Yadav Sonu, Joshi Poonam, Dahiya Ujjwal, Baidya Dalim Kumar, Goswami Ravinder, Guleria Randeep, Lakshmy Ramakrishnan
Department of Critical Care Nursing and Paediatric Nursing, College of Nursing, All India Institute of Medical Sciences, New Delhi, India.
Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
Indian J Anaesth. 2018 Jan;62(1):47-52. doi: 10.4103/ija.IJA_531_17.
Effect of serum 25-hydroxy vitamin D (25[OH] D) levels on the recovery of critically ill mechanically ventilated patients is unclear. Hence, this study assessed 25(OH)D levels of critically ill patients on mechanical ventilation at the time of admission to the Intensive Care Unit (ICU) and its relationship with clinical outcome.
In this prospective observational pilot study, forty adult patients receiving mechanical ventilation in the ICU were included. Serum 25(OH)D was assessed within 24 h of admission. Primary outcome was 30-day mortality and secondary outcomes were days on mechanical ventilation, ICU-length of stay (ICU-LOS), days to reach spontaneous breathing trial (SBT), requirement of advanced care modality and complications.
Seventy-five percent patients had low serum 25(OH)D (65% deficient and 10% insufficient). Between patients with low and normal vitamin D, there was no significant difference in 30-day mortality (10% vs. 16.7%; = 0.81), days on mechanical ventilation (16.2 ± 8.9 vs. 19.9 ± 8.4; = 0.23), ICU-length of stay (18.7 ± 8.5 vs. 23.3 ± 11.4; = 0.28), days to reach SBT (11.5 (0-20) vs. 21 (8-30); = 0.78), complications developed during ICU stay ( = 0.60) and need for advanced care modalities ( = 0.72).
Low Vitamin D level at admission did not affect 30-day mortality of critically ill patients on mechanical ventilation.
血清25-羟基维生素D（25[OH]D）水平对危重症机械通气患者恢复的影响尚不清楚。因此，本研究评估了重症监护病房（ICU）收治的机械通气危重症患者入院时的25（OH）D水平及其与临床结局的关系。
在这项前瞻性观察性试点研究中，纳入了40例在ICU接受机械通气的成年患者。入院后24小时内评估血清25（OH）D。主要结局是30天死亡率，次要结局是机械通气天数、ICU住院时间（ICU-LOS）、达到自主呼吸试验（SBT）的天数、高级护理方式的需求和并发症。
75%的患者血清25（OH）D水平较低（65%缺乏，10%不足）。维生素D水平低和正常的患者之间，30天死亡率（10%对16.7%；P = 0.81）、机械通气天数（16.2±8.9对19.9±8.4；P = 0.23）、ICU住院时间（18.7±8.5对23.3±11.4；P = 0.28）、达到SBT的天数（11.5（0-20）对21（8-30）；P = 0.78）、ICU住院期间发生的并发症（P = 0.60）和对高级护理方式的需求（P = 0.72）均无显著差异。
入院时维生素D水平低并不影响机械通气危重症患者的30天死亡率。
