Antonelli, M

Autunno, A

Cutuli, SL

De Pascale, G

Di Gravio, V

Gasperin, E

Giacobelli, D

Marsili, S

Pennisi, MA

Quraishi, SA

Schiattarella, A

Vallecoccia, MS

Zuppi, C

Intensive Care Medicine Experimental

G De Pascale

MS Vallecoccia

E Gasperin

D Giacobelli

A Schiattarella

A Autunno

V Di Gravio

S Marsili

SL Cutuli

MA Pennisi

C Zuppi

SA Quraishi

M Antonelli

Springer - Publisher Connector

CLINICAL OUTCOME OF SEPTIC PATIENTS WITH UNDETECTABLE VITAMIN D LEVELS AT ICU ADMISSION

Harvard University - DASH 

Clinical outcome of septic patients with undetectable vitamin D levels at ICU admission

POSTER PRESENTATION Open Access
Clinical outcome of septic patients with
undetectable vitamin D levels at ICU admission
G De Pascale1*, MS Vallecoccia1, E Gasperin1, D Giacobelli1, A Schiattarella2, A Autunno1, V Di Gravio1, S Marsili1,
SL Cutuli1, MA Pennisi1, C Zuppi2, SA Quraishi3, M Antonelli1
From ESICM LIVES 2015
Berlin, Germany. 3-7 October 2015
Introduction
Septic patients with very low vitamin D (VD) levels are
expected to most benefit from supplementation strategies
but few data are available in this specific population [1].
Objectives
Our purpose is to investigate the clinical/epidemiologi-
cal profile and sepsis-related outcome of critically ill
septic patients with undetectable VD levels at ICU
admission.
Methods
We conducted an observational study enrolling, during a
12 months period, consecutive patients admitted to our
ICU with severe sepsis/septic shock.
Results
170 blood samples were obtained from 107 patients
(septic shock / severe sepsis: 62% / 38%). ICU admission
VD deficiency (≤ 20ng/mL) was observed in 93.5% of
the patients: 57 (53.3%) showed undetectable levels
(< 7ng/mL). In patients (n = 33) who received, during
the ICU stay, more than one VD blood sampling, hypo-
vitaminosis D category did not change over time (p=ns).
The principal infection site was the lung (48.6%):
50 (46.7%) patients were bacteraemic. Comparing
patients with undetectable VD levels with those ones
with values ≥ 7ng/mL, there were not significant differ-
ences regarding main comorbidities, presenting features
and disease severity (p=ns). The former group showed a
higher rate of microbiologically confirmed infections but
a lower percentage of microbiological eradication (80.7%
vs. 58%, p = 0.02; 35.3% vs 68%; p = 0.03, respectively).
Furthermore they experienced longer duration of
mechanical ventilation and vasopressor support: 9 ds
[3.75-12.5] vs. 4 ds [2-0], p = 0.04; 7 ds [4-10] vs. 4 ds
[2-7.25], p= 0.02. Sepsis-related mortality rate was
higher in patients with VD levels < 7ng/mL (50.9% vs
26%). Multivariable regression analysis confirmed ICU
admission undetectable VD concentration (p = 0.01) as
independent predictor of sepsis-related mortality.
Conclusions
Our results suggest that in critically ill septic patients
undetectable VD levels at ICU admission may be a
major determinant of clinical outcome. Further studies
should assess the impact of replacement strategies in
this subgroup of patients.
Authors’ details
1Sacro Cuore Catholic University, A. Gemelli Hospital, Department of
Anesthesiology and Intensive Care, Rome, Italy. 2Sacro Cuore Catholic
University, A. Gemelli Hospital, Institute of Biochemestry and Clinical
Biochemestry, Rome, Italy. 3Harvard Medical School, Massachusetts General
Hospital, Department of Anesthesia, Critical Care and Pain Medicine, Boston,
United States.
Published: 1 October 2015
Reference
1. Amrein K, et al: Effect of high-dose vitamin D3 on hospital length of stay
in critically ill patients with vitamin D deficiency: the VITdAL-ICU
randomized clinical trial. Jama 2014, 312(15):1520-30.
doi:10.1186/2197-425X-3-S1-A80
Cite this article as: De Pascale et al.: Clinical outcome of septic patients
with undetectable vitamin D levels at ICU admission. Intensive Care
Medicine Experimental 2015 3(Suppl 1):A80.
1Sacro Cuore Catholic University, A. Gemelli Hospital, Department of
Anesthesiology and Intensive Care, Rome, Italy
Full list of author information is available at the end of the article
De Pascale et al. Intensive Care Medicine Experimental 2015, 3(Suppl 1):A80
http://www.icm-experimental.com/content/3/S1/A80
© 2015 De Pascale et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License
(http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided
the original work is properly cited.


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Clinical outcome of septic patients with undetectable vitamin D levels at ICU admission

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