Short-term Effects of Alfacalcidol on Hospital Length of Stay in Patients Undergoing Valve Replacement Surgery: A Randomized Clinical Trial

Naguib, Sandra N.; Sabry, Nirmeen A.; Farid, Samar; Alansary, Adel

doi:10.1016/j.clinthera.2020.11.008

Cited by 6 publications

(22 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among them, 28 studies were further excluded in the full-text assessments (list of excluded studies with reasons in Supplementary Material 4 ). Finally, we included 14 studies ( 17 – 21 , 24 – 32 ) involving 2,324 patients in our meta-analysis (flow diagram in Figure 1 ). The sample size ranged from 25 to 1,078, including 10 small sample studies (number of included patients <100) ( 17 – 19 , 24 – 27 , 29 – 32 ).…”

Section: Resultsmentioning

confidence: 99%

“…Finally, we included 14 studies ( 17 – 21 , 24 – 32 ) involving 2,324 patients in our meta-analysis (flow diagram in Figure 1 ). The sample size ranged from 25 to 1,078, including 10 small sample studies (number of included patients <100) ( 17 – 19 , 24 – 27 , 29 – 32 ). The analyzed population included patients with various disorders, including medical patients ( 21 , 30 , 32 ), neurological or surgical patients ( 18 , 20 , 24 – 26 , 28 , 29 ), and both medical and surgical patients ( 17 , 19 , 27 , 31 ).…”

Section: Resultsmentioning

confidence: 99%

“…The sample size ranged from 25 to 1,078, including 10 small sample studies (number of included patients <100) ( 17 – 19 , 24 – 27 , 29 – 32 ). The analyzed population included patients with various disorders, including medical patients ( 21 , 30 , 32 ), neurological or surgical patients ( 18 , 20 , 24 – 26 , 28 , 29 ), and both medical and surgical patients ( 17 , 19 , 27 , 31 ). In 10 trials, all the participants had vitamin D deficiency (≤20 ng/ml) ( 18 , 20 , 21 , 25 – 30 , 32 ).…”

Section: Resultsmentioning

confidence: 99%

“…In 10 trials, all the participants had vitamin D deficiency (≤20 ng/ml) (18,20,21,(25)(26)(27)(28)(29)(30)32). In the trial conducted by Naguib et al (24), about 60% of the participants had vitamin D deficiency. Han et al (17) included critically ill patients with MV; 43% of them had vitamin D deficiency.…”

Section: Study Characteristicsmentioning

confidence: 99%

See 3 more Smart Citations

The Effect of Vitamin D Supplementation on Clinical Outcomes for Critically Ill Patients: A Systemic Review and Meta-Analysis of Randomized Clinical Trials

et al. 2021

View full text Add to dashboard Cite

Purpose: Vitamin D deficiency is a common scenario in critically ill patients and has been proven to be associated with poor outcomes. However, the effect of vitamin D supplementation for critically ill patients remains controversial. Thus, we conducted a meta-analysis to evaluate the effect of vitamin D supplementation among critically ill patients.Methods: Electronic databases PubMed, Embase, Scopus, and the Cochrane Library were searched for eligible randomized controlled trials between 2000 and January 2021. The primary outcome was overall mortality, and the secondary ones were the length of intensive care unit stay, the length of hospital stay, as well as the duration of mechanical ventilation. Subgroup analyses were performed to explore the treatment effect by type of admission, route of administration, dose of supplemented vitamin D, and the degree of vitamin D deficiency.Results: A total of 14 studies involving 2,324 patients were finally included. No effect on overall mortality was found between vitamin D supplementation and control group [odds ratio (OR), 0.73; 95% CI, 0.52–1.03; I2 = 28%]. The vitamin D supplementation reduced the length of intensive care unit stay [mean difference (MD), −2.25; 95% CI, −4.07 to −0.44, I2 = 71%] and duration of mechanical ventilation (MD, −3.47; 95% CI, −6.37 to −0.57, I2 = 88%). In the subgroup analyses, the vitamin D supplementation for surgical patients (OR, 0.67; 95% CI, 0.47–0.94; I2 = 0%) or through parenteral way (OR, 0.42; 95% CI, 0.22–0.82, I2 = 0%) was associated with reduced mortality.Conclusion: In critically ill patients, the supplementation of vitamin D has no effect on overall mortality compared to placebo but may decrease the length of intensive care unit stay and mechanical ventilation. Further trials are necessary to confirm our findings.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

See 2 more Smart Citations

The Effect of Vitamin D Supplementation on Clinical Outcomes for Critically Ill Patients: A Systemic Review and Meta-Analysis of Randomized Clinical Trials

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Overall mortality was screened with different measures in all studies. Six studies (17,18,(24)(25)(26)32) reported in-hospital mortality, four studies (19,27,28,30) reported 28-/30-day mortality, and four studies (20,21,29,31) reported multiple results; we chose 28-/30-day mortality in the analysis. The pooled result indicated that vitamin D supplementation did not reduce overall mortality rate for critically ill patients (OR, 0.73; 95% CI, 0.52-1.03; I 2 = 28%, Figure 2).…”

Section: Primary Outcomementioning

confidence: 99%

Data_Sheet_2.PDF

View full text Add to dashboard Cite

An update on essential micronutrients in critical illness

Berger

2023

Current Opinion in Critical Care

View full text Add to dashboard Cite

Purpose of review Numerous micronutrients are involved in antioxidant and immune defence, while their blood concentrations are frequently low in critically ill patients: this has fuelled many supplementation trials. Numerous observational, randomized studies have been published, which are presented herein. Recent findings Micronutrient concentrations must be analysed considering the context of the inflammatory response in critical illness. Low levels do not always indicate a deficiency without objective micronutrients losses with biological fluids. Nevertheless, higher needs and deficiencies are frequent for some micronutrients, such as thiamine, vitamins C and D, selenium, zinc and iron, and have been acknowledged with identifying patients at risk, such as those requiring continuous renal replacement therapy (CRRT). The most important trials and progress in understanding have occurred with vitamin D (25(OH)D), iron and carnitine. Vitamin D blood levels less than 12 ng/ml are associated with poor clinical outcomes: supplementation in deficient ICU patients generates favourable metabolic changes and decreases mortality. Single high-dose 25(OH)D should not be delivered anymore, as boluses induce a negative feedback mechanism causing inhibition of this vitamin. Iron-deficient anaemia is frequent and can be treated safely with high-dose intravenous iron under the guidance of hepcidin to confirm deficiency diagnosis. Summary The needs in critical illness are higher than those of healthy individuals and must be covered to support immunity. Monitoring selected micronutrients is justified in patients requiring more prolonged ICU therapy. Actual results point towards combinations of essential micronutrients at doses below upper tolerable levels. Finally, the time of high-dose micronutrient monotherapy is probably over.

show abstract

Short-term Effects of Alfacalcidol on Hospital Length of Stay in Patients Undergoing Valve Replacement Surgery: A Randomized Clinical Trial

Cited by 6 publications

References 61 publications

The Effect of Vitamin D Supplementation on Clinical Outcomes for Critically Ill Patients: A Systemic Review and Meta-Analysis of Randomized Clinical Trials

The Effect of Vitamin D Supplementation on Clinical Outcomes for Critically Ill Patients: A Systemic Review and Meta-Analysis of Randomized Clinical Trials

Data_Sheet_2.PDF

An update on essential micronutrients in critical illness

Contact Info

Product

Resources

About