Outcomes of High-Dose Versus Low-Dose Vitamin D on Prognosis of Sepsis Requiring Mechanical Ventilation: A Randomized Controlled Trial.
Ashoor. Tarek Mohamed TM; Abd Elazim. Abd Elmoniem Hassan AEH; Mustafa. Zakaria Abd Elaziz ZAE; Anwar. Maha Ahmad MA; Gad. Ihab Ahmad IA; Mamdouh Esmat. Ibrahim I
Key Findings
- High‑dose vitamin D (50,000 IU) significantly increased serum LL‑37 levels by day 7
- Procalcitonin, a marker of infection severity, dropped more in the high‑dose group
- SOFA scores and hospital length of stay were markedly better with high‑dose vitamin D; early ventilator‑associated pneumonia was less common
- No cases of 25‑hydroxyvitamin‑D toxicity were observed
Practical Outcomes
- A short, high‑dose vitamin D regimen may boost innate immunity via LL‑37 and improve outcomes in acute severe infections. For biohackers, this suggests that a brief, medically‑supervised high‑dose vitamin D boost could be explored during serious infections, but it’s not a routine daily protocol and should be used with caution and monitoring.
Summary
Giving a big single dose of vitamin D (50,000 IU) to very sick patients with sepsis on a ventilator raised their natural antimicrobial peptide LL‑37, lowered an infection marker (procalcitonin), improved organ‑failure scores, cut the risk of early pneumonia and shortened hospital stay, without causing vitamin‑D toxicity.
Abstract
<b>Background:</b> Critically ill patients with sepsis have a high incidence of vitamin D deficiency. Vitamin D promotes the synthesis of human cathelicidin antimicrobial peptide, a precursor of LL-37, which is a part of the innate immune system. This study investigated the effectiveness and safety of the early administration of high-dose enteral vitamin D<sub>3</sub> in comparison with low-dose vitamin D<sub>3</sub> in patients with sepsis requiring mechanical ventilation (MV). <b>Methods:</b> Eighty adult patients with sepsis requiring MV with known vitamin D deficiency were randomly assigned to receive either an enteral 50 000 IU (Group I) or 5000 IU (Group II) vitamin D supplementation. Clinical and laboratory parameters were evaluated at baseline and on days 4 and 7 between the study groups. The change in serum procalcitonin (PCT) levels on day 7 was the primary outcome, while the change in serum LL-37 levels on day 7, changes in sequential organ failure assessment (SOFA) score, and clinical pulmonary infection score on day 7, MV duration, and hospital length of stay (LOS) were the secondary outcomes. <b>Results:</b> The (day 7-day 0) change in serum PCT and LL-37 levels and SOFA score were significantly different in Group I (<i>P</i> = .010, <i>P</i> < .001, and <i>P</i> < .001, respectively). The SOFA score was significantly different on days 4 and 7 in Group I (<i>P</i> < .001 and <i>P</i> < .001, respectively). The incidence of early ventilator-associated pneumonia was significantly different between both treatment groups (<i>P</i> = .025). The hospital LOS was shorter in Group I (<i>P</i> < .001). No 25-hydroxyvitamin-D toxicity was observed in either group. <b>Conclusions:</b> Early enteral administration of high-dose vitamin D<sub>3</sub> in critically ill patients with sepsis requiring MV along with standard treatment for sepsis decreased serum procalcitonin levels, increased serum LL-37 levels, and ameliorated illness severity scores.
Study Information
pubmed
2024
2024-05-05T00:00:00.000Z
10.1177/08850666241250319
7
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