Outcome of High Dose Vitamin D on Prognosis of Sepsis Requiring Mechanical Ventilation: A Randomized Controlled Trial

Abstract

Abstract Background Critically ill patients have an increased requirement for vitamin D in sepsis and these patients have low levels of vitamin D. The researchers validated the efficiency and safety of high-dose oral vitamin D (50,000 IU) in patients with sepsis requiring mechanical ventilation. Methods Seventy five patients were randomly assigned to 2 groups (Group I = 37 patient and Group II = 38 patient) in accordance with the vitamin D treatment regimen: Group I (GI): patients received 50,000 IU vitamin D crushed and diluted in 50 ml of water and delivered to patients in the nasogastric tube (NGT) once daily for 5 consecutive days; Group II (GII): patients received daily requirements of vitamin D (5000 IU/ day) crushed in 50 ml of water and delivered to patients in the nasogastric tube (NGT) once daily for 5 consecutive days. Primary outcome of this study was the change in procalcitonin levels at day 7 and the changes in plasma vitamin D levels were secondary outcomes. Results Procalcitonin (PCT) decreased at day 4 and day 7 in study groups, procalcitonin (PCT) levels at days 4, 7 were significantly lower in high dose group (p < 0.032 and p < 0.013, respectively) and procalcitonin (PCT) levels reductions (day 7 – day 0) were significantly higher in high dose group (p < 0.010). Serum vitamin D (25(OH)D) levels increased at day 4 then decreased at day 7 in study groups, serum Vitamin D (25(OH)D) levels at days 4, 7 were significantly higher in high dose group (p < 0.001 and p < 0.001, respectively) and serum Vitamin D (25(OH)D) levels elevations (day 7 – day 0) were significantly higher in high dose group (p < 0.001). Conclusion The early use of high-dose oral vitamin D in patients with sepsis requiring mechanical ventilation in combination with the standard treatment for sepsis lowered the procalcitonin level, increased the antioxidant status, and improved the illness severity. Trial Registration This trial is registered with ClinicalTrials.gov Identifier (NCT05244018).