Fewer days in ICU after 300,000 IU of vitamin D, but not 540,000 – meta-analysis

Created September 2020

Vitamin D supplementation and the outcomes of critically ill adult patients: a systematic review and meta-analysis of randomized controlled trials

Scientific Reports volume 10, Article number: 14261 (2020)

Shao-Huan Lan, Chih-Cheng Lai, Shen-Peng Chang, Li-Chin Lu, Shun-Hsing Hung & Wei-Ting

1. Would expect much better results if had one or more of the following1. Start Loading dose BEFORE ICU* Better still, start before surgery1. Use a Gut-Friendly Vitamin D* Often people in the ICU have poor digestion, and will not absorb the Vitamin D very well1. Use a larger dose for those are obese1. Also use Resveratrol or other supplements that increase Vitamin D getting to cells1. Also use Omega-3 - which had been found to help in the ICU 1. # Items in both categories Meta-analysis and Loading Dose:{category} 1. Loading Dose of Vitamin D category has the following{include}

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This meta-analysis assessed the association between vitamin D supplementation and the outcomes of critically ill adult patients. A literature search was conducted using the PubMed, Web of Science, EBSCO, Cochrane Library, Ovid MEDLINE, and Embase databases until March 21, 2020. We only included randomized controlled trials (RCTs) comparing the efficacy of vitamin D supplementation with placebo in critically ill adult patients. The primary outcome was their 28-day mortality. Overall, 9 RCTs with 1867 patients were included. In the pooled analysis of the 9 RCTs, no significant difference was observed in 28-day mortality between the vitamin D supplementation and placebo groups (20.4% vs 21.7%, OR, 0.73; 95% CI, 0.46–1.15; I2 = 51%). This result did not change as per the method of vitamin D supplementation (enteral route only: 19.9% vs 18.2%, OR, 1.19; 95% CI, 0.88–1.57; I2 = 10%; intramuscular or intravenous injection route: 25.6% vs 40.8%, OR, 0.48; 95% CI, 0.21–1.06; I2 = 19%) or daily dose (high dose: 20.9% vs 19.8%, OR, 0.83; 95% CI, 0.51–1.36; I2 = 53%; low dose: 15.6% vs 21.3%, OR, 0.74; 95% CI, 0.32–1.68; I2 = 0%). No significant difference was observed between the vitamin D supplementation and placebo groups regarding the length of ICU stay (standard mean difference [SMD], − 0.30; 95% CI, − 0.61 to 0.01; I2 = 60%), length of hospital stay (SMD, − 0.17; 95% CI, − 041 to 0.08; I2 = 65%), and duration of mechanical ventilation (SMD, − 0.41; 95% CI, − 081 to 0.00; I2 = 72%). In conclusion, this meta-analysis suggested that the administration of vitamin D did not provide additional advantages over placebo for critically ill patients. However, additional studies are needed to confirm our findings.

Tags: Loading dose Meta-analysis Trauma and surgery