500,000 IU of vitamin D cut in half the hospital days following a lung failure – RCT 2015

Created May 2015

A Pilot Randomized Controlled Trial Of High-Dose Vitamin D In Lung Failure

Jenny E. Han , MD.MSc 1 , , 2 , Jennifer L. Jones , PhD, RD 3 , Mona Brown , BSN 4 , Vin Tangpricha , MD, PhD 3 , Lou Ann Brown , PhD 4 , Li Hao , MD 3 , Gautam Hebbar , MD,MPH 5 , Shuling Liu , MS 4 , Thomas R. Ziegler , MD 5 , Gregory S. Martin , MD MSc 4 ,

Publication Date: 2015

Presented at American Thoracic Society meeting in Denver

Small Random Controlled Trial

31 patients – average 21 ng Vitamin D

Vitamin D loading dose spread over 5 days

|| |500,000 IU |250,000 IU|0 IU

Length of stay| 18 days|25 days|36 days

Vitamin D @ 14 days|62 ng |29 ng |21 ng||

Note: days and ng are correct, and different than in the submitted abstract

A Pilot Randomized Controlled Trial of High-Dose Vitamin D in Lung Failure,

J.E. Han, MD.MSc, J.L. Jones, PhD, RD, M. Brown, BSN, V. Tangpricha, MD, PhD, L.A. Brown, PhD, L. Hao, MD, G. Hebbar, MD,MPH, S. Liu, MS, T.R. Ziegler, MD, G.S. Martin, MD MSc

Atlanta, GA/US

Rationale: Immune dysfunction and nosocomial infections are important contributors to short-term and long-term survival after critical illness. Cost-effective adjunctive therapies that can be rapidly implemented to improve the host response are imperative. It is now well established that vitamin D has pleotrophic effects on immune cells by upregulation of antimicrobial peptides, (e.g. LL-37).

Methods: We completed a double blind, randomized, controlled trial to evaluate the safety and efficacy of two doses of vitamin D3 (total 250,000 IU or 500,000 IU over 5 days,) versus placebo in adult critically ill patients with respiratory failure. Our purpose was to determine whether high-dose vitamin D3 would increase plasma 25(OH)D and LL-37 levels (measured by chemiluminescence and ELISA, respectively) without adverse effects and whether this would improve clinical outcomes [hospital and ICU length of stay (LOS), ventilator days, SOFA score, hospital infection rate].

Results: 31 subjects were enrolled and completed the treatment protocol. Mean age was 62.9, 61% male, 47% Black, 42% surgical patients, 43% infection on admission, mean APACHE I I score 22.4 and mean SOFA 7.6. These were equally balanced across all groups except for race. Aggregated mean values of 25 (OH)D and LL-37 were greater with Vitamin D3 treatment. (Table 1)

Table 1. 25(OH)D and LL-37 and Clinical Outcomes Across Groups (Just top portion of the table).