No Benefit for Treating Vitamin D Deficiency in Critically Ill Patients

Vitamin deficiencies are common in critically ill patients; however, whether these are markers of illness or modifiable risk factors is unclear. A previous phase 2 clinical trial (JAMA 2014; 312:1520) and subsequent meta-analysis of a series of smaller trials suggested a mortality benefit is associated with repletion of vitamin D among patients in the intensive care unit (ICU).

To test this hypothesis, U.S. investigators randomized more than 1000 critically ill patients with low 25-hydroxyvitamin D levels (<20 ng/mL) to receive a single dose of enteral vitamin D₃ (540,000 international units) or placebo. Baseline mean 25-hydroxyvitamin D levels were 11 ng/mL in both groups; on day 3, mean levels were 47 ng/mL in the vitamin D group and still…