Abstract
It is well documented that a large percentage of the general population is either vitamin D insufficient or deficient. Vitamin D deficiency adversely affects bone health. More recently, it has been reported that vitamin D is an important component in immune function and glycemic control Substantial data exist that demonstrate an association between vitamin D insufficiency/deficiency and mortality/clinical outcomes of critically ill patients. The larger clinical trials addressing this association have demonstrated an increased odds ratio for mortality in both vitamin D insufficient and deficient patients when compared to those with sufficient vitamin D. There is also some evidence that vitamin D status worsens during critical illness without supplementation of this vitamin. Supplementation of vitamin D during critical illness of patients with vitamin D deficiency has been studied, but not in great detail. Daily supplementation of the recommended dietary allowance (RDA) of vitamin D does very little to improve the 25(OH)D serum concentrations in the critically ill patients with vitamin D insufficiency or deficiency. There is some evidence that high-dose therapy of vitamin D improves the depressed serum concentrations of this vitamin; however, there are no clinical outcome data available yet. The association between vitamin D insufficiency or deficiency and clinical outcome in the critically ill appears to be important. Supplementation of vitamin D will increase the serum concentrations of this vitamin; however the optimal dose needs to be identified along with an assessment of clinical outcome.
Highlights
Vitamin D is a required nutrient in the human diet
It is recognized that vitamin D is important in bone health and it is critical in calcium and phosphorus balance
They reported a significant association between vitamin D deficiency and an increased severity of illness at ICU admission. 25(OH)D deficiency was significantly associated with fewer hospital free days; no significant association was found between vitamin D deficiency and mortality
Summary
Vitamin D is a required nutrient in the human diet. The Food and Nutrition Board Recommended. [14] In patients with asthma, reduced vitamin D concentrations were associated with airway hyper-responsiveness and reduced glucocorticoid response, and increasing vitamin D concentrations were associated with improved lung function [8] In another study, vitamin D insufficiency and deficiency were shown to be significantly associated with respiratory disease mortality [4]. The high prevalence of vitamin D deficiency and the disease and mortality associated with it in the general population led to the concern that this disorder would be important in the critically ill. In this population there is a substantial amount of literature about vitamin D deficiency and its associated morbidity and mortality [16]. This review aims to highlight the prevalence of vitamin D deficiency in the critically ill population, assess the clinical implications of vitamin D deficiency, and evaluate the effects of vitamin D supplementation in this population
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