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Critical illness – Vitamin D levels start low and then drop for several days – Feb 2018

Vitamin D kinetics in the acute phase of critical illness: A prospective observational study

Journal of Critical Care February 2018 Volume 43, Pages 294–299
DOI: http://dx.doi.org/10.1016/j.jcrc.2017.09.179


Highlights
•The vitamin D kinetics in critically ill patients was studied.
•The vitamin D serum level is changeable in the initial phase of a critical illness.
•The median of the vitamin D level decreases until the fourth measurement then stabilizes and finally increases unevenly.
•One of the most likely reasons for such an observation could be a hypothesis that the serum vitamin D concentration mirrors the severity of illness.

Purpose: The objective of this study was to assess the vitamin D kinetics in critically ill patients by performing periodic serum vitamin D measurements in short time intervals in the initial phase of a critical illness.

Materials and methods: We performed vitamin D serum measurements: at admission and then in 12-hour time intervals. The minimum number of vitamin D measurements was 4, and the maximum was 8 per patient.

Results: A total of 363 patients were evaluated for participation, and 20 met the inclusion criteria. All patients had an initial serum vitamin D level between 10.6 and 39 ng/mL. Nineteen patients had vitamin D levels between 10 and 30 ng/mL, which means that they had vitamin D insufficiency or deficiency, and only one patient had a normal vitamin D serum plasma level. We observed that the median of the vitamin D level decreases until the fourth measurement then stabilizes around the 4th and 5th measurement and then appears to increase unevenly. The highest drop is at the very beginning.

Conclusions: The vitamin D serum level is changeable in the initial phase of a critical illness. We hypothesize that the serum vitamin D concentration can mirror the severity of illness.

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