Vitamin D Status and Supplementation in the Critically Ill

Curr Gastroenterol Rep. 2016 Apr;18(4):18. doi: 10.1007/s11894-016-0492-2.

Abstract

Vitamin D deficiency has recently been recognized as a widespread global disorder. Generally considered a direct extension of malnutrition, even subclinical hypovitaminosis D is now recognized in adequately nourished populations. Compared to the general population, the prevalence of hypovitaminosis D is greater in the critically ill population. In fact, several studies have shown poorer outcomes in critically ill patients discovered to be vitamin D deficient or insufficient. Controversy persists regarding vitamin D measurements, quantity of supplementation, and appropriate target level in various populations. Vitamin D has a vital role in calcium homeostasis and extra-skeletal health, such as immune function. Therefore, vitamin D supplementation may have a role for improving outcomes in critically ill patients. In this review, we will first discuss the metabolism and function of vitamin D under normal physiologic conditions. We will then explore the prevalence and prognostic value of vitamin D deficiency in critical illness. Finally, we will examine recent trials focusing on appropriate dosing, route of administration, and outcomes associated with vitamin D supplementation in the ICU.

Keywords: Critical care; Hypovitaminosis D; Intensive care; Malnutrition; Vitamin D; Vitamin D deficiency.

Publication types

  • Review

MeSH terms

  • Biomarkers / blood
  • Critical Care / methods
  • Critical Illness / therapy
  • Dietary Supplements*
  • Humans
  • Prognosis
  • Vitamin D / blood
  • Vitamin D / physiology
  • Vitamin D / therapeutic use*
  • Vitamin D Deficiency / diagnosis*
  • Vitamin D Deficiency / drug therapy*
  • Vitamin D Deficiency / epidemiology

Substances

  • Biomarkers
  • Vitamin D