Administration of vitamin D and its metabolites in critically ill adult patients: an updated systematic review with meta-analysis of randomized controlled trials.
Critically ill
Mechanical ventilator weaning
Meta-analysis
Mortality
Nutrition
Vitamin D
Journal
Critical care (London, England)
ISSN: 1466-609X
Titre abrégé: Crit Care
Pays: England
ID NLM: 9801902
Informations de publication
Date de publication:
06 09 2022
06 09 2022
Historique:
received:
01
03
2022
accepted:
25
08
2022
entrez:
6
9
2022
pubmed:
7
9
2022
medline:
9
9
2022
Statut:
epublish
Résumé
The clinical significance of vitamin D administration in critically ill patients remains inconclusive. The purpose of this systematic review with meta-analysis was to investigate the effect of vitamin D and its metabolites on major clinical outcomes in critically ill patients, including a subgroup analysis based on vitamin D status and route of vitamin D administration. Major databases were searched through February 9, 2022. Randomized controlled trials of adult critically ill patients with an intervention group receiving vitamin D or its metabolites were included. Random-effect meta-analyses were performed to estimate the pooled risk ratio (dichotomized outcomes) or mean difference (continuous outcomes). Risk of bias assessment included the Cochrane tool for assessing risk of bias in randomized trials. Sixteen randomized clinical trials with 2449 patients were included. Vitamin D administration was associated with lower overall mortality (16 studies: risk ratio 0.78, 95% confidence interval 0.62-0.97, p = 0.03; I Vitamin D supplementation in critically ill patients may reduce mortality. Parenteral administration might be associated with a greater impact on mortality. Heterogeneity and assessed certainty among the studies limits the generalizability of the results. PROSPERO international prospective database of systematic reviews (CRD42021256939-05 July 2021).
Sections du résumé
BACKGROUND
The clinical significance of vitamin D administration in critically ill patients remains inconclusive. The purpose of this systematic review with meta-analysis was to investigate the effect of vitamin D and its metabolites on major clinical outcomes in critically ill patients, including a subgroup analysis based on vitamin D status and route of vitamin D administration.
METHODS
Major databases were searched through February 9, 2022. Randomized controlled trials of adult critically ill patients with an intervention group receiving vitamin D or its metabolites were included. Random-effect meta-analyses were performed to estimate the pooled risk ratio (dichotomized outcomes) or mean difference (continuous outcomes). Risk of bias assessment included the Cochrane tool for assessing risk of bias in randomized trials.
RESULTS
Sixteen randomized clinical trials with 2449 patients were included. Vitamin D administration was associated with lower overall mortality (16 studies: risk ratio 0.78, 95% confidence interval 0.62-0.97, p = 0.03; I
CONCLUSIONS
Vitamin D supplementation in critically ill patients may reduce mortality. Parenteral administration might be associated with a greater impact on mortality. Heterogeneity and assessed certainty among the studies limits the generalizability of the results.
TRIAL REGISTRATION
PROSPERO international prospective database of systematic reviews (CRD42021256939-05 July 2021).
Identifiants
pubmed: 36068584
doi: 10.1186/s13054-022-04139-1
pii: 10.1186/s13054-022-04139-1
pmc: PMC9446655
doi:
Substances chimiques
Vitamins
0
Vitamin D
1406-16-2
Types de publication
Journal Article
Meta-Analysis
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
268Informations de copyright
© 2022. The Author(s).
Références
Osteoporos Int. 2018 Aug;29(8):1697-1711
pubmed: 29713796
Horm Metab Res. 2020 Mar;52(3):168-178
pubmed: 32215888
Indian J Crit Care Med. 2021 Oct;25(10):1147-1154
pubmed: 34916747
J Clin Transl Endocrinol. 2016 Jun;4:59-65
pubmed: 27419080
Front Nutr. 2021 May 04;8:664940
pubmed: 34017850
JAMA. 2021 Mar 16;325(11):1053-1060
pubmed: 33595634
N Engl J Med. 2019 Dec 26;381(26):2529-2540
pubmed: 31826336
Iran J Pharm Res. 2019 Spring;18(2):1067-1072
pubmed: 31531088
Crit Care. 2021 Jul 23;25(1):260
pubmed: 34301303
PLoS One. 2020 Dec 14;15(12):e0243768
pubmed: 33315950
J Neurosurg. 2019 Sep 13;:1-10
pubmed: 31518978
Front Immunol. 2018 Jul 02;9:1511
pubmed: 30013565
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2017 Feb;29(2):106-110
pubmed: 28625255
JAMA. 2014 Oct 15;312(15):1520-30
pubmed: 25268295
Syst Rev. 2015 Apr 25;4:57
pubmed: 25908184
BMJ. 2008 Apr 26;336(7650):924-6
pubmed: 18436948
BMJ. 2021 Mar 29;372:n71
pubmed: 33782057
Endocr Connect. 2018 Dec 1;7(12):R304-R315
pubmed: 30352414
J Intensive Care Med. 2020 Oct;35(10):992-1001
pubmed: 30270710
Cochrane Database Syst Rev. 2021 May 24;5:CD015043
pubmed: 34029377
Nutr Clin Pract. 2020 Jun;35(3):548-558
pubmed: 31486158
Am J Respir Crit Care Med. 2014 Sep 1;190(5):533-41
pubmed: 25029202
Biol Blood Marrow Transplant. 2016 Jul;22(7):1271-1274
pubmed: 27044905
J Crit Care. 2018 Apr;44:300-305
pubmed: 29248753
Sci Rep. 2020 Aug 31;10(1):14261
pubmed: 32868842
Clin Nutr. 2022 Jun;41(6):1357-1424
pubmed: 35365361
Health Technol Assess. 2019 Jan;23(2):1-44
pubmed: 30675873
J Autoimmun. 2017 Dec;85:78-97
pubmed: 28733125
Circ Res. 2018 May 25;122(11):1576-1585
pubmed: 29798901
Crit Care Med. 2015 Sep;43(9):1928-37
pubmed: 26086941
BMJ. 2019 Aug 28;366:l4898
pubmed: 31462531
Clin Nutr. 2019 Dec;38(6):2756-2762
pubmed: 30583965
BMJ Open. 2019 Nov 12;9(11):e031083
pubmed: 31722941
BMC Anesthesiol. 2015 Jun 04;15:84
pubmed: 26041306
Clin Nutr. 2018 Aug;37(4):1238-1246
pubmed: 28549527
J Crit Care. 2017 Apr;38:109-114
pubmed: 27883968
Crit Care. 2022 Jan 19;26(1):23
pubmed: 35045885
Clin Drug Investig. 2020 Apr;40(4):327-334
pubmed: 32172522
Crit Care. 2011;15(2):R104
pubmed: 21443793
Epidemiol Health. 2021;43:e2021074
pubmed: 34607398
Metabolism. 2021 Jun;119:154753
pubmed: 33774074
BMC Infect Dis. 2020 Mar 4;20(1):189
pubmed: 32131740
J Steroid Biochem Mol Biol. 2020 Oct;203:105751
pubmed: 32871238
Indian J Endocrinol Metab. 2017 Jan-Feb;21(1):131-136
pubmed: 28217512
BMC Med Res Methodol. 2017 Mar 6;17(1):39
pubmed: 28264661