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- W2033402015 abstract "There is growing recognition that vitamin D deficiency is very common in critically ill adults and children, with or without sepsis (1–10). Low serum concentrations of the biomarker of vitamin D status, 25-hydroxyvitamin D (25[OH]D), when documented at intensive care unit (ICU) admission, remain unchanged or significantly decrease during the subsequent 7- to 10-day period without adequate vitamin D supplementation (2–5). Several studies have variously demonstrated a significant association between vitamin D deficiency (blood 25[OH]D levels < 15–20 ng/ml] in the ICU and adverse clinical outcomes (e.g., length of hospital stay, readmission rates, and mortality) (4–10). For example, in a retrospective observational study in 1,325 patients, Braun and colleagues found that serum 25(OH)D levels ≤ 15 ng/ml obtained within 7 days before or after initiation of critical care were associated with higher 30-, 60-, and 365-day mortality, even after multivariate adjustment (6). Large retrospective cohort studies indicate that low serum levels of 25(OH)D obtained at time points within 1 year prior to ICU admission are associated with higher rates of sepsis, bloodstream infection, and mortality (11, 12). The reasons for the high rate of vitamin D deficiency in the ICU is likely multifactorial. Decreased exposure to sunlight and/or dietary intake of vitamin D prior to ICU admission may occur, and inflammation, decreased synthesis of vitamin D–binding protein (VDBP; which may result in urinary loss of 25[OH]D), interstitial extravasation, and hemodilution due to fluid loads may play a role after admission (1, 13)." @default.
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- W2033402015 date "2014-09-01" @default.
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- W2033402015 title "Vitamin D Supplementation in Sepsis and Critical Illness: Where Are We Now?" @default.
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- W2033402015 doi "https://doi.org/10.1164/rccm.201408-1443ed" @default.
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