study.
Int J Surg. 2019 Sep 5. pii: S1743-9191(19)30227-4. doi: 10.1016/j.ijsu.2019.08.035.
Rehman M1, Bhettani MK2, Ahmed M3, Altaf HN4, Choudry UK5, Khan KH6.
Note: Best if can raise vitamin D levels to > 30 ng before surgery.
- Orthopaedic surgeries need Vitamin D – many studies
- Foot and Ankle Surgeries should benefit from Vitamin D – Feb 2019
- Low vitamin D at ICU admission is associated with cancer, infections, acute respiratory insufficiency and liver failure – Oct 2018
- Better Surgical outcomes if preceded by Vitamin D loading dose – Oct 2018
- Anesthesia can cause cognitive problems in elderly with low vitamin D - many studies
- Vitamin D appears essential to survive many critical illnesses - review Oct 2018
- Getting Vitamin D before heart surgery prevented Afib in those who had been deficient – July 2018
- Improve your health BEFORE surgery (prehabilitation) helps your recovery - 2018
Files that are in both categories: Intervention and Trauma/Surgery
- Half as much AFIB after bypass if 600,000 IU of vitamin D before surgery – RCT April 2022
- Half as many problems if take Vitamin D (300,000 IU) before thyroidectomy – RCT Jan 2021
- Those getting an injection of 300,000 IU Vitamin D got out of the ICU a week sooner – RCT Dec 2020
- Traumatic Brain Injury – 120,000 IU of Vitamin D resulted in 3 fewer days on ventilators – RCT March 2020
- Better Surgical outcomes if preceded by Vitamin D loading dose – Oct 2018
- Knee replacement not helped by 2,000 IU of vitamin D (both too late and too little) – RCT July 2018
- Heart attack ICU costs cut in half by Vitamin D – Oct 2018
- Urinary sepsis – a single Vitamin D injection reduced hospital days by 40 percent – RCT April 2018
- Ventilator-associated pneumonia death rate cut in half by Vitamin D injection (300,000 IU) – RCT July 2017
- ICU cost reduced by at least 27,000 dollars if get high dose vitamin D in first week - April 2017
- Vitamin D and Glutamine reduced Trauma Center deaths by half – March 2017
- Hospital ICU added high dose vitamin D - malpractice lawsuit costs dropped from 26 million dollars to ZERO - Oct 2016
- Vitamin D and exercise after hip fracture surgery – far fewer deaths – July 2016
- 18 fewer hospital days if given 500,000 IU of vitamin D while ventilated in ICU – RCT June 2016
- ICU death rate reduced 3X when a vitamin D injection changed the PTH – Nov 2015
- Heart Attack ICU costs reduced $37,000 by $20 of Vitamin D – Nov 2015
- Vitamin D intervention increased by 20 percent the survival of critically ill patients- RCT June 2014
- Vitamin D aided progesterone in reducing traumatic brain injury – RCT Dec 2012
- Sepsis is both prevented and treated by Vitamin D - many studies
Files that are in both categories: Loading Dose and Trauma/Surgery
- Large dose Vitamin D before surgery was found to help by 35 studies
- Vitamin D is needed before most surgeries – many studies and RCTs
- Half as much AFIB after bypass if 600,000 IU of vitamin D before surgery – RCT April 2022
- ICU mortality reduced by non-oral vitamin D – meta-analysis May 2021
- Taking Vitamin D just before and after surgery helps (open-heart in this case) – RCT Feb 2021
- Half as many problems if take Vitamin D (300,000 IU) before thyroidectomy – RCT Jan 2021
- Fewer days in hospital if 300,000 IU of vitamin D before brain surgery - RCT Feb 2021
- ICU Vitamin D injection (300,000 IU) helped - RCT Feb 2021
- Those getting an injection of 300,000 IU Vitamin D got out of the ICU a week sooner – RCT Dec 2020
- ICU patients greatly helped by Vitamin D loading doses – if gut-friendly – Oct 2020
- Fewer days in ICU after 300,000 IU of vitamin D, but not 540,000 – meta-analysis Aug 2020
- 3X less Septic Shock in children with sepsis getting 150,000 IU of Vitamin D - RCT June 2020
- 100,000 IU daily of Vitamin D for 5 days increased Hemoglobin in Mechanically Ventilated adults – RCT Jan 2018
- Traumatic Brain Injury – 120,000 IU of Vitamin D resulted in 3 fewer days on ventilators – RCT March 2020
- Hip surgery with multiple doses of 50,000 IU of vitamin D weekly both before and after – RCT 2023
- Use of Vitamin D in a trauma surgery - Dr. Matthews on Facebook – Jan 2020
- Surgeries often deplete Vitamin D - 300,000 IU resulted in little response – Nov 2018
- 10 fewer days of ICU Mechanical Ventilation 300,000 IU injection of vitamin D – RCT March 2019
- Intensive Care (ICU) helped by Vitamin D – review of past and on-going studies – Dec 2018
- ICU adults getting 540,000 IU of Vitamin D were 2X more likely to be alive 30 days later – RCT June 2019
- Traumatic Brain Injury recovery helped by injection of 100,000 IU of Vitamin D – March 2019
- Rapidly restore Vitamin D levels with 10,000 IU per kg for children in ICU – RCT 2024
- Esophageal Cancer surgery helped by 300,000 IU of Vitamin D – RCT Sept 2018
- Severe sepsis may be prevented by 400,000 IU of vitamin D – RCT 2023
- Critically ill children – randomized clinical trial to give single doses of up to 400,000 IU of vitamin D – 2019
- Vitamin D loading doses reduce ICU mortality by 30 percent – meta-analysis April 2017
- Children in Intensive Care need Vitamin D loading dose of 10000 IU per kg (nearing a consensus) - Oct 2016
- Vitamin D Loading dose - 20,000 IU daily is not enough if obese, etc. (Cancer) great table and chart – Oct 2016
- Rapid Normalization of Vitamin D in Critically Ill Children (10,000 IU per kg) – clinical trial
- VITdAL-ICU - AMA RCT Sept 2014
- Critically ill need vitamin D – how much and which test to use is TBD – Nov 2014
- ICU survival increased with vitamin D single 540K IU loading dose - JAMA Sept 2014
- 540000 IU before ICU raised vitamin D by 25 ng in 2 days – March 2011
- Hip surgery followed by 100000 IU then 1000 IU of vitamin D daily – June 2010
- 600,000 IU intramuscular D3 helped BMD after pancreatic surgery – June 2010
Files that are in both categories: Injection and Trauma/Surgery
- Oral Vitamin D much better than injection (after Knee Arthroplasty in this case) – Sept 2021
- ICU mortality reduced by non-oral vitamin D – meta-analysis May 2021
- Fewer days in hospital if 300,000 IU of vitamin D before brain surgery - RCT Feb 2021
- ICU Vitamin D injection (300,000 IU) helped - RCT Feb 2021
- Those getting an injection of 300,000 IU Vitamin D got out of the ICU a week sooner – RCT Dec 2020
- 10 fewer days of ICU Mechanical Ventilation 300,000 IU injection of vitamin D – RCT March 2019
- Following brain surgery Vitamin D injections did not raise blood levels much – RCT June 2019
- Traumatic Brain Injury recovery helped by injection of 100,000 IU of Vitamin D – March 2019
- Vitamin D levels might be raised very quickly
- Urinary sepsis – a single Vitamin D injection reduced hospital days by 40 percent – RCT April 2018
- Ventilator-associated pneumonia death rate cut in half by Vitamin D injection (300,000 IU) – RCT July 2017
- 300,000 IU Vitamin D injection before brain tumor surgery – RCT to finish Dec 2017
- 600,000 IU intramuscular D3 helped BMD after pancreatic surgery – June 2010
INTRODUCTION:
Hypocalcaemia after thyroidectomy is observed with increasing frequency, often resulting in prolonged hospital stay with increased use of resources, delayed return to work and reduced quality of life. The administration of vitamin D is essential in the therapy of postoperative hypocalcaemia. What has not been examined so far is whether and how routine preoperative vitamin D prophylaxis can help to prevent postoperative hypocalcaemia.
MATERIALS AND METHODS:
This is a prospective cohort study which was conducted from June 2016 to July 2017 at a tertiary care hospital. One hundred and two patients with thyroid disease who were admitted for thyroid surgery were interviewed and underwent physical examination and laboratory investigations. The patients enrolled in the study were randomly assigned to either the Interventional group (Pre-operative Vitamin D Supplementation) or the control group (placebo). The work is reported in line with the standards set by STROCCS criteria 1.
RESULTS:
Out of 102 patients there were 89 females (87.25%) and 13 males (12.7%) with a mean age of 39.35 ± 7.01 years. In the test group 45(88.2%) patients had no clinical hypocalcemia, 5(9.82%) had latent while 1(2%) patient had overt hypocalcemic symptoms. In placebo group 37(72.5%) had no clinical hypocalcemia, 10(19.6%) had latent and 4(7.8%) had overt hypocalcemic symptoms. (P-value<0.05).
CONCLUSION:
As the general population is deficient in Vitamin D, a prophylactic vitamin D dose given in immediate preoperative period can significantly reduce acute symptomatic postoperative hypocalcemia in patients undergoing thyroid surgery.