Vitamin D and outcomes in adult critically ill patients. A systematic review and meta-analysis of randomized trials

• Published in: Journal of critical care 2017-04, Vol.38, p.109-114
• Main Authors: Putzu, Alessandro, Belletti, Alessandro, Cassina, Tiziano, Clivio, Sara, Monti, Giacomo, Zangrillo, Alberto, Landoni, Giovanni
• Format: Article
• Language: English
• Subjects: Bias; Critical Care; Critical illness; Critical Illness - mortality; Dietary Supplements; Hospitals; Humans; Hypotheses; Hypothesis testing; Intensive Care Units; Intervention; Meta-analysis; Mortality; Population; Randomized Controlled Trials as Topic; Sepsis; Studies; Survival; Vitamin D; Vitamin D - administration & dosage; Vitamin D - blood; Vitamin deficiency
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2016.10.029

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 endpoint was mortality among trials with low risk of bias. The secondary endpoints 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 to placebo (101/320 [32%] in the Vitamin D group versus 123/307 [40%] in the placebo group, OR =0.70 [95% CI, 0.50, 0.98], P = .04, I2 = 0%). No differences in adverse events and other secondary endpoints 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.