Early High-Dose Vitamin D3 for Critically Ill, Vitamin D-Deficient Patients
Early High-Dose Vitamin D3 for Critically Ill, Vitamin D-Deficient Patients
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DOI：
10.1056/nejmoa1911124
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发表时间：
2019-12-26
影响因子：
158.5
通讯作者：
Talmor, Daniel
中科院分区：
文献类型：
--
作者：
Ginde, Adit A.;Brower, Roy G.;Talmor, Daniel
背景维生素 D 缺乏是危重患者发病率和死亡率的常见且可能可逆的因素。补充维生素 D 对急性危重疾病的潜在益处需要进一步研究。方法 我们对死亡风险高、缺乏维生素 D 的危重患者进行了一项早期补充维生素 D-3 的随机、双盲、安慰剂对照 3 期试验。在决定将患者送入重症监护室后 12 小时内进行随机分组。符合条件的患者接受单次肠内剂量的 540,000 IU 维生素 D-3 或匹配的安慰剂。主要终点是 90 天全因、全地点死亡率。结果 共有 1360 名患者在床边筛查中被发现缺乏维生素 D，并接受了随机分组。在这些患者中，1078 名基线维生素 D 缺乏（25-羟基维生素 D 水平，
Background Vitamin D deficiency is a common, potentially reversible contributor to morbidity and mortality among critically ill patients. The potential benefits of vitamin D supplementation in acute critical illness require further study. Methods We conducted a randomized, double-blind, placebo-controlled, phase 3 trial of early vitamin D-3 supplementation in critically ill, vitamin D-deficient patients who were at high risk for death. Randomization occurred within 12 hours after the decision to admit the patient to an intensive care unit. Eligible patients received a single enteral dose of 540,000 IU of vitamin D-3 or matched placebo. The primary end point was 90-day all-cause, all-location mortality. Results A total of 1360 patients were found to be vitamin D-deficient during point-of-care screening and underwent randomization. Of these patients, 1078 had baseline vitamin D deficiency (25-hydroxyvitamin D level,