{
  "abstract": "Background and Importance Deficiency of vitamin D is common among severe injury victims and hypovitaminosis is associated to unfavourable outcome however, the need and method of regular vitamin D supplementation is not clear.Aim and Objectives Aim of our study was to assess the effect of standard clinical nutrition interventions on vitamin D levels during long-term clinical nutrition and to test a clinical pharmacologist initiated enteral supplementation formula to correct low vitamin D levels.Material and Methods Single-centre, prospective, observational study. Only adult, major trauma patients admitted to intensive care unit and requiring long-term (>2 weeks) clinical nutrition were involved. Demographic, clinical data, nutritional status (NRS-2002), method and length of clinical nutrition and outcome parameters were registered. Vitamin D level was measured by central lab (ABBOTT Immunoassay) at day 1, 7, 14, 28. Vitamin D supplementation was performed enterally by 100.000 international unit cholecalciferol (4x25.000 IU vitamin D3, Fresenius Kabi). Statistical analysis: Mann–Whitney test, Chi-squared test (p<0.05).Results We enrolled 57 patients (84% men, median age 51, median BMI 26). Majority of them suffered major multiple trauma (median ISS: 25). Malnutrition (NRS > 3) at admission was detected in 31% of patients. Median LOS in ICU was 13 days and a 25% mortality was observed. Enteral nutrition was applied in 94%, parenteral in 38% and oral supplementation in 38% of patients. Energy and protein goals were achieved in 82% and 75% of the treatment days. Standard, factory-based formulas were used. Vitamin D deficiency was detected in 39% of patients. Vitamin D level increased only in 45% of patients, but deficiency was corrected only in 35% of cases by standard care. In a subset of patients admitted with low vitamin D level (n=23; vitamin D = 21 nmol/l), a single dose of 100.000 unit cholecalciferol corrected the hypovitaminosis state in 22/23 patients within 5 days.Conclusion and Relevance Vitamin D deficiency is common in intensive care unit. Standard clinical nutrition is sufficient to maintain normal vitamin levels, but unable to correct deficiency. Vitamin D therapy might be required in patients admitted with low vitamin D levels and a single dose of enteral 100.000 IU cholecalciferol seems to be efficient enough to normalise vitamin D levels in critically ill trauma patients.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Manninger Jenő Trauma Centre, Anaesthesiology and Intensive Care, Budapest, Hungary"
      ],
      "name": "G Nardai"
    },
    {
      "affiliations": [
        "National Korányi Institute of Pulmonology, Hospital Pharmacy Service, Budapest, Hungary"
      ],
      "name": "C Ferdinandy"
    },
    {
      "affiliations": [
        "Manninger Jenő Trauma Centre, Hospital Pharmacy Service, Budapest, Hungary"
      ],
      "name": "A Szilvay"
    }
  ],
  "title": "4CPS-189 Pharmacological vitamin D substitution is required beyond standard nutrition formulas to correct hypovitaminosis in critically ill trauma patients",
  "uid": "4675e2a4-ac40-557b-8c3b-6c58bcc31bdc"
}