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.

Mohamed Gaber Ibrahim Mostafa Allam, Atef A Alfeky, Ayman Salah Emara Abouelnour, Eman Gabr S Hemaidah, Zeinab Adawy, Hany Said Ismail Ramadan, Mohammed Ezzelarab, Mohamed A Elbadawy, Sameh Abdalla Moursi, Anas Fawzy Khalil, Hazem Abdallah Ali, Ahmed Maher Abouelnasr Khalifa, Asmaa Othman Ibrahim Aly, Ahmed Mohamed Abdelhakim Mekkawy, Belal Hamza Talaat, Mohamed Alshahat Elsayed Ali, Emad Abd Elhaliem Abd Elsalam Mahmoud, Abdulmabod Omar, Mahmoud Mostafa Elshamy, Muhammad Mosleh Muhammad Muhammad Zabady, Mohamed Mohamed Hegab, Rania M Saleh, Ahmed Gamal Salah Elsawy

Journal: La Clinica terapeutica 2026;177(1):65-73

PMID: 41525115

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Abstract

BACKGROUND

Recent studies have shown that vitamin D deficiency is highly prevalent among critically ill patients, with reported rates ranging from 40% to 80% in ICU cohorts. Its deficiency associated with increased risk for respiratory infections, prolonged ventilation and increased length of stay, and mortality.

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.

Address: Department of Anesthesia, Faculty of Medicine, Ain Shams University, Cairo, Egypt.; Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.; Department of Anesthesia, Intensive Care, and pain management, Faculty of Medicine For girls, Al-Azhar University, Cairo, Egypt.; Department of chest diseases, Faculty of Medicine for girls, Al-Azhar University, Cairo, Egypt.; Department of clinical pathology, Faculty of Medicine, Menoufia university, ShebinElkom, Egypt.; Department of Cardio Thoracic Surgery, Faculty of Medicine, Assiut University, Egypt.; Department of Emergency Medicine, Alghad College for Applied Medical Sciences, Riyadh, Saudi Arabia.; Department of clinical pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.; Department of clinical pathology, Faculty of Medicine, Suez Canal University, Egypt.

DOI: 10.7417/CT.2026.1976

MeSH Terms: Humans, Male, Double-Blind Method, Female, Dietary Supplements, Prospective Studies, Respiration, Artificial, Sepsis, Vitamin D, Middle Aged, Pneumonia, Ventilator-Associated, Lung Injury, Contusions, Adult, Length of Stay, Vitamins, Aged, Intensive Care Units