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Vitamin D deficiency, often defined by total serum 25-hydroxyvitamin D (25[OH]D) &lt;20 ng/ml, is common in critically ill patients, with associations with increased mortality and morbidity in the intensive care unit. Correction of vitamin D deficiency in critical illness has been recommended, and ongoing clinical trials are investigating the effect of repletion on patient outcome. The biologically active amount of 25(OH)D depends on the concentration and protein isoform of vitamin D-binding protein (VDBP), which is also an acute-phase reactant affected by inflammation and injury.

Critically Ill Children Have Low Vitamin D Binding Protein, Influencing Bioavailability of Vitamin D