The Prevalence Of Vitamin D Deficiency In Intensive Care Unit And Its Influence On Prognosis

Objective:To investigate the effect of vitamin D and its effect on different organs and systems.To investigate the correlation between different levels of 25 hydroxyvitamin D（25（OH）D,Main active components of vitamin D）and the severity of primary disease and the prognosis of critically ill patient in the intensive care unit（ICU）and emergency care unit（EICU）,To study the effect of different supplemental doses on the prognosis of patient.To deepen the understanding of the contact between vitamin D and critical illness,to better guide the treatment and serve the clinical.Methods:The clinical data including gender,nationality,age,nutritional status,body mass index,past medical history,current medication and critical illness score were collected and analyzed.The infection status,body fluid culture（blood,sputum,urine,pleural effusion）results,electrolyte levels such as calcium and phosphorus,and renal function of the subjects were evaluated;the auxiliary mechanical time,ICU hospitalization time,and mortality were evaluated.Serum 25（OH）D samples were collected within the first 24 hours.The level of 25（OH）D was detected by ELISA kit.All patients were treated according to different diseases.According to the 2014 edition of guidelines for the application of vitamin D and adult bone health,The deficiency group was divided into different treatment doses according to the random digit table method,and given 400 IU（95 cases）and 800 IU（84 cases）vitamin D supplement respectively.Methods of administration:the treatment group was given calcium carbonate tablets（each containing about 400 IU VD₃）orally or through oral or jejunal tube,and the placebo group was given starch capsules 0.5 UG·day orally or through oral or jejunal tube,with a course of 7 days.The differences of SOFA score,ICU retention time,main biochemical indexes and mortality among 25（OH）D adequate group,400 IU supplement group and 800 IU supplement group were compared.Result:69.92%of ICU patients had serum 25（OH）D deficiency.In vitamin D deficiency group,APACHEⅡscore was high,positive rate of body fluid culture was high,incidence of MODS was high,and in-hospital mortality was high.Serum 25（OH）D level was negatively correlated with APACHEⅡscore and in-hospital mortality.Multivariate analysis showed that vitamin D deficiency could independently affect the prognosis of patients.Different doses of vitamin D supplementation can improve the prognosis of the patients,and is related to the dose of vitamin D supplementation.Conclusion:This study investigated the influence of different supplementation schemes on the physiology and prognosis of patients in intensive care unit.The incidence rate of vitamin D deficiency in critically ill patients was higher.Vitamin D supplementation can effectively improve the function of patient and improve the prognosis of the patients.It further proves the significance of vitamin D in maintaining the health of the body.Through this study,we can provide an important reference value to improve the prognosis of critically ill patients.