Abstract
BACKGROUND: In this study, we examined the association between 25-hydroxyvitamin D (25(OH)D) concentration and successful weaning from mechanical ventilation in a cohort of ICU survivors requiring prolonged mechanical ventilation.
METHODS: This was a retrospective cohort study of ICU survivors admitted to a long-term acute care hospital. Demographic data were extracted from medical records, including 25(OH)D concentrations drawn on admission. Subjects were divided into 2 groups based on their 25(OH)D concentrations (deficient, < 20 ng/mL; not deficient, ≥ 20 ng/mL), and associations between 25(OH)D concentration and successful weaning were calculated.
RESULTS: A total of 183 subjects were studied. A high prevalence of 25(OH)D deficiency was found (61%, 111/183). No association was found between 25(OH)D concentration and weaning from mechanical ventilation. Increased comorbidity burden (Charlson comorbidity index) was associated with decreased odds of weaning (odds ratio of 0.50, 95% CI 0.25–0.99, P = .05).
CONCLUSIONS: Vitamin D deficiency is common in ICU survivors requiring prolonged mechanical ventilation. Surprisingly, there was no significant relationship between 25(OH)D concentration and successful weaning. This finding may be due to the low 25(OH)D concentrations seen in our subjects. Given what is known about vitamin D and lung function and given the low vitamin D concentrations seen in patients requiring long-term ventilatory support, interventional studies assessing the effects of 25(OH)D supplementation in these patients are needed.
Footnotes
- Correspondence: Avelino C Verceles MD, Division of Pulmonary and Critical Medicine, University of Maryland School of Medicine, 110 South Paca Street, Second Floor, Baltimore, MD 21201. E-mail: avercele{at}medicine.umaryland.edu.
This work was supported by National Institute on Aging Grant R03 AG045100 (to Dr Verceles), University of Maryland Claude D Pepper Older Americans Independence Center Grant P30 AG028747 from the National Institute on Aging and the Baltimore Veterans Affairs Geriatric Research, Clinical, and Education Center (to Drs Verceles, Goldberg, and Sorkin), and National Institutes of Health Grant 5R21AG045573-02 (to Dr Netzer). The authors have disclosed no conflicts of interest.
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