Efficacy and safety of enteral supplementation with high-dose vitamin D in critically ill patients with vitamin D deficiency

Background: Vitamin D deficiency is associated with mortality and morbidity in critically ill patients. This study investigated the safety and effectiveness of enteral high-dose vitamin D supplementation in intensive care unit (ICU) patients in Asia. Methods: This was a multicenter, prospective, ran...

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Main Authors: An-Yi Wang, Yu-Chang Yeh, Kuang-Hua Cheng, Yin-Yi Han, Ching-Tang Chiu, Chai-Chi Chang, I-Ting Wang, Anne Chao
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Journal of the Formosan Medical Association
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Online Access:http://www.sciencedirect.com/science/article/pii/S0929664624002419
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author An-Yi Wang
Yu-Chang Yeh
Kuang-Hua Cheng
Yin-Yi Han
Ching-Tang Chiu
Chai-Chi Chang
I-Ting Wang
Anne Chao
author_facet An-Yi Wang
Yu-Chang Yeh
Kuang-Hua Cheng
Yin-Yi Han
Ching-Tang Chiu
Chai-Chi Chang
I-Ting Wang
Anne Chao
author_sort An-Yi Wang
collection DOAJ
description Background: Vitamin D deficiency is associated with mortality and morbidity in critically ill patients. This study investigated the safety and effectiveness of enteral high-dose vitamin D supplementation in intensive care unit (ICU) patients in Asia. Methods: This was a multicenter, prospective, randomized-controlled study. Eligible participants with vitamin D deficiency were randomly assigned to the control or vitamin D supplementation group. In the vitamin D supplementation group, the patients received 569,600 IU vitamin D. The primary outcome was the serum 25(OH)D level on day 7. Results: 41 and 20 patients were included in the vitamin D supplementation and control groups, respectively. On day 7, the serum 25(OH)D level was significantly higher in the vitamin D supplementation group compared to the control group (28.5 [IQR: 20.2–52.6] ng/mL and 13.9 [IQR: 11.6–18.8] ng/mL, p < 0.001). Only 41.5% of the patients achieved serum 25(OH)D levels higher than 30 ng/mL in the supplementation group. This increased level was sustained in the supplementation group on both day 14 and day 28. There were no significant adverse effects noted in the supplementation group. Patients who reached a serum 25(OH)D level of >30 ng/mL on day 7 had a significantly lower 30-day mortality rate than did those who did not (5.9% vs 37.5%, p < 0.05). Conclusions: In our study, less than half of the patients reached adequate vitamin D levels after the enteral administration of high-dose vitamin D. A reduction in 30-day mortality was noted in the patients who achieved adequate vitamin D levels. Trial registration clinicaltrials.gov id: NCT04292873, Registered, March 1, 2020.
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spelling doaj-art-c40ce5c2e3494b1aa1da60236eaee9ad2025-08-20T02:49:22ZengElsevierJournal of the Formosan Medical Association0929-66462025-04-01124435536010.1016/j.jfma.2024.05.005Efficacy and safety of enteral supplementation with high-dose vitamin D in critically ill patients with vitamin D deficiencyAn-Yi Wang0Yu-Chang Yeh1Kuang-Hua Cheng2Yin-Yi Han3Ching-Tang Chiu4Chai-Chi Chang5I-Ting Wang6Anne Chao7Department of Emergency and Critical Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Emergency Medicine, School of Medicine, College of Medicine, Taipei Medical University, TaiwanDepartment of Anesthesiology, National Taiwan University Hospital, TaiwanDepartment of Critical Care Medicine, Mackay Memorial Hospital, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, TaiwanDepartment of Traumatology, National Taiwan University Hospital, TaiwanDepartment of Anesthesiology, National Taiwan University Hospital, TaiwanDepartment of Anesthesiology, National Taiwan University Hospital, TaiwanDepartment of Critical Care Medicine, Mackay Memorial Hospital, Taiwan; Corresponding author.Department of Anesthesiology, National Taiwan University Hospital, Taiwan; Corresponding authors. Department of Anesthesiology, National Taiwan University Hospital, Taiwan.Background: Vitamin D deficiency is associated with mortality and morbidity in critically ill patients. This study investigated the safety and effectiveness of enteral high-dose vitamin D supplementation in intensive care unit (ICU) patients in Asia. Methods: This was a multicenter, prospective, randomized-controlled study. Eligible participants with vitamin D deficiency were randomly assigned to the control or vitamin D supplementation group. In the vitamin D supplementation group, the patients received 569,600 IU vitamin D. The primary outcome was the serum 25(OH)D level on day 7. Results: 41 and 20 patients were included in the vitamin D supplementation and control groups, respectively. On day 7, the serum 25(OH)D level was significantly higher in the vitamin D supplementation group compared to the control group (28.5 [IQR: 20.2–52.6] ng/mL and 13.9 [IQR: 11.6–18.8] ng/mL, p < 0.001). Only 41.5% of the patients achieved serum 25(OH)D levels higher than 30 ng/mL in the supplementation group. This increased level was sustained in the supplementation group on both day 14 and day 28. There were no significant adverse effects noted in the supplementation group. Patients who reached a serum 25(OH)D level of >30 ng/mL on day 7 had a significantly lower 30-day mortality rate than did those who did not (5.9% vs 37.5%, p < 0.05). Conclusions: In our study, less than half of the patients reached adequate vitamin D levels after the enteral administration of high-dose vitamin D. A reduction in 30-day mortality was noted in the patients who achieved adequate vitamin D levels. Trial registration clinicaltrials.gov id: NCT04292873, Registered, March 1, 2020.http://www.sciencedirect.com/science/article/pii/S0929664624002419Vitamin D deficiencyCritical illnessEfficacySafety
spellingShingle An-Yi Wang
Yu-Chang Yeh
Kuang-Hua Cheng
Yin-Yi Han
Ching-Tang Chiu
Chai-Chi Chang
I-Ting Wang
Anne Chao
Efficacy and safety of enteral supplementation with high-dose vitamin D in critically ill patients with vitamin D deficiency
Journal of the Formosan Medical Association
Vitamin D deficiency
Critical illness
Efficacy
Safety
title Efficacy and safety of enteral supplementation with high-dose vitamin D in critically ill patients with vitamin D deficiency
title_full Efficacy and safety of enteral supplementation with high-dose vitamin D in critically ill patients with vitamin D deficiency
title_fullStr Efficacy and safety of enteral supplementation with high-dose vitamin D in critically ill patients with vitamin D deficiency
title_full_unstemmed Efficacy and safety of enteral supplementation with high-dose vitamin D in critically ill patients with vitamin D deficiency
title_short Efficacy and safety of enteral supplementation with high-dose vitamin D in critically ill patients with vitamin D deficiency
title_sort efficacy and safety of enteral supplementation with high dose vitamin d in critically ill patients with vitamin d deficiency
topic Vitamin D deficiency
Critical illness
Efficacy
Safety
url http://www.sciencedirect.com/science/article/pii/S0929664624002419
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