Short-term effects of high-dose oral vitamin D3 in critically ill vitamin D deficient patients: a randomized, double-blind, placebo-controlled pilot study

被引：135

作者：

Amrein, Karin ^{[1
,2
]}

Sourij, Harald ^{[1
]}

Wagner, Gerit ^{[3
]}

Holl, Alexander ^{[4
]}

Pieber, Thomas R. ^{[1
]}

Smolle, Karl Heinz ^{[2
]}

Stojakovic, Tatjana ^{[5
,6
]}

Schnedl, Christian ^{[1
]}

Dobnig, Harald ^{[1
]}

机构：

[1] Med Univ Graz, Dept Internal Med, Div Endocrinol & Metab, A-8036 Graz, Austria

[2] Med Univ Graz, Dept Internal Med, Med Intens Care Unit, A-8036 Graz, Austria

[3] Med Univ Graz, Dept Med Informat Stat & Documentat, A-8036 Graz, Austria

[4] Med Univ Graz, Dept Neurol, Div Special Neurol, A-8036 Graz, Austria

[5] Med Univ Graz, Inst Clin Med, A-8036 Graz, Austria

[6] Med Univ Graz, Chem Lab Diagnost, A-8036 Graz, Austria

来源：

CRITICAL CARE | 2011年 / 15卷 / 02期

关键词：

INFLAMMATORY RESPONSE; SUPPLEMENTATION; GUIDELINES; FAILURE; ILLNESS;

D O I：

10.1186/cc10120

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Introduction: Vitamin D deficiency is encountered frequently in critically ill patients and might be harmful. Current nutrition guidelines recommend very low vitamin D doses. The objective of this trial was to evaluate the safety and efficacy of a single oral high-dose vitamin D3 supplementation in an intensive care setting over a one-week observation period. Methods: This was a randomized, double-blind, placebo-controlled pilot study in a medical ICU at a tertiary care university center in Graz, Austria. Twenty-five patients (mean age 62 +/- 16yrs) with vitamin D deficiency [25-hydroxyvitamin D (25(OH) D) <= 20 ng/ml] and an expected stay in the ICU >48 hours were included and randomly received either 540,000 IU (corresponding to 13.5 mg) of cholecalciferol (VITD) dissolved in 45 ml herbal oil or matched placebo (PBO) orally or via feeding tube. Results: The mean serum 25(OH) D increase in the intervention group was 25 ng/ml (range 1-47 ng/ml). The highest 25(OH) D level reached was 64 ng/ml, while two patients showed a small (7 ng/ml) or no response (1 ng/ml). Hypercalcemia or hypercalciuria did not occur in any patient. From day 0 to day 7, total serum calcium levels increased by 0.10 (PBO) and 0.15 mmol/L (VITD; P < 0.05 for both), while ionized calcium levels increased by 0.11 (PBO) and 0.05 mmol/L (VITD; P < 0.05 for both). Parathyroid hormone levels decreased by 19 and 28 pg/ml (PBO and VITD, ns) over the seven days, while 1,25(OH) D showed a transient significant increase in the VITD group only. Conclusions: This pilot study shows that a single oral ultra-high dose of cholecalciferol corrects vitamin D deficiency within 2 days in most patients without causing adverse effects like hypercalcemia or hypercalciuria. Further research is needed to confirm our results and establish whether vitamin D supplementation can affect the clinical outcome of vitamin D deficient critically ill patients.

引用

页数：6

共 28 条

[1] High-dose oral vitamin D3 supplementation in the elderly [J].