Vitamin D and critical illness outcomes. Issue 4 (August 2016)

• Record Type: Journal Article
• Authors: Christopher, Kenneth B.
• Is Part Of: Current opinion in critical care. Volume 22:Issue 4(2016:Aug.)
• Publication Date: 2016-08
• Subjects: critical care outcomes -- epigenetics -- vitamin D; Critical care medicine -- Periodicals; 616.028
• DOI: 10.1097/MCC.0000000000000328
• Languages: English
• ISSNs: 1070-5295

Abstract

Abstract : Purpose of review: Although low vitamin D levels have been shown to be a risk factor for adverse outcomes in critical care, it is not clear to date if supplementation can alter such outcomes in all ICU patients. The focus of vitamin D research now is on interventional trials to identify a critically ill patient subset who may benefit from high-dose vitamin D supplementation. Recent findings: The VITdAL-ICU trial, a randomized, double-blind, placebo-controlled, single center trial of 475 heterogeneous critically ill patients, did not show improvement in hospital length of stay or overall mortality but did demonstrate in a secondary outcome that high-dose oral vitamin D3 improved mortality in patients with severe vitamin D deficiency. Summary: Vitamin D supplementation may represent a personalized and targeted therapy for critical illness. Vitamin D regulates over 1000 genes in the human genome, and the mechanism of action is influenced by gene polymorphisms and epigenetics. The study of the metabolomics, transcriptomics and epigenetics of vitamin D status and supplementation holds promise generating insights into critical illness outcomes.