Effect of Oral Versus Intramuscular Vitamin D Replacement on Oxidative Stress and Outcomes in Traumatic Mechanical Ventilated Patients Admitted to Intensive Care Unit.

Abstract

This study aimed to evaluate the safety and efficacy of 2 forms of vitamin D supplementation on oxidative stress and weaning from the ventilator in patients with traumatic injury and vitamin D deficiency. Seventy-two patients were randomly divided into 3 groups: receiving 50,000 IU pearl cholecalciferol daily for 6 days, 1 intramuscular injection of 300,000 IU of cholecalciferol, or a control group that did not receive any supplement. Duration of mechanical ventilation, body composition, and biochemical biomarkers were measured before and after the intervention. At the end of the study, the mean serum 25(OH)D increased in the intervention groups compared with the control group (P<.05). The interleukin 6, erythrocyte sedimentation rate, C-reactive protein levels, Sequential Organ Failure Assessment score, duration of mechanical ventilation, and length of intensive care unit admission significantly decreased; however, total antioxidant capacity concentration did not differ significantly between the 2 intervention groups. Among the body composition variables, extracellular water ratio changes were statically different in oral vitamin D group compared with the control group (P=.001). No side effects were reported with the supplements. Vitamin D administration improved clinical signs and biochemical biomarkers in a small group of patients with traumatic injury. Well-designed multicenter clinical studies with longer intervention duration are necessary for this field.