Effect of vitamin D as Nutrition Supplement on Patients with Prolonged Ventilation due to Ventilator Associated Pneumonia and Sepsis Followed Severe Traumatic Lung Contusion: A Randomized Controlled Trial.
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Allam Mohamed Gaber Ibrahim Mostafa, Alfeky Atef A, Abouelnour Ayman Salah Emara, Hemaidah Eman Gabr S, Adawy Zeinab, Ramadan Hany Said Ismail, Ezzelarab Mohammed, Elbadawy Mohamed A, Moursi Sameh Abdalla, Khalil Anas Fawzy, Ali Hazem Abdallah, Khalifa Ahmed Maher Abouelnasr, Aly Asmaa Othman Ibrahim, Mekkawy Ahmed Mohamed Abdelhakim, Talaat Belal Hamza, Ali Mohamed Alshahat Elsayed, Mahmoud Emad Abd Elhaliem Abd Elsalam, Omar Abdulmabod, Elshamy Mahmoud Mostafa, Zabady Muhammad Mosleh Muhammad Muhammad, Hegab Mohamed Mohamed, Saleh Rania M, Elsawy Ahmed Gamal Salah
Аннотация
OBJECTIVE: The primary objective was to evaluate the effect of high-dose vitamin D supplementation on recovery from severe traumatic lung contusion, VAP, and sepsis. The secondary objectives were to assess its impact on duration of mechanical ventilation, length of ICU stay, and mortality.
METHODS: This prospective, double-blinded randomized controlled trial included 80 adult ICU patients with severe traumatic lung contusion who remained mechanically ventilated for 10 consecutive days and subsequently developed VAP and sepsis (Murray score >4, CPIS >6, SOFA score > 10, excluding GCS). Patients were randomized to receive either standard enteral nutrition (Group A, n=40) or standard nutrition plus high-dose vitamin D (cholecalciferol 100,000 IU/day for 14 days) (Group B, n=40). Clinical outcomes were assessed over a 14-day follow-up period.
RESULTS: Compared with Group A, patients in Group B demonstrated significantly faster recovery from lung contusion, VAP, and sepsis, reflected by lower Murray, CPIS, and SOFA scores at both week 1 and week 2 (p<0.05). Group B also showed significantly shorter durations of mechanical ventilation and ICU stay (p<0.001) and a lower mortality rate (10.0% vs. 27.5%, p=0.045).
CONCLUSION: This study clarifies the effect of vitamin D in controlling all clinical manifestation of severe traumatic lung contusion, controlling all clinical manifestation of VAP, controlling all clinical manifestation of sepsis, accelerate weaning from ventilation, shorten the duration of ICU stay and decreasing the mortality rate of those patients who had sever traumatic lung contusion and ventilated for ten days, then complicated by VAP and sepsis as complications from prolonged ventilation.