• Pascal L Langlois, Celeste Szwec, Frédérick D'Aragon, Daren K Heyland, and William Manzanares.
• Department of Anesthesiology and Reanimation, Faculty of Médecine and Health Sciences, Sherbrooke University Hospital, Sherbrooke, Québec, Canada.
• Clin Nutr. 2018 Aug 1; 37 (4): 1238-1246.

IntroductionVitamin D insufficiency is reported in up to 50% of the critically ill patients and is associated with increased mortality, length of stay (LOS) in intensive care unit (ICU) and hospital, and respiratory disorders with prolonged ventilation. Benefits of vitamin D supplementation remain unclear. The aim of this systematic review was to evaluate the clinical benefits of vitamin D administration in critically ill patients.MethodsWe searched Medline, Embase, CINAHL and Cochrane database for randomized controlled trials (RCT) conducted on heterogeneous ICU patients comparing vitamin D administration to placebo. Evaluated outcomes included mortality, infectious complications, hospital/ICU LOS and length of mechanical ventilation. Two independent reviewers assessed eligibility, risk of bias and abstracted data. Data was pooled using a random effect model to estimate the risk ratio (RR) or weighted mean difference. Pre-defined subgroup analysis included oral-enteral vs. parenteral administration, high vs. low dose, vitamin d deficient patient, high vs. low quality trials.ResultsSix RCTs (695 patients) met study inclusion. No reduction in mortality was found (P = 0.14). No differences in ICU and hospital LOS, infection rate and ventilation days existed. In the subgroup analysis, the oral-enteral group, there was no improvement in mortality (P = 0.12) or hospital LOS (P = 0.16). Daily doses >300,000 IU did not improve mortality (P = 0.12) and ICU LOS (P = 0.12).ConclusionsIn critically ill patients, Vitamin D administration does not improve clinical outcomes. The statistical imprecision could be explained by the sparse number of trials.Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

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