Premium
High‐Dose Vitamin D 3 Administration Is Associated With Increases in Hemoglobin Concentrations in Mechanically Ventilated Critically Ill Adults: A Pilot Double‐Blind, Randomized, Placebo‐Controlled Trial
Author(s) -
Smith Ellen M.,
Jones Jennifer L.,
Han Jenny E.,
Alvarez Jessica A.,
Sloan John H.,
Konrad Robert J.,
Zughaier Susu M.,
Martin Greg S.,
Ziegler Thomas R.,
Tangpricha Vin
Publication year - 2018
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607116678197
Subject(s) - medicine , placebo , hepcidin , hemoglobin , vitamin , vitamin d and neurology , anemia , randomized controlled trial , vitamin d deficiency , cholecalciferol , gastroenterology , alternative medicine , pathology
Background : Anemia and vitamin D deficiency are highly prevalent in critical illness, and vitamin D status has been associated with hemoglobin concentrations in epidemiologic studies. We examined the effect of high‐dose vitamin D therapy on hemoglobin and hepcidin concentrations in critically ill adults. Materials and Methods : Mechanically ventilated critically ill adults (N = 30) enrolled in a pilot double‐blind, randomized, placebo‐controlled trial of high‐dose vitamin D 3 (D 3 ) were included in this analysis. Participants were randomized to receive placebo, 50,000 IU D 3 , or 100,000 IU D 3 daily for 5 days (totaling 250,000 IU D 3 and 500,000 IU D 3 , respectively). Blood was drawn weekly throughout hospitalization for up to 4 weeks. Linear mixed‐effects models were used to assess change in hemoglobin and hepcidin concentrations by treatment group over time. Results : At enrollment, >75% of participants in all groups had plasma 25‐hydroxyvitamin D (25(OH)D) concentrations <30 ng/mL, and >85% of participants across groups were anemic. In the 500,000‐IU D 3 group, hemoglobin concentrations increased significantly over time ( P group × time = .01) compared with placebo but did not change in the 250,000‐IU D 3 group ( P group × time = 0.59). Hepcidin concentrations decreased acutely in the 500,000‐IU D 3 group relative to placebo after 1 week ( P = .007). Hepcidin did not change significantly in the 250,000‐IU D 3 group. Conclusion : In these critically ill adults, treatment with 500,000 IU D 3 was associated with increased hemoglobin concentrations over time and acutely reduced serum hepcidin concentrations. These findings suggest that high‐dose vitamin D may improve iron metabolism in critical illness and should be confirmed in larger studies.